Take two doses a day - take the first dose in the morning with your breakfast, and the second dose with your evening meal.
The most common side-effect is seeing flashes of colour (or haloes) caused by sudden changes in light intensity. Please take extra care when using tools or machines and when driving.
|Type of medicine||A selective sinus node If inhibitor|
|Used for||To prevent angina pain; heart failure|
Angina is a pain that comes from the heart. It is usually caused by the narrowing of one or more of the arteries that supply blood to your heart. This narrowing reduces the blood supply to parts of your heart muscle. When your heart needs more blood and oxygen than it can get through the narrowed arteries (for example, when you walk fast or climb stairs), you feel angina pain.
Heart failure is a condition where your heart does not pump as effectively as it once did. This causes problems getting blood and oxygen to the rest of your body.
Ivabradine works by slowing down your heart rate a little. Because your heart is working less quickly, the amount of oxygen your heart needs is reduced. If you have been prescribed ivabradine to prevent angina, this will help to reduce the number of angina attacks you have. It also means that your heart needs to do less work to pump blood around your body if you have heart failure.
Before taking ivabradine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking ivabradine it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you know you have a slow or irregular heart rhythm.
- If you know you have low blood pressure.
- If you have a pacemaker fitted.
- If you have recently had a stroke or a heart attack.
- If you have a problem with the retina of your eye.
- If you have any problems with the way your liver works, or any problems with the way your kidneys work.
- If you have ever had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take ivabradine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about ivabradine and will also provide you with a full list of side-effects which you could experience from taking it.
- Take ivabradine exactly as your doctor tells you to. It is usual to take a dose twice daily, one in the morning and the other in the evening. When starting your treatment, your doctor may give you a small dose (such as half of a 5 mg tablet) and then increase it after a short while. This will help avoid any unwanted side-effects, particularly dizziness. There are two strengths of tablet available - 5 mg and 7.5 mg. Your doctor will tell you which is right for you to continue treatment with.
- Try to take your doses at the same times of day each day, as this will help you to remember to take ivabradine regularly. Take the tablet during a meal with a drink of water. Do not chew or crush the tablets.
- If you forget to take a dose at your usual time, take it when you remember. However, if it is nearly time to take your next dose when you remember, then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Ivabradine tablets are not suitable to take to relieve pain if you are having an angina attack. Your doctor will also prescribe a nitrate medicine, such as glyceryl trinitrate (GTN), for you to take if this happens. If after using GTN your pain has not eased within a few minutes, call for an ambulance.
- Try to keep your regular appointments with your doctor. This is so your doctor can monitor your progress and check your heart rate.
- It is best to avoid or limit the amount of grapefruit juice you drink while you are on ivabradine. This is because a chemical in grapefruit juice increases the amount of ivabradine in your bloodstream. This makes side-effects more likely.
- If you buy any medicines 'over the counter', please check with a pharmacist that they are suitable for you to take with your prescribed medicines.
- If you are due to have an operation or any dental treatment, please tell the person carrying out the treatment which medicines you are taking.
Can ivabradine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with ivabradine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common ivabradine side-effects (these effect more than 1 in 10 people)||What can I do if I experience this?|
|Difficulties with changes in light, blurred vision||Do not drive (especially at night) and do not use tools or machines until you know how you react|
|Common ivabradine side-effects (these effect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy (possibly due to a slow heart rate)||If this happens, do not drive and do not use tools or machines while affected. Let your doctor know so that your heart rate can be checked|
|Headache||This is common when you first start ivabradine but it should soon settle down. In the meantime, ask your doctor or pharmacist to recommend a suitable painkiller|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store ivabradine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Procoralan® 5 mg and 7.5 mg tablets; Servier Laboratories Limited, The electronic Medicines Compendium. Dated January 2018.
British National Formulary, 76th Edition (Sep 2018); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.