The first new heart failure drug to be listed on the PBS in a decade is cause for excitement.

This ‘first in class’ therapy reduces heart rate through selective inhibition of the current regulating the sinoatrial node, without affecting intra-cardiac conduction, contractility or ventricular repolarisation. It may reduce mortality for patients with a heart rate at, or above, 77bpm.

Authority restrictions limit expenditure (≤$30mil in year 5) by constraining ivabradine access to 10% of those 300,000 Australians with chronic heart failure who remain uncontrolled with optimal standard treatments.

Sudden changes in light intensity can cause transient luminous phenomena (phosphenes) due to slower retinal conduction, and should be considered when driving or using machinery.

Contraindications include patients who have unstable heart failure or angina, where the sinoatrial node does not control the heart rate, bradycardia, severe hepatic failure, and combination with potent cytochrome P450 3A4 (CYP 3A4) inhibitors.

Ivabradine is also indicated to control angina in patients with coronary artery disease, either when beta-blockers are unsuitable or in combination with atenolol when heart rate is ≥60bpm.

Please review full product information before prescribing.

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