LETTER TO EDITOR
Year : 2009  |  Volume : 1  |  Issue : 3  |  Page : 284 Table of Contents     

Ivabradine: Novel if channel inhibitor


1 Faculty of Medicine, AIMST University, Malaysia
2 Unit of Pharmacology, Faculty of Medicine, Malaysia

Date of Web Publication13-Oct-2009

Correspondence Address:
H Ameya
Faculty of Medicine, AIMST University
Malaysia
Login to access the Email id


DOI: 10.4103/0975-1483.57073

Get Permissions


How to cite this article:
Ameya H, Kumar A. Ivabradine: Novel if channel inhibitor. J Young Pharmacists 2009;1:284

How to cite this URL:
Ameya H, Kumar A. Ivabradine: Novel if channel inhibitor. J Young Pharmacists [serial online] 2009 [cited 2014 Apr 20];1:284. Available from: http://www.jyoungpharm.in/text.asp?2009/1/3/284/57073

Pacemaker activity of the heart involves interplay between several ionic currents that influence spontaneous diastolic depolarization of the sinoatrial node, including I f current. The search for pure heart rate-lowering agents to prevent angina without over all adverse effects of β-blockers[1] began more than three decades ago. The discovery of I f current and I f channels offered a possible approach to the developing pure heart rate-lowering agents. [1]

Ivabradine is a selective I f channel blocker drug which can be used in the treatment of angina. Ivabradine causes bradycardia without any negative inotropic effects. It causes an immediate increase in coronary blood flow due to an increase in the diastolic time interval during which blood flows to the myocardium. Ivabradine reduces myocardial oxygen demand, improves exercise capacity and preserves ventricular contractility. Further Ivabradine does not change any major electrophysiological parameters unrelated to heart rate. 'Pure' heart-rate lowering via I f inhibition effectively prevents angina with acceptable tolerability. [1]

Ivabradine effectively prevents angina and concomitantly reduces ischemia. Ivabradine 5 mg and 7.5 mg twice daily (bid) are the licensed dosages for the treatment of stable angina. [1],[2]

About 14.5% of all patients taking the drug experience 'luminous phenomena' (sensations of enhanced brightness in a fully maintained visual field). This is probably due to blockage of Ih ion channels in the retina which are very similar to cardiac If. These symptoms are mild, transient and fully reversible. Bradycardia occurs in two per cent of the patients. Headaches, AV block, ventricular extrasystoles and dizziness are also associated with the use of Ivabradine.[1]

Ivabradine is contraindicated in severe bradycardia, moderate to severe heart failure, severe hypotension, second and third degree heart blocks. Its use is not recommended in cardiac arrhythmias that interfere with sinus node function. [1]

Ivabradine is indicated for chronic stable angina in sinus rhythm patients who have a contraindication or intolerance to beta blockers and a high resting heart rate. [2],[3]

 
   References Top

1.Sulfi S, Timmis AD. Ivabradine-the first selective sinus node If channel inhibitor in the treatment of stable angina. Int J Clin Pract 2006;60:222-8.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Tardif JC, Ford I, Tendera M, Bourassa MG, Fox K. Efficacy of ivabradine: A new selective I (f) inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J 2005;26:2529-36.  Back to cited text no. 2      
3.Anonymous. New medicines: Procoralan. Pharmaceutical Journal 2006;276:131.  Back to cited text no. 3      




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed706    
    Printed79    
    Emailed1    
    PDF Downloaded76    
    Comments [Add]    

Recommend this journal