Ivabradină Teva (Ivabradine)

Ivabradină Teva acts on the cardiac If current to lower heart rate in conditions where rate control improves outcomes.

• Chronic stable angina pectoris: reduces the frequency of angina attacks and improves exercise tolerance.
• Heart failure with reduced ejection fraction: lowers heart rate, alleviating symptoms and supporting cardiac function.
• Chronic stable angina despite optimal therapy: provides additional symptom relief when beta‑blockers are insufficient.

• Ivabradine selectively blocks the funny (If) current in the sinoatrial node, which slows the spontaneous depolarisation of pacemaker cells. This results in a reduction of resting heart rate without decreasing myocardial contractility or blood pressure, helping to improve myocardial oxygen balance in angina and to lessen cardiac workload in heart failure.

Adverse reactions reported with Ivabradină Teva are generally related to its heart‑rate lowering action and visual perception.

Common Side Effects

• Phosphenes (transient luminous phenomena)
• Bradycardia
• Headache
• Dizziness
• Fatigue
• Visual blur

Serious or Rare Side Effects

• Severe symptomatic bradycardia requiring medical intervention
• Atrial fibrillation or other arrhythmias
• Symptomatic hypotension
• Persistent visual impairment
• Allergic reactions including rash or angioedema

Before initiating therapy, clinicians should evaluate cardiovascular status and potential risk factors.

• Cardiac assessment: confirm stable hemodynamics and absence of severe conduction disorders.
• Conduction disease: avoid in patients with sick sinus syndrome or high-degree AV block unless a pacemaker is present.
• Hepatic impairment: use with caution in moderate to severe liver disease.
• Pregnancy and lactation: safety not established; weigh benefits against potential risks.
• Pediatric use: not recommended as efficacy and safety have not been established in children.
• Drug interactions: review concomitant medications that affect CYP3A4 or heart rate.
• Store at ambient temperature: keep below 25°C in the original packaging, protect from moisture and light.

Ivabradină Teva may interact with drugs that influence heart rate or its metabolic pathway.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase ivabradine plasma levels.
• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce therapeutic effect.
• Concomitant use with other potent bradycardic agents (e.g., high‑dose beta‑blockers) can cause excessive heart‑rate reduction.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil): may require dose adjustment.
• Other rate‑controlling drugs (e.g., digoxin, amiodarone): monitor heart rate and rhythm.
• QT‑prolonging agents: observe for additive electrophysiological effects.