Corlanor®: twice-daily dosing with meals1

RECOMMENDED STARTING DOSE

5 mg  2x/day

OR
2.5 mg 2x/day

For patients in whom bradycardia could lead to hemodynamic compromise or with a history of conduction defects.

MAXIMUM DOSE

7.5 mg  2x/day

  • Does not require washout period of SOC2
AFTER 2 WEEKS, CHECK RESTING HEART RATE1
> 60 bpm Increase dose by 2.5 mg 2x/day
up to a max of 7.5 mg 2x/day
TARGET RANGE
50-60 bpm
Maintain dose
< 50 bpm
OR SYMPTOMS OF BRADYCARDIA
Decrease dose by 2.5 mg 2x/day Discontinue therapy if current dose is 2.5 mg 2x/day
  • No dosage adjustment is required for patients with moderate to severe renal impairment (CrCl 15 to 60 mL/min)
  • Does not require additional routine lab monitoring

BPM = beats per minute; CrCl = creatinine clearance; SOC = standard of care.

References
  1. Corlanor® (ivabradine) Prescribing Information, Amgen.
  2. Swedberg K, Komajda M, Böhm, et al. Lancet. 2010;376:875-885.
IMPORTANT SAFETY INFORMATION
SEE MORELESS

IMPORTANT SAFETY INFORMATION Contraindications: Corlanor® is contraindicated in patients with acute decompensated heart failure, blood pressure < 90/50 mmHg, sick sinus syndrome, sinoatrial block, 3rd degree atrioventricular block (unless a functioning demand pacemaker is present), a resting heart rate < 60 bpm prior to treatment, severe hepatic impairment, pacemaker dependence (heart rate maintained exclusively by the pacemaker), and concomitant use of strong cytochrome P450 3A4 (CYP3A4) inhibitors.

Fetal Toxicity: Corlanor® may cause fetal toxicity when administered to a pregnant woman based on embryo-fetal toxicity and cardiac teratogenic effects observed in animal studies. Advise females to use effective contraception when taking Corlanor®.

Atrial Fibrillation: Corlanor® increases the risk of atrial fibrillation. The rate of atrial fibrillation in patients treated with Corlanor® compared to placebo was 5% vs. 3.9% per patient-year, respectively. Regularly monitor cardiac rhythm. Discontinue Corlanor® if atrial fibrillation develops.

Bradycardia and Conduction Disturbances: Bradycardia, sinus arrest and heart block have occurred with Corlanor®. The rate of bradycardia in patients treated with Corlanor® compared to placebo was 6% (2.7% symptomatic; 3.4% asymptomatic) vs. 1.3% per patient‐year, respectively. Risk factors for bradycardia include sinus node dysfunction, conduction defects, ventricular dyssynchrony, and use of other negative chronotropes. Bradycardia may increase the risk of QT prolongation which may lead to severe ventricular arrhythmias, including torsades de pointes, especially in patients with risk factors such as use of QTc prolonging drugs.

Concurrent use of verapamil or diltiazem also increases Corlanor® exposure, contributes to heart rate lowering, and should be avoided. Avoid use of Corlanor® in patients with 2nd degree atrioventricular block unless a functioning demand pacemaker is present

Adverse Reactions: The most common adverse drug reactions reported at least 1% more frequently with Corlanor® than placebo and that occurred in more than 1% of patients treated with Corlanor® were bradycardia (10% vs. 2.2%), hypertension or increased blood pressure (8.9% vs. 7.8%), atrial fibrillation (8.3% vs. 6.6%), and luminous phenomena (phosphenes) or visual brightness (2.8% vs. 0.5%).

In postmarketing experience, torsades de pointes has been observed.


INDICATION

Corlanor® (ivabradine) is indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with left ventricular ejection fraction 35%, who are in sinus rhythm with resting heart rate 70 beats per minute and either are on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use.

back to top