Ivaprex 7.5 mg is an oral anti-anginal medication specifically designed for the symptomatic treatment of chronic stable angina pectoris in patients with coronary artery disease and normal sinus rhythm. It is particularly indicated for patients who cannot tolerate beta-blockers or for those who require additional therapy in combination with beta-blockers when heart rate remains above 60 bpm. Ivaprex works by selectively lowering heart rate, reducing cardiac workload, and improving myocardial oxygen supply, providing targeted relief from angina symptoms without affecting blood pressure or heart contractility.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Other Anti-anginal & Anti-ischaemic drugs

Composition

Each tablet contains:

• Ivabradine 7.5 mg – a selective heart rate lowering agent

Indications

Ivaprex 7.5 mg is indicated for:

• Symptomatic treatment of chronic stable angina pectoris in coronary artery disease patients

• Patients unable to tolerate or with contraindications to beta-blockers

• In combination with beta-blockers in patients inadequately controlled by optimal beta-blocker therapy with a heart rate > 60 bpm

Pharmacology

Ivaprex 7.5 mg is a pure heart rate-lowering agent that selectively inhibits the I_f (“funny”) current in the sinoatrial node, which regulates spontaneous pacemaker activity. By decreasing heart rate:

• Cardiac workload and oxygen consumption are reduced

• Diastole is prolonged, enhancing coronary artery perfusion

• Myocardial oxygen supply is improved

Importantly, Ivaprex acts specifically on the sinus node without affecting intra-atrial, atrioventricular, or intraventricular conduction, nor does it influence myocardial contractility or ventricular repolarization.

Dosage and Administration

Adults:

• Starting dose: 5 mg twice daily, taken with meals

• Adjustment: After 3–4 weeks, may be increased to 7.5 mg twice daily depending on therapeutic response

• Dose reduction: If resting heart rate drops below 50 bpm or if bradycardia symptoms occur, reduce to 2.5 mg twice daily

• Discontinuation: Required if heart rate remains below 50 bpm or bradycardia symptoms persist

Elderly:

• Consider a lower starting dose of 2.5 mg twice daily

Children and Adolescents:

• Not recommended

Contraindications

• Hypersensitivity to Ivabradine or excipients

• Resting heart rate <60 bpm

• Cardiogenic shock, acute myocardial infarction, severe hypotension (<90/50 mmHg)

• Severe hepatic insufficiency

• Sick sinus syndrome, sino-atrial block, 3rd degree AV block

• Pacemaker-dependent patients

• Unstable angina

• Concomitant use with strong CYP3A4 inhibitors (e.g., macrolide antibiotics, azole antifungals, HIV protease inhibitors)

Side Effects

Common adverse reactions may include:

• Visual disturbances (phosphenes)

• Blurred vision

• Bradycardia

• First-degree AV block

• Ventricular extrasystoles

• Headache and dizziness

Drug Interactions

• Avoid combination with QT-prolonging medications (cardiovascular and non-cardiovascular)

• Concomitant use with strong CYP3A4 inhibitors is contraindicated

• Caution with drugs that may exacerbate bradycardia

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions and Warnings

• Use with caution in mild to moderate hypotension, atrial fibrillation, congenital QT syndrome, moderate hepatic impairment, and severe renal insufficiency

• Monitor heart rate regularly to adjust dosing as needed

Pregnancy and Lactation

• Contraindicated in pregnancy due to limited human data

• Excreted in breast milk; not recommended during breastfeeding

Storage Conditions

• Store below 30°C, protected from light and moisture

• Keep out of reach of children

Mode of Action

Ivaprex 7.5 mg selectively inhibits the I_f current in the sinus node, slowing heart rate and reducing myocardial oxygen demand while preserving cardiac contractility and conduction, effectively alleviating angina symptoms.