Corlanor Side Effects, Dosage, Cost, Approval and Prescribing Information for Chronic Heart Failure | Wing (Bernadette) Cheung, PharmD | RxEconsult
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Corlanor (ivabradine) Side Effects, Dosage, Cost, Approval and Prescribing Information for Chronic Heart Failure Category: Heart Disease by - April 22, 2015 | Views: 58484 | Likes: 0 | Comment: 0  

How effective is Corlanor in controlling heart failure?

Corlanor was studied in 6,505 patients with stable heart failure, left ventricular ejection fraction ≤35%, and resting heart rate ≥70 bpm. All patients had prior hospitalization for heart failure within 12 months. Patients were stable on standard heart failure treatments including beta-blockers, ACE inhibitors or ARBs, spironolactone, and diuretics. Patients were given either placebo or Corlanor 5 mg twice daily and the dose was adjusted to 7.5 mg twice daily or decreased to 2.5 mg twice daily to maintain the heart rate between 50-60 beats per minute. 

The percentage of patients hospitalized for worsening heart failure was 15.6% in the Corlanor group compared to 20.2% in the placebo group  Cardiovascular death occurred in 8.9% of patients in the Corlanor group and 8.5% in the placebo group. It was concluded that Corlanor reduced the risk of the combined endpoint of hospitalization for worsening heart failure or cardiovascular death. 

Interesting facts about Corlanor

  • Corlanor is the first new heart failure medicine approved in nearly ten years the first of its kind.
  • Unlike beta-blockers Corlanor reduces heart rate without reducing the heart’s contractility,
  • Corlanor is used for patients who are already on the maximum tolerated dose of beta-blockers or are unable to use beta blockers.
  • Corlanor causes light flashes in the eyes (phosphenes) because it also inhibits a specific current that is responsible for restricting the eye’s response to light.

What are side effects of Corlanor?

Common side effects reported with Corlanor include slowing of heart rate (bradycardia), high blood pressure, arrhythmias (atrial fibrillation), and temporary visual disturbance described as flashing of light (luminous phenomena or phosphenes).

What is the dosage of Corlanor?

Corlanor is available as 5 mg and 7.5 mg tablets. The recommended starting dose is 5 mg twice daily. The dose is adjusted based on heart rate after two weeks of treatment. The maximum dose is 7.5 mg twice daily. 

For patients with a history of conduction defects or patients who may have circulation complications following bradycardia, the recommended starting dose is 2.5 mg twice daily. Adjust dose according to heart rate after two weeks of treatment. 

Corlanor should be stored at room temperature, 15°C-30°C (59°F-86°F).

What are Corlanor drug interactions?

Corlanor relies on CYP3A4 enzymes for metabolism. CYP3A4 is a group of liver enzymes that  break down medications, including Corlanor. Therefore, any drug that inhibits or increases the activity CYP3A4 enzymes will affect the concentration and effect of Corlanor in the body.

Corlanor should not be combined with medications that inhibit CYP3A4 enzymes because they may increase the level of Corlanor in the body. Examples of CYP3A4 inhibitors include azole antifungals (for example, fluconazole), certain antibiotics (for example, clarithromycin), certain HIV medications (for example nelfinavir), and grapefruit juice.

Corlanor should not be combined with medications that increase the effect of CYP3A4 enzymes because they may decrease the effectiveness of Corlanor. Examples of such drugs include inSt. John’s wort, rifampin, barbiturates, and phenytoin.

Negative chronotropes are medications that reduce heart rate. The risk of reducing heart rate (bradycardia) increases when Corlanor is combined with negative chronotropes. Examples of negative chronotropes include beta-blockers, digoxin, and amiodarone.

Next: Warnings, Cost

 



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