Ivanor 7.5 mg Tablet 10's pack

Overview

Ivanor (Ivabradine) 7.5 mg Tablet is a selective heart rate-lowering agent manufactured by Square Pharmaceuticals PLC. It specifically inhibits the cardiac pacemaker If current in the sinus node, reducing heart rate without affecting myocardial contractility or ventricular repolarization. The 7.5 mg dose represents the maintenance/maximum dose used in the treatment of chronic stable angina pectoris in adults with coronary artery disease and normal sinus rhythm who are intolerant of or inadequately controlled on beta-blocker therapy.

Dosage and Administration

The usual maintenance dose is 7.5 mg twice daily (morning and evening with meals), typically up-titrated from 5 mg twice daily after 3–4 weeks if the therapeutic response is adequate and resting heart rate remains above 60 bpm. If resting heart rate falls persistently below 50 bpm or bradycardia symptoms develop, reduce the dose. Discontinue if heart rate remains below 50 bpm. Elderly patients (≥75 years): start with 2.5 mg twice daily with cautious up-titration. No dose adjustment is required for mild-to-moderate renal impairment (CrCl >15 ml/min). Caution is advised in moderate hepatic impairment; contraindicated in severe hepatic insufficiency. Not recommended for children and adolescents.

Interaction

Avoid concurrent use with QT-prolonging drugs — cardiovascular (quinidine, disopyramide, bepridil, sotalol, ibutilide, amiodarone) and non-cardiovascular (pimozide, ziprasidone, sertindole, mefloquine, halofantrine, pentamidine, cisapride, IV erythromycin) — as heart rate reduction may exacerbate QT prolongation. Concomitant use with strong CYP3A4 inhibitors (azole antifungals, macrolide antibiotics, HIV protease inhibitors) is contraindicated.

Contraindications

Contraindicated in hypersensitivity to ivabradine, resting heart rate below 60 bpm before treatment, cardiogenic shock, acute myocardial infarction, severe hypotension (<90/50 mmHg), severe hepatic insufficiency, sick sinus syndrome, sino-atrial block, 3rd degree AV block, pacemaker dependency, unstable angina, heart failure, and concurrent use of strong CYP3A4 inhibitors.

Side Effects

Common side effects include visual symptoms (luminous phenomena/phosphenes), blurred vision, bradycardia, 1st degree AV block, ventricular extrasystoles, headache, and dizziness. Inform your doctor if you experience persistent slow heart rate or unusual visual disturbances.

Pregnancy and Lactation

Ivabradine is contraindicated during pregnancy due to insufficient safety data in humans. It is excreted into breast milk in animal studies; therefore, Ivanor is contraindicated during breastfeeding.

Precautions and Warnings

Use with caution in patients with mild-to-moderate hypotension, atrial fibrillation, congenital QT syndrome, or those receiving QT-prolonging medications. Caution is warranted in moderate hepatic impairment and severe renal insufficiency. Monitor heart rate closely, particularly during up-titration. Always take with meals for optimal effect.

Storage Conditions

Keep below 30°C, away from light and moisture. Keep out of the reach of children.

Frequently Asked Questions

Q: What is the difference between Ivanor 5 mg and 7.5 mg?
A: Ivanor 5 mg is the starting dose, while 7.5 mg is the standard maintenance dose used after 3–4 weeks if the response is adequate and resting heart rate remains above 60 bpm. The 7.5 mg dose provides more effective heart rate reduction for angina control.

Q: How quickly does Ivanor 7.5 mg work?
A: Ivabradine reaches peak plasma concentrations within approximately 1 hour. Heart rate reduction begins promptly, but the full therapeutic benefit for chronic stable angina is assessed over several weeks of treatment.