title: Ivabradine: A Review of Labeled and Off-Label Uses.
abstract: Ivabradine is a unique medication recently approved in the USA for the treatment of select heart failure patients. It was first approved for use in several countries around the world over a decade ago as an anti-anginal agent, with subsequent approval for use in heart failure patients. Since ivabradine has selective activity blocking the I f currents in the sinus node, it can reduce heart rate without appreciable effects on blood pressure. Given this heart-rate-specific effect, it has been investigated in many off-label indications as an alternative to traditional heart-rate-reducing medications such as beta blockers and calcium channel blockers. We conducted searches of PubMed and Google Scholar for ivabradine, heart failure, HFrEF, HFpEF, angina, coronary artery disease, inappropriate sinus tachycardia, postural orthostatic hypotension, coronary computed tomography angiography and atrial fibrillation. We reviewed and included studies, case reports, and case series published between 1980 and June 2016 if they provided information relevant to the practicing clinician. In many cases, larger clinical trials are needed to solidify the benefit of ivabradine, although studies indicate benefit in most therapeutic areas explored to date. The purpose of this paper is to review the current labeled and off-label uses of ivabradine, with a focus on clinical trial data.
authors.affiliation: Methodist University Hospital, 1265 Union Avenue, Memphis, 38104, TN, USA. carrie.oliphant@mlh.org.|College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA. carrie.oliphant@mlh.org.
authors.forename: Carrie S
authors.identifier: http://orcid.org/0000-0002-2256-8962
authors.initials: CS
authors.lastname: Oliphant
authors.affiliation: Methodist University Hospital, 1265 Union Avenue, Memphis, 38104, TN, USA.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Owens
authors.affiliation: College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Oluwaseyi B
authors.initials: OB
authors.lastname: Bolorunduro
authors.affiliation: College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Jha
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D000077550:Ivabradine; D056687:Off-Label Use
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002317:Cardiovascular Agents; D000077550:Ivabradine