Does Ivabradine Cause Weight Gain?
No, ivabradine does not cause weight gain. Weight gain is not a recognized adverse effect of ivabradine therapy based on major clinical trials and guideline evidence.
Evidence from Major Clinical Trials
The landmark SHIFT trial, which enrolled 6,588 patients with heart failure and followed them for a median of 23 months, provides the most robust safety data for ivabradine 1. The documented adverse effects in this trial were:
- Symptomatic bradycardia: 5% of patients on ivabradine versus 1% on placebo 1
- Visual side effects (phosphenes): 3% of patients on ivabradine versus 1% on placebo 1
Weight gain was not reported as an adverse effect in this large trial 1.
Additional Safety Evidence
The BEAUTIFUL trial provided further safety data, enrolling 10,917 patients with coronary heart disease and left ventricular dysfunction who were followed for a median of 19 months 1. This trial confirmed that ivabradine was well tolerated, and again, weight gain was not identified as an adverse effect 1.
Mechanism of Action Context
Ivabradine works by selectively inhibiting the If current in the sinus node, which specifically slows heart rate without affecting other cardiac functions 1, 2. This targeted mechanism does not involve metabolic pathways that would typically lead to weight changes 2, 3.
Contrast with Other Cardiovascular Medications
Unlike certain other cardiovascular medications, ivabradine does not share the weight gain profile seen with:
- Beta-blockers (particularly non-selective ones): Can promote weight gain by decreasing metabolic rate 1, 4
- Alpha-blockers: Associated with weight gain, likely from fluid retention 1
Clinical Monitoring Recommendations
While weight gain is not an expected side effect of ivabradine, routine monitoring should focus on the documented adverse effects: