Ivabradin Teva B.V. (Ivabradine)

• Ivabradin Teva B.V. acts on the cardiac If current to manage conditions where heart‑rate reduction is therapeutic.
• Chronic stable angina: reduces the frequency of angina attacks by lowering myocardial oxygen demand.
• Heart failure with reduced ejection fraction: decreases resting heart rate, improving ventricular filling and functional capacity.

• Ivabradine selectively inhibits the funny (If) current in sinoatrial node cells, which slows the depolarization rate of pacemaker cells. This results in a reduction of spontaneous heart rate without affecting myocardial contractility, ventricular repolarisation, or blood pressure, providing a heart‑rate‑lowering effect that is independent of beta‑adrenergic pathways.

Ivabradin Teva B.V. may cause a range of adverse reactions.

Common Side Effects

• Bradycardia: resting heart rate falls below the intended range.
• Visual disturbances (phosphenes): transient luminous phenomena.
• Headache: mild to moderate intensity.
• Dizziness or vertigo: especially on standing.
• Fatigue: general feeling of tiredness.
• Nausea: occasional gastrointestinal upset.

Serious or Rare Side Effects

• Symptomatic bradycardia requiring medical intervention.
• Atrial fibrillation or other arrhythmias.
• Severe hypotension leading to syncope.
• Persistent visual impairment or retinal disorders.
• Heart block or advanced atrioventricular conduction disturbances.
• Allergic reactions such as rash, angioedema, or anaphylaxis.

• Before prescribing Ivabradin Teva B.V., clinicians should consider several safety measures.
• Assess heart rate before initiation: ensure resting heart rate is ≥ 50 bpm.
• Avoid use in severe hepatic impairment: drug exposure may increase markedly.
• Monitor for symptomatic bradycardia: discontinue if severe bradycardia occurs.
• Caution with concomitant beta‑blockers or digoxin: risk of excessive heart‑rate reduction.
• Contraindicated in patients with sick‑sinus syndrome unless a pacemaker is present.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Ivabradin Teva B.V. can interact with several medicines that affect its metabolism or cardiac effects.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may raise ivabradine plasma concentrations.
• Co‑administration with other bradycardic agents (beta‑blockers, digoxin): can cause excessive heart‑rate reduction.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil): may modestly increase ivabradine levels.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce ivabradine efficacy.
• Antacids containing aluminium or magnesium: may impair absorption if taken simultaneously.