Ivabradine (Corlanor) is a selective cardiac pacing channel blocker that decreases heart rate without affecting other cardiovascular functions. It has been shown to improve symptoms in patients with postural orthostatic tachycardia syndrome (POTS).

Please carefully follow your dosing instructions in your RTHM dashboard. Take this medication with food to avoid stomach upset.

Ivabradine lowers your heart rate. When increasing your dose of ivabradine, you should check your blood pressure and heart rate the day before the planned increase dose. Your heart rate should be above 65 bpm and your blood pressure should be above 90/60 for you to proceed with any dose increase. You should again check your vitals 2 hours after you take the increased dose and again the next day after your dose change. Your heart rate should be above 58 bpm and your blood pressure should be above 90/60.

If you’re on a stable dose of ivabradine, check your blood pressure and heart rate at least once a month. Your heart rate should be above 58 bpm and your blood pressure should be above 90/60.

Ivabradine should be taken with food. However, do not eat grapefruit or drink grapefruit juice while taking ivabradine. This can dangerously alter the amount of ivabradine absorbed in the body.

Tapering Off Ivabradine

If your heart rate is below 58 bpm, your blood pressure is below 90/60 or you are having significant side effects, you’ll need to lower your dose of ivabradine or stop taking ivabradine according to the instructions in your patient portal.

If you need to stop taking ivabradine, follow the below instructions. You must also notify your primary care provider and RTHM immediately. Make sure to include your vital signs and symptoms when you contact RTHM.

To prevent a sudden rise in heart rate, it is best to decrease your dose of ivabradine slowly over time rather than stopping immediately. Reduce your daily dose by 2.5 mg twice a day every 7 days until your dose is zero. Then stop taking ivabradine. Here are the specific taper instructions depending on your dose:

Please read this treatment guide in its entirety for additional important information.

If you miss a dose, take it as soon as possible. If you are close to the time of your next dose, wait to take the next dose and then resume your normal dosing schedule. Do not “double-up” the dose.

You should:

For some medications, it’s common to experience mild side effects as your body adjusts during the first few months of use. Mild side effects can occur when taking ivabradine. These side effects can include:

Take medication only as directed. In the event of an accidental overdose, contact emergency services immediately.

Serious side effects with ivabradine are not common, but they can occur. If you experience any of these symptoms, call your healthcare provider right away or seek emergency medical care.

Ivabradine can potentially negatively interact with many different medications to cause a lethal cardiac arrhythmia (heart beating erratically and ineffectively pumping blood), or lethal bradycardia (excessively low heart rate). While these occurrences are rare, the following medications should not be taken with ivabradine, even at low doses.

Certain medical conditions can be contraindicated with ivabradine. You should not take ivabradine if:

If you have questions about this medication, please contact us by using our support form. We generally respond within 2 business days. If you have a more urgent issue, please seek care from your local primary care provider, urgent care or emergency services.