PharmaceuticalAnti-anginalHeart-rate-lowering agentIf current inhibitor

Ivabradine

Also known as Procoralan · Corlanor · S 16257

Written by enwyReviewed 5 Aug 20262 sources0 comments

A selective heart-rate-lowering drug that blocks the sinoatrial node's If ('funny') current, slowing heart rate without affecting contractility or blood pressure. Approved for chronic stable angina and heart failure with reduced ejection fraction. Not WADA-banned.

01 Overview

Ivabradine selectively and specifically inhibits the hyperpolarisation-activated cyclic-nucleotide-gated (HCN) channels responsible for the If pacemaker current in the sinoatrial node. This slows spontaneous diastolic depolarisation and thereby heart rate, reducing myocardial oxygen demand while leaving myocardial contractility, conduction and blood pressure essentially unchanged.

It is used for stable angina in patients intolerant of or inadequately controlled by beta-blockers, and for symptomatic chronic HFrEF with heart rate above 70 bpm in sinus rhythm (SHIFT trial). A characteristic dose-related visual side effect, phosphenes, arises from HCN channels in the retina.

02 Mechanism

Selectively blocks the If (funny) pacemaker current via HCN channels in the sinoatrial node, slowing heart rate and reducing myocardial oxygen demand without affecting contractility or blood pressure.

03 Dosing

Tier	Dose	Route	Notes
Starting dose	5 mg	Oral	5 mg twice daily with meals; 2.5 mg in the elderly.

04 Effects

Effect	Magnitude	Evidence
Heart-rate reductionPure rate-lowering effect reduces angina and myocardial oxygen demand.	~10 bpm	Clinical
Reduced HF hospitalisationIn HFrEF with heart rate above 70 bpm, reduced the composite of CV death or HF hospitalisation (SHIFT).		Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Phosphenes (visual brightness)Transient enhanced brightness in the visual field, usually early in treatment.	Mild	Common	Clinical
BradycardiaExcessive slowing of heart rate, especially with other rate-limiting drugs.	Moderate	Common	Clinical
Atrial fibrillationIncreased incidence of AF reported in trials.	Moderate	Uncommon	Clinical

06 Legal status

United Kingdom

Prescription medicine

Licensed for angina and chronic heart failure. · as of Jan 2026

United States

Prescription medicine

FDA-approved for HFrEF (Corlanor). · as of Jan 2026

07 References

Ivabradine and outcomes in chronic heart failure (SHIFT)The Lancet, 2010

Antianginal and anti-ischaemic effects of ivabradine (BEAUTIFUL)The Lancet, 2008

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.