Corlanor, containing the active ingredient ivabradine hydrochloride, is a medication primarily prescribed for managing heart failure. It is a hyperpolarization-activated cyclic nucleotide-gated channel blocker that reduces heart rate by inhibiting the cardiac sinus node. This article provides a detailed overview of Corlanor, its uses, potential side effects, and essential precautions.
What is Corlanor (Ivabradine)?
Ivabradine, sold under the brand name Corlanor, is used to treat chronic heart failure in adults with symptoms, reducing the risk of hospitalization for worsening heart failure. It is also prescribed for children six months and older with stable heart failure due to dilated cardiomyopathy. Corlanor works by decreasing the heart rate, reducing the heart's workload. It is available in tablet form in strengths of 5 mg and 7.5 mg for oral administration, and as an oral solution.
How Corlanor Works
Corlanor functions by slowing the heart rate, allowing the heart to pump more efficiently. In heart failure patients, this helps prevent the condition from worsening. Ivabradine selectively inhibits the If current in the sinoatrial node, which controls heart rate.
Uses of Corlanor
Primary Uses
- Heart Failure: Corlanor is primarily used to treat heart failure, helping to prevent the condition from worsening and reducing the need for hospital treatment.
- Dilated Cardiomyopathy: It is also used in children with heart failure due to an enlarged heart (dilated cardiomyopathy).
Off-Label Uses
While not explicitly approved for other uses, healthcare professionals may prescribe Corlanor for conditions outside of its approved professional labeling if deemed appropriate.
Dosage and Administration
How to Take Corlanor
- Oral Administration: Take Corlanor by mouth with a glass of water.
- Frequency: Usually taken twice daily with food, following the prescription label instructions.
- Avoid Grapefruit Juice: Avoid grapefruit juice as it may increase the chance of side effects.
- Medication Guide: Read the Medication Guide provided by the pharmacist with each prescription and refill.
- Children: Talk to your healthcare team about the use of this medication in children, as precautions apply even for children as young as six months.
What to Do If You Miss a Dose
If you miss a dose, skip it and take the next dose at the normal time. Do not take extra or two doses simultaneously to make up for the missed dose.
Read also: Complement Your Keto Lifestyle
Overdosage
If you think you have taken too much Corlanor, contact a poison control center or emergency room immediately.
Important Considerations Before Taking Corlanor
Medical History
Inform your healthcare team about any pre-existing conditions, especially:
- Certain heart conditions, such as sick sinus syndrome, sinoatrial block, or third-degree atrioventricular block
- Heart failure that has recently worsened
- Liver disease
- Low blood pressure
- Low resting heart rate
- Pacemaker
- Allergic reactions to ivabradine or any other medications, foods, dyes, or preservatives
- Pregnancy or plans to become pregnant
- Breastfeeding
Pregnancy and Breastfeeding
- Pregnancy: Corlanor may harm an unborn baby. Women who can become pregnant must use effective birth control while taking this medicine. If you think you have become pregnant, tell your doctor right away.
- Breastfeeding: Breastfeeding is not recommended while using Corlanor.
Potential Side Effects of Corlanor
Common Side Effects
- Luminous Phenomena (Phosphenes): Seeing temporary bright or flashing spots, halos around lights, shifting patterns, or colors. These are usually triggered by sudden variations in light intensity and generally occur within the first two months of treatment.
- Increased Blood Pressure
Side Effects Requiring Medical Attention
Report the following side effects to your healthcare team as soon as possible:
- Allergic Reactions: Skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart Rhythm Changes: Fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Low Blood Pressure: Dizziness, feeling faint or lightheaded, blurry vision
- Slow Heartbeat: Dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
Serious Side Effects
- Atrial Fibrillation: Ivabradine may increase the risk of atrial fibrillation, an irregular heart rhythm. Symptoms include fast or pounding heartbeat, tiredness, dizziness, chest pain, and worsened shortness of breath.
- Bradycardia: Ivabradine can cause a slower than normal heart rate (bradycardia). Symptoms include feeling lightheaded, dizziness, confusion, weakness, and shortness of breath.
Side Effects That Usually Do Not Require Medical Attention
- Luminous phenomena-seeing temporary bright or flashing spots, halos around lights, shifting patterns or colors. Report to your care team if they continue or are bothersome.
Drug Interactions
Contraindications
Do not take Corlanor with the following medications:
- Adagrasib
- Ceritinib
- Certain antibiotics, such as chloramphenicol, clarithromycin, telithromycin
- Certain antivirals for HIV or hepatitis
- Certain medications for fungal infections, such as ketoconazole, itraconazole, posaconazole, voriconazole
- Idelalisib
- Lonafarnib
- Nefazodone
- Ribociclib
- Tucatinib
Interactions to Monitor
Corlanor may also interact with the following:
Read also: Is Craniosacral Therapy right for you? Learn about the risks
- Certain medications for blood pressure, heart disease, or irregular heartbeat
- Certain medications for seizures, such as phenobarbital or phenytoin
- Rifampin
- St. John's wort
CYP3A4 Inhibitors and Inducers
- CYP3A4 Inhibitors: Concomitant use of CYP3A4 inhibitors (e.g., azole antifungals, macrolide antibiotics, HIV protease inhibitors) increases ivabradine plasma concentrations, potentially exacerbating slow heart rate and conduction disturbances.
- CYP3A4 Inducers: Avoid concomitant use of CYP3A4 inducers (e.g., St. John’s wort, rifampicin, barbiturates, phenytoin) as they decrease ivabradine plasma concentrations.
Negative Chronotropes
The risk of slow heart rate increases with concomitant administration of drugs that slow heart rate (e.g., digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking Corlanor with other negative chronotropes.
Other Interactions
- Grapefruit Juice: Avoid grapefruit juice as it may increase the risk of serious side effects.
Warnings and Precautions
General Precautions
- Regular Check-ups: Visit your healthcare team for regular checks on your progress.
- Vision Changes: Be cautious when driving or using machinery, especially when sudden changes in light intensity may occur, particularly at night.
- Other Medications: Do not take other medicines unless discussed with your doctor, including prescription, over-the-counter medications, herbal supplements, and vitamins.
Specific Warnings
- Heart Rhythm Problems: This medicine may increase your risk for heart rhythm problems, including atrial fibrillation and bradycardia. Seek immediate medical attention if you experience fast, slow, or irregular heartbeat, dizziness, fainting, or trouble breathing.
- Visual Brightness: Corlanor may cause temporary visual brightness, usually caused by sudden changes in light (luminous phenomena or phosphenes).
Contraindications
Corlanor is contraindicated in individuals with:
- Allergy to ivabradine or any of its components
- Severe heart failure
- Low blood pressure
- Certain heart conditions (sick sinus syndrome, sinoatrial block, third-degree AV block)
- Liver problems
- Dependence on a pacemaker
Storage and Disposal
Storage
- Store Corlanor tablets at room temperature between 68°F to 77°F (20°C to 25°C).
- Keep the medication away from light and moisture, and out of reach of children and pets.
- For the oral liquid form, protect from light and do not remove it from the foil pouch until ready to use.
Disposal
- Take unused or expired medication to a medication take-back program.
- If a take-back program is unavailable, check the label or package insert for instructions on disposal in the garbage or toilet. If unsure, ask your healthcare team.
- If disposing of in the trash, mix the medication with an unwanted substance like cat litter or coffee grounds, seal it in a bag or container, and place it in the trash.
Clinical Trials Experience
Adult Patients
In the Systolic Heart failure treatment with the If inhibitor ivabradine Trial (SHIFT), the most common adverse drug reactions were bradycardia, hypertension, atrial fibrillation, and phosphenes.
Pediatric Patients
In pediatric patients, bradycardia occurred at rates similar to those in adults.
Read also: Is RM3 Weight Loss Right For You?