Ivabradin

Bravadin tablets are indicated for:

• Symptomatic treatment of chronic stable angina pectoris.
• Treating chronic heart failure.

Structure

Active substance: ivabradine;

1 coated tablet contains 5 mg of ivabradine, which is equivalent to 5.39 mg of ivabradine hydrochloride;

Excipients: lactose, magnesium stearate, corn starch, maltodextrin, colloidal silicon dioxide, hypromellose;

Film sheath: hypromellose, titanium dioxide (E 171), talc, propylene glycol, iron oxide yellow (E172), iron oxide red (E 172).

Contraindications

• Hypersensitivity to the active substance or any excipients.
• Heart rate at rest <70 beats / min before treatment.
• Cardiogenic shock.
• Acute myocardial infarction.
• Severe arterial hypotension (blood pressure <90/50 mm Hg. Art.).
• Severe liver failure.
• Sick sinus syndrome.
• Sinoatrial block.
• Unstable or acute heart failure.
• The patient has an artificial pacemaker (heart rate is controlled exclusively by an artificial pacemaker).
• Unstable angina pectoris.
• AV block of the III degree.

Mode of application

The drug Bravadin is prescribed for adults.

Tablets are taken orally twice a day: in the morning and in the evening with food.

The tablet of the drug Bravadin 5 mg can be divided into equal parts.

Application features

Pregnant women

Contraindicated.

Children

Contraindicated.

Drivers

Carefully.

Overdose

An overdose of ivabradine can lead to severe and prolonged bradycardia (see section "Adverse reactions"). Severe forms of bradycardia require symptomatic therapy in specialized institutions. In case of bradycardia with impaired hemodynamic parameters, the use of intravenous beta-stimulating agents such as isoprenaline is recommended. In extremely severe cases, you can consider the temporary use of a pacemaker.

Side effects

• Neurological disorders. Often: headache, usually during the first month of treatment; dizziness, probably associated with bradycardia.
• From the side of the organs of vision. Very often visual phenomena (phosphene). Often blurry vision.
• Cardiac disorders. Often, bradycardia of an AV block of I degree (on an ECG - lengthening of the PQ interval) ventricular extrasystole atrial fibrillation.
• From the vessels. Often uncontrolled blood pressure.
• From the respiratory system, chest and mediastinal organs. Infrequent shortness of breath.
• From the gastrointestinal tract. Infrequent nausea, constipation, diarrhea, pain in the abdominal region.
• On the part of the skin and subcutaneous tissue. Infrequently: angioedema; rashes.
• From the musculoskeletal system and connective tissue. Infrequently muscle cramps.

Interaction

The simultaneous use of ivabradine and cardiovascular and non-cardiovascular drugs that extend the QT interval should be avoided, since a decrease in heart rate can enhance the prolongation of the QT interval. If necessary, such a combination should ensure close monitoring of cardiac activity.

The simultaneous use of ivabradine and such strong CYP3A4 inhibitors as antifungal drugs related to azoles (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin for oral administration, josamycin, telithromyzin), non-rifonivirin-protease inhibitors (non-rifonavirafid) see section "Contraindications"). Strong CYP3A4 inhibitors such as ketoconazole (200 mg / day) and josamycin (1 g 2 times a day) increase the average concentration of ivabradine in blood plasma by 7-8 times.

Storage conditions

Keep out of the reach of children.

Shelf life is 2 years.