Coralan (5mg) 56 Tablets

Ivabradine's primary mechanism of action is to selectively inhibit the If current (also known as the funny current, I(f)) in the sinoatrial (SA) node of the heart, which is responsible for generating the cardiac rhythm. By blocking this specific ion channel, Ivabradine reduces the heart rate without affecting the contractility or force of the heart's contractions. It achieves this by inhibiting the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, which are primarily responsible for the 'funny' or pacemaker current in the SA node. This action results in a decrease in the slope of the pacemaker potential, leading to a reduction in the heart rate, particularly in the presence of elevated heart rates. Ivabradine's effect is more pronounced in conditions with increased sympathetic activity, where it helps to normalize the heart rate without causing bradycardia or negatively impacting cardiac function.

Ivabradine 5mg

Calcium channel blocker.

Tablet

The following are the uses of Ivabradine 5mg Tablet:

• Used for treating stable angina, reducing the number of angina attacks.
• Used to control and regulate heart rate in patients with chronic heart failure.
• Used to manage symptoms like chest pain and shortness of breath.
• Used to lower the risk of hospitalization for heart issues.
• Used to improve exercise capacity in patients with heart conditions.
• Used for long-term heart rate management, providing sustained control.
• Used as an alternative for patients unable to tolerate beta-blockers.
• Used in combination with other medications for comprehensive heart care.

Tailoring Treatment for Optimal Health, Prescribed Medication Dosage is:

• Ivabradine is used for the treatment of chronic stable angina and heart failure.
• Dosage adjustments may be required based on individual circumstances and medical conditions.
• Consult a qualified healthcare professional before taking this medication.
• For chronic stable angina- Adult- Start with 5 mg taken twice a day approximately 1 hour before meals. The dosage can then be increased to a total of 10 mg twice a day based on the response to the medication.
• For heart failure- Adult- Start with 5 mg taken twice a day approximately 1 hour before meals and increase slowly over several weeks to a maximum of 7.5 mg twice a day if tolerated.

In the case of an overdose of Ivabradine 5mg Tablets, immediate medical intervention is necessary. Symptoms may include severe bradycardia, hypotension, and potentially cardiac issues. Promptly contact emergency services or seek medical help, providing them with details of the medication, the quantity ingested, and the time of overdose. Quick action can help manage the adverse effects and ensure the best possible outcome for the patient's health and well-being.

In the case of a missed dose of Ivabradine 5mg Tablet, it is important to take the medication as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of side effects. If you miss multiple doses, consult your healthcare professional for guidance on how to safely resume your medication without affecting the overall treatment plan.

To take Ivabradine 5mg Tablet, swallow the tablet whole with a glass of water, preferably at the same time each day, following the dosage instructions provided by your healthcare professional, typically starting with one tablet twice daily, which can be adjusted based on your body's response.

Following are the conditions when Ivabradine 5mg Tablet should not be used:

• Must not be taken by patients with a known allergy to Ivabradine or any of its ingredients.
• Not suitable for individuals with severe liver disease.
• Contraindicated in patients with unstable heart failure, including those who have recently experienced decompensated heart failure.
• Should not be used in individuals with a resting heart rate below 60 beats per minute (bradycardia).
• Not recommended for patients with sick sinus syndrome, unless a functioning pacemaker is present.
• Should be avoided in patients with severe hypotension (very low blood pressure).
• Must not be used in patients with cardiogenic shock, which is a critical condition resulting from the heart's inability to pump enough blood.
• Contraindicated in patients with severe aortic valve stenosis, a condition where the aortic valve is narrowed.
• Not suitable for individuals with heart block (second• or third-degree AV block) without a pacemaker.
• Should be used with caution and is generally not recommended in patients with ongoing unstable angina (chest pain due to reduced blood flow to the heart).

The side effects of Ivabradine 5mg Tablet may include:

• Bradycardia (slow heart rate)
• High blood pressure during exercise
• Visual disturbances (e.g., blurred vision, phosphenes • seeing flashes of light)
• Headache
• Dizziness
• Fatigue
• Nausea
• Skin rashes

Following are the precautions and warnings for Ivabradine 5mg Tablet:

• Not suitable for patients with a history of severe liver disease, as it can worsen their condition.
• Patients with heart problems such as sick sinus syndrome, heart block, or cardiogenic shock should not take this medication.
• May cause visual disturbances, so caution is advised when driving or operating machinery.
• Elderly patients may require close monitoring due to increased sensitivity to the medication's effects.
• Not recommended for children and adolescents under 18 years of age due to insufficient data.
• Patients with a history of severe allergic reactions should be closely monitored, as rare cases of allergic reactions have been reported.
• Ivabradine may interact with other medications, especially those affecting heart rate, so inform your doctor about all medications you are taking.

Following are the drug interactions for Ivabradine 5mg Tablet:

• Concomitant use with verapamil or diltiazem can significantly increase ivabradine plasma concentrations, leading to bradycardia and hypotension.
• Strong CYP3A4 inhibitors like ketoconazole or clarithromycin may increase ivabradine levels, requiring dosage adjustments.
• Ivabradine may have additive effects with beta-blockers, resulting in excessive bradycardia and increased risk of atrioventricular block.
• Grapefruit juice, a CYP3A4 inhibitor, can increase ivabradine exposure and should be avoided.
• The combination with digoxin can increase digoxin levels, requiring monitoring and possible dosage adjustments.
• Ivabradine may reduce the efficacy of class III antiarrhythmic drugs (e.g., amiodarone), necessitating close ECG monitoring.
• Caution is advised when combining Ivabradine with other medications that prolong the QT interval, as this may increase the risk of arrhythmias.

Following are the food interactions to be aware of when taking Ivabradine 5mg Tablet:

• Avoid consuming grapefruit or grapefruit juice as it can increase the levels of Ivabradine in the blood, potentially leading to an increased risk of side effects.
• Alcohol should be limited or avoided as it can cause additional lowering of heart rate and may enhance the sedative effects of the medication.
• Caffeine-rich foods and beverages like coffee, tea, and energy drinks might counteract the heart rate-lowering effect of Ivabradine, reducing its effectiveness.
• High-fat meals can slightly increase the absorption of Ivabradine, but this is generally not clinically significant.
• Avoid taking herbal supplements like St. John's Wort, as it can affect the metabolism of Ivabradine.
• Certain citrus fruits like Seville oranges and pomelos might have a similar effect to grapefruit, so it's best to avoid them.
• Always follow the advice of your healthcare provider regarding dietary restrictions or recommendations while taking this medication.
• Generally, Ivabradine can be taken with or without food, but maintaining a consistent routine is advisable.

Ivabradine 5mg Tablets should be stored in a secure and dry location, preferably in their original packaging or a tightly sealed container, to protect them from moisture and light. It is recommended to keep the medication at room temperature, away from excessive heat or cold, and avoid storing it in the bathroom or kitchen where humidity and temperature fluctuations can occur. Always check the expiration date regularly and do not use the tablets if they are past their expiry. When it comes to disposal, do not flush the medication down the toilet or throw it into the trash. Instead, follow local guidelines or consult your pharmacist for safe disposal methods to prevent environmental contamination. Keep the tablets out of the reach of children and pets to ensure safety and avoid accidental ingestion.

Following are the quick tips for Ivabradine 5mg Tablet:

• Take the tablet as directed by your doctor, typically once or twice daily.
• Consume the tablet whole with a full glass of water, preferably at the same time each day.
• Avoid cutting, crushing, or chewing the tablet.
• Take it regularly, even if you feel well, to maintain a steady heart rate.
• Do not stop taking the medication without consulting your doctor to prevent potential complications.
• Store the tablets in a cool, dry place, away from direct sunlight and moisture.
• Inform your doctor about all the medications you are taking to avoid potential drug interactions.

When discussing laboratory tests and medications with your doctor, it is important to disclose all medications you are currently taking, including over-the-counter drugs and supplements. This is especially important if you are taking Ivabradine 5mg for a heart condition. While taking Ivabradine 5mg, specific laboratory tests may be necessary to monitor your health and ensure the safe continuation of the medication. These tests, which may be tailored to your individual needs and underlying medical conditions, may include: