Ivabradine

It selectively reduces the heart rate and it is used in the symptomatic relief of chronic stable angina with normal sinus rate in patients with beta-blocker intolerance ^{(Koruth 2017)}. Oral administration in two daily doses.

At the date of the last update we did not find any published data on its excretion in breast milk.

A mother told us in 2022 that she had taken ivabradine for 8 months while breastfeeding (dose and age of the infant not specified) without apparent side effects on her baby (comment left on "Help us improve this record" of e-lactancia.org).

Its very high volume of distribution makes excretion in breast milk difficult, but its low protein binding could facilitate it.

Its low oral bioavailability minimizes the passage into plasma of the infant from ingested breast milk, except in the premature and in the immediate neonatal period in which there may be greater intestinal permeability.

The half-life or elimination half-time (T½) of ivabradine is 2 hours, but that of its active metabolite S18982 is 11 hours. ^{(Choi 2013)}

The most common side effects are bradycardia, heart block, phosphenes, blurred vision and headache. ^{(Bocchi 2019, Swedberg 2010)}

If administered during lactation, it is advisable to prescribe a sufficient minimum dose and monitor heart rate, feeding and weight gain in the infant. ^{(Kearny 2018, Briggs 2015)}

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

See below the information of this related product:

• Maternal Cardiopathy (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)