Ivabradine is used on its own or together with other medicines to treat angina pectoris (chest pain) and heart failure (weakness and inability of the heart to pump blood).
This medicine may be used to treat other conditions as decided by your doctor.
Take Ivabradine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it together with food or immediately after a meal. Try to take it at the same time each day.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition and your response to the medication.
Ivabradine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- heart failure which has become worse
- unstable angina (chest pain that occurs randomly or unexpectedly)
- heart attack
- cardiogenic shock (a serious sudden condition when the heart cannot supply enough oxygen-rich blood to the brain and vital organs of the body)
- congenital QT prolongation (an inherited disease causing abnormally fast and erratic heartbeats)
- sick sinus syndrome (abnormal heart rhythms due to problems with your heart's natural pacemaker)
- sinoatrial block (skipped heartbeats or pauses caused by blocked or slowed signals to the upper heart chambers)
- 3rd-degree heart block
- very low blood pressure (less than 90/50 mmHg)
- heart rate maintained exclusively by a pacemaker (device implanted in the chest that helps control your heartbeat)
- severe liver disease
as Ivabradine may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Ivabradine, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Ivabradine.
Do not take this medicine if you are breastfeeding.
Do not take Ivabradine with medicines used to treat fungal infection, HIV infection, chest pain, and certain antibiotics. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- retinitis pigmentosa (rare inherited eye disease causing a slow loss of vision)
- mild to moderate case of low blood pressure
- other heart conditions e.g. 1st- or 2nd-degree heart block, irregular heartbeat
- severe kidney disease
- moderate liver disease
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. heart rate, ECG [test used to record the electrical activity of the heart]) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise or fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
Ivabradine may cause temporary brightness in your field of vision. If affected, do not drive or take part in any activity in which you need to see clearly.
Other side effects include any of the following: headache, dizziness, nausea, vomiting, diarrhoea, constipation, muscle cramps, and dizziness with sensations of spinning.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- slow or irregular heartbeat
- chest pain or pressure, passing out
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Ivabradine with the following medicines:
- certain medicines to treat fungal infection e.g. ketoconazole, itraconazole
- certain antibiotics e.g. clarithromycin, telithromycin
- medicines for HIV infection e.g. nelfinavir, ritonavir
- nefazodone (medicine to treat depression)
- certain medicines for high blood pressure and chest pain e.g. diltiazem, verapamil
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. phenytoin
- medicines for irregular heartbeat e.g. amiodarone, quinidine, sotalol
- water pills or medicines for water retention e.g. hydrochlorothiazide, furosemide
- rifampicin (medicine to treat TB [lung infection known as tuberculosis])
- fluconazole (medicine to treat fungal infection)
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Ivabradine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Protect the oral solution from light.
Medicines must not be used past the expiry date.
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