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ivabradine (Corlanor, Lancora)
Indications:
- treatment of chronic heart failure
- FDA-approved for reducing risk of hospitalization from worsening chronic heart failure [3]
- indicated for stable patients with systolic heart failure & a heart rate of > 70/minute despite maximally tolerated beta-blockers [3,4]
- treatment of postural orthostatic tachycardia syndrome
- no benefit for stable coronary artery disease without heart failure [2]
* no advantages over commonly used beta-blockers [5]
Contraindications:
- not useful in patients with atrial fibrillation [7]
Adverse effects:
- myocardial infarction [5]
- severe bradycardia [5]
Mechanism of action:
- inhibits atrial sinus node & slows heart rate
General
autonomic agent
References
- Swedberg K et al.
Ivabradine and outcomes in chronic heart failure (SHIFT):
A randomised placebo-controlled study.
Lancet 2010 Aug 29
PMID: 20801500
http://dx.doi.org/10.1016/S0140-6736(10)61198-1
- Bohm M et al.
Heart rate as a risk factor in chronic heart failure (SHIFT):
The association between heart rate and outcomes in a
randomised placebo-controlled trial.
Lancet 2010 Aug 29
PMID: 20801495
http://dx.doi.org/10.1016/S0140-6736(10)61259-7
- Fox K et al for the SIGNIFY Investigators.
Ivabradine in stable coronary artery disease without clinical
heart failure.
N Engl J Med 2014 Aug 31;
PMID: 25176136
http://www.nejm.org/doi/full/10.1056/NEJMoa1406430
- Ohman EM and Alexander KP.
The challenges with chronic angina.
N Engl J Med 2014 Aug 31
PMID: 25176137
http://www.nejm.org/doi/full/10.1056/NEJMe1409369
- Medscape Oncology
FDA Approves Ivabradine (Corlanor) for Chronic HF.
http://www.medscape.com/viewarticle/843242
- Yancy CW et al
Heart Failure Focused Update on Pharmacological Therapy.
2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy
for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for
the Management of Heart Failure.
Circulation 2016 134:
PMID: 27208050
http://circ.ahajournals.org/content/early/2016/05/18/CIR.0000000000000435.full.pdf+html
- J Am Coll Cardiol. 2016 May 17.
PMID: 27216111 Free Article
- Antman EM et al
Editorial: ACC/AHA/HFSA and ESC Updated Heart Failure Guideline
Collaboration. Updated Clinical Practice Guidelines on Heart
Failure: An International Alignment.
Circulation 2016 134:
PMID: 27216110 Free Article
http://circ.ahajournals.org/content/early/2016/05/18/CIR.0000000000000436.full.pdf+html
- Therapeutics Letter #108. Therapeutics Initiative
Drugs to Avoid.
http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
- Taub PR, Zadourian A, Lo HC et al.
Randomized trial of ivabradine in patients with hyperadrenergic
postural orthostatic tachycardia syndrome.
J Am Coll Cardiol 2021 Feb 23; 77:861.
PMID: 33602468
https://www.sciencedirect.com/science/article/abs/pii/S0735109720381316
- Medical Knowledge Self Assessment Program (MKSAP) 19
American College of Physicians, Philadelphia 2022