From the Guidelines
Yes, Corlanor (ivabradine) can cause hypotension.
Important Considerations
- The medication is contraindicated if BP <90/50 mm Hg 1, indicating that it can exacerbate hypotension in patients with already low blood pressure.
- Hypertension is listed as a potential adverse effect, but in the context of hypotension, this suggests that ivabradine can have variable effects on blood pressure, potentially lowering it in some cases.
- The drug's mechanism and potential for interactions with other medications that can exacerbate bradycardia or affect blood pressure highlight the need for cautious use and monitoring.
Clinical Implications
- Clinicians should be aware of the potential for ivabradine to cause hypotension, especially in patients with pre-existing low blood pressure or those taking other medications that can lower blood pressure.
- Dosing adjustments and careful consideration of drug interactions are crucial when prescribing ivabradine to minimize the risk of hypotension and other adverse effects 1.
From the FDA Drug Label
The following adverse reactions have been identified in adults during post-approval use of ivabradine: syncope, hypotension, torsade de pointes, ventricular fibrillation, ventricular tachycardia, angioedema, erythema, rash, pruritus, urticaria, vertigo, and diplopia, and visual impairment.
Hypotension is listed as an adverse reaction that has been identified in adults during post-approval use of ivabradine 2 and 3. Therefore, yes, Corlanor (ivabradine) can cause hypotension.
From the Research
Effects of Corlanor (Ivabradine) on Blood Pressure
- Ivabradine has been shown to reduce heart rate without appreciable effects on blood pressure 4.
- A retrospective analysis of 29 consecutive patients treated for acute heart failure found that systolic blood pressure showed no variation during the first 24 hours of ivabradine administration or at discharge 5.
- No episodes of significant bradycardia or hypotension were recorded after starting ivabradine in acute heart failure patients 5.
- Ivabradine reduced systolic blood pressure in L-NAME-induced hypertensive rats, but its effect on blood pressure in healthy rats was not significant 6.
- Ivabradine may help increase blood pressure in patients with heart failure by optimizing heart rate, allowing for the up-titration of beta-blockers 7, 8.