| name | Ivabradine |
| Classification | Class III antiarrhythmic agent; specific If current inhibitor. |
| Pharmacokinetics | | absorption | Rapidly absorbed after oral administration, with peak plasma concentrations typically reached within 1-2 hours. | | distribution | Distributed throughout the body, with moderate to high concentrations in the heart and liver. | | metabolism | Primarily metabolized by the liver via CYP3A4. | | excretion | Excreted primarily in the urine, both unchanged and as metabolites. |
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| suggested dosage | | formulation | Oral tablets | | general info | Individualized; starting dose typically 2.5mg twice daily, titrated upwards to a maximum dose of 7.5mg twice daily. Consult a physician for specific recommendations. | | considerations for patient | Patient weight of 70 kg and age of 25 years should not be a major consideration for the initial dosage of ivabradine. The specific dosage for ivabradine, including initial and maintenance, is primarily determined by the underlying condition and needs to be carefully monitored by a medical professional. No adjustment to the dosage would be expected for this patient based on age or weight alone. |
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| indications | | 1 | Symptomatic chronic stable angina pectoris in patients who are not suitable for other antianginal therapy. | | 2 | For slowing down the resting heart rate in patients with stable sinus rhythm. | | 3 | Some evidence suggests use in certain heart failure patients when other treatments are not suitable |
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| safety in pregnancy | Limited data available. Avoid use during pregnancy unless clearly necessary and potential benefits outweigh the potential risks. Consult a physician. |
| safety in breastfeeding | Limited data; possible excretion into breast milk. Discontinue breastfeeding or discontinue the drug if breastfeeding is essential, carefully weighing the benefits and risks. |
| side effects | | 1 | Bradycardia (slow heart rate) | | 2 | Atrioventricular block (conduction problem between the atria and ventricles) | | 3 | Headache | | 4 | Flushing | | 5 | Dizziness | | 6 | Nasal congestion | | 7 | Fatigue | | 8 | Constipation | | 9 | Abdominal pain | | 10 | Sinus bradycardia | | 11 | Visual disturbances (e.g., blurred vision, altered colour perception) | | 12 | Peripheral edema | | 13 | Mild increases in liver enzymes (generally transient and reversible). |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to ivabradine | | 2 | Severe bradycardia | | 3 | Sick sinus syndrome (without a pacemaker) | | 4 | Second or third-degree atrioventricular block (without a pacemaker) | | 5 | Severe hypotension (low blood pressure) | | 6 | Significant hepatic impairment | | 7 | Recent myocardial infarction | | 8 | Severe uncontrolled heart failure |
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| interactions | | 1 | Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) may increase ivabradine concentrations, potentially increasing side effects. | | 2 | Strong CYP3A4 inducers (e.g., rifampicin) may decrease ivabradine concentrations, potentially reducing its effectiveness. | | 3 | Ivabradine can potentially interact with other medications that affect heart rate or blood pressure. | | 4 | Check for potential drug interactions with other medications the patient is taking. |
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| warnings and precautions | | 1 | Monitor heart rate closely, especially during initiation and titration of therapy. | | 2 | Caution in patients with pre-existing cardiac conduction abnormalities. | | 3 | Patients should be informed of the potential for visual disturbances. | | 4 | Regular monitoring of liver function tests is recommended. | | 5 | Monitor for signs of heart failure or worsening angina |
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| additional information | Consult a cardiologist or other qualified medical professional for proper diagnosis and treatment planning, as this information is for educational purposes only and does not constitute medical advice. Ivabradine use in combination with other medications should be carefully evaluated by a physician. |
| patient specific notes | This information should not be considered a substitute for professional medical advice. It's crucial that the specific dosage, monitoring, and overall treatment plan for ivabradine are discussed and tailored by a healthcare provider based on the patient's complete medical history, current condition, and other medications. |
