Last update March 6, 2022

Ivabradine

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

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.)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ivabradine is also known as


Ivabradine in other languages or writings:

Group

Ivabradine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Ivabradine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 %
Molecular weight 469 daltons
Protein Binding 70 %
VD 1.43 l/Kg
pKa 9.37 -
Tmax 1 hours
2 (metab.S18982 : 11) hours

References

  1. Bocchi EA, Salemi VMC. Ivabradine for treatment of heart failure. Expert Opin Drug Saf. 2019 May;18(5):393-402. Abstract
  2. Kearney L, Wright P, Fhadil S, Thomas M. Postpartum Cardiomyopathy and Considerations for Breastfeeding. Card Fail Rev. 2018 Abstract Full text (link to original source) Full text (in our servers)
  3. Koruth JS, Lala A, Pinney S, Reddy VY, Dukkipati SR. The Clinical Use of Ivabradine. J Am Coll Cardiol. 2017 Oct 3;70(14):1777-1784. Abstract Full text (link to original source)
  4. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  5. Choi HY, Noh YH, Cho SH, Ghim JL, Choe S, Kim UJ, Ah Jung J, Bae KS, Lim HS. Evaluation of pharmacokinetic and pharmacodynamic profiles and tolerability after single (2.5, 5, or 10 mg) and repeated (2.5, 5, or 10 mg bid for 4.5 days) oral administration of ivabradine in healthy male Korean volunteers. Clin Ther. 2013 Jun;35(6):819-35. Abstract
  6. Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L; SHIFT Investigators.. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. 2010 Sep 11;376(9744):875-85. Abstract

Total visits

7,894

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by El Parto Es Nuestro of Spain

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM