Varadin

Symptomatic treatment of chronic stable angina pectoris in CAD patients w/ normal sinus rhythm & heart rate ≥70 bpm. Adults unable to tolerate or w/ contraindication to use of β-blockers; or in combination w/ β-blockers in patients inadequately controlled w/ optimal β-blocker dose. Chronic heart failure NYHA II-IV class w/ systolic dysfunction, in patients in sinus rhythm & whose heart rate is ≥75 bpm, in combination w/ standard therapy including β-blocker therapy or when β-blocker therapy is contraindicated or not tolerated.

Symptomatic treatment of chronic stable angina pectoris Patient <75 yr Max starting dose: 5 mg bd. May be increased to the next higher dose in patients receiving 2.5 mg bd or 5 mg bd if still symptomatic, if initial dose is well tolerated & if resting heart rate remains >60 bpm after 3-4 wk of treatment. Max maintenance dose: 7.5 mg bd. Chronic heart failure Initially 5 mg bd, can be increased to 7.5 mg bd after 2 wk if resting heart rate is persistently >60 bpm or decreased to 2.5 mg bd if resting heart rate is persistently <50 bpm or in case of symptoms related to bradycardia. Elderly ≥75 yr Consider lower starting dose of 2.5 mg bd before up-titration if necessary.

Should be taken with food: Take tab bd ie, once in the morning & once in the evening during meals. Avoid intake of grapefruit juice.

Hypersensitivity. Resting heart rate <70 bpm prior to treatment, cardiogenic shock, acute MI, severe hypotension (<90/50 mmHg), sick sinus syndrome, SA block, unstable or acute heart failure, pacemaker dependent, unstable angina, 3rd degree AV-block. Combination w/ strong CYP450 3A4 inhibitors eg, azole antifungals (ketoconazole, itraconazole), macrolides (clarithromycin, erythromycin PO, josamycin, telithromycin), HIV PIs (nelfinavir, ritonavir) & nefazodone; verapamil or diltiazem which are moderate CYP3A4 inhibitors w/ heart rate reducing properties. Severe hepatic insufficiency. Women of childbearing potential not using appropriate contraceptive measures. Pregnancy & lactation.

Anti-Anginal Drugs

C01EB17 - ivabradine ; Belongs to the class of other cardiac preparations.

POM