The Brand Name CORALAN Has Generic Salt :: IVABRADINE 

CORALAN  Is From Company Serdia Priced :: Rs. 560

CORALAN have IVABRADINE is comes under Sub class Anti Anginals of  Main Class Cardiovascular System

Main Medicine Class:: Cardiovascular System  Sub Medicine Class :: Anti Anginals 

Indications for Drugs ::

Chronic stable angina

Drug Dose ::

Adult: PO Chronic stable angina pectoris in coronary artery disease patients with normal sinus rhythm who are unable to tolerate or has a contraindication to beta-blockers; or used with beta-blockers in patients inadequately controlled with an optimal dose of beta-blockers and whose heart rate is >60 beats/min Initial: 5 mg twice daily. Increase if necessary to 7.5 mg twice daily after 3-4 weeks. Titrate downward to 2.5-5 mg twice daily if develop bradycardia (resting heart rate < 50 beats/min) or experience symptoms of bradycardia (dizziness, fatigue, hypotension) or resting heart rate is persistently <50 beats/min). Elderly: >75 yr old: Initiate treatment at 2.5 mg bid. Titrate up if necessary.

Contraindication ::

Pregnancy, lactation, resting heart rate <60 beats/min prior to treatment, cardiogenic shock, acute myocardial infarction, severe hypotension (<90/50 mmHg), severe hepatic insufficiency, sick sinus syndrome, sino-atrial block, heart failure patients with NYHA class III-IV, pacemaker dependent, unstable angina, 3rd degree AV-block, concurrent use with potent CYP3A4 inhibitors. Drug Precautions ::

Reduce dose if resting heart rate is persistently <50 beats/min or patient develops bradycardia symptoms during treatment; discontinue if heart rate <50 beats/min and symptoms persist. Not recommended in patient with AF or other cardiac arrhythmias that interfere with sinus node rhythm; monitor regularly for AF occurrence. Not recommended for concomitant use with heart rate reducing calcium channel blockers (e.g. diltiazem or verapamil), immediate use after a stroke or in patients with 2nd degree AV-block. Severe renal insufficiency, Moderate hepatic insufficiency. Stop treatment if visual field deteriorates unexpectedly. Patients with retinitis pigmentosa. Drug Side Effects ::

Luminous phenomena (phosphena), blurred vision, bradycardia, 1st degree AV-block, ventricular extrasystole, supraventricular extrasystoles, palpitations, headache, dizziness, nausea, constipation, diarrhoea, vertigo, dyspnoea, muscle cramps, hyperuricaemia, eosinophilia, elevated blood-creatinine.

Pregnancy category ::

0

Drug Mode of Action ::  

Ivabradine is a heart rate lowering agent that works through selective and specific inhibition of the cardiac pacemaker If current. If current controls the spontaneous diastolic depolarisation in the sinus node and regulate heart rate.

Drug Interactions ::

Concomitant use with QT-prolonging drugs (e.g. quinidine, disopyramide, bepridil, sotalol, ibutilide, amiodarone, pimozide, ziprasidone, sertinole, mefloquine, halofantrine, pentamide, cisapride, erythromycin IV) is not recommended as QT prolongation may be enhanced by heart rate reduction. Concentrations may increase when used with CYP3A4 inhibitors. Use with verapamil or diltiazem (moderate CYP3A4 inhibitors) is not recommended. If used with other moderate CYP3A4 inhibitors (e.g. fluconazole), may consider starting at lower dose and with heart rate monitoring if resting heart rate >60 beats/min. Concentration may be reduced with CYP3A4 inducers (e.g. rifampicin, barbiturates, phenytoin, St John’s Wort) and may require Ivabradine dose adjustment. Potentially Fatal: Concurrent use with potent CYP3A4 inhibitors is contraindicated; e.g. azole antifungals (ketoconazole, itraconazole), macrolides (clarithromycin, erythromycin PO, josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone.