What is Lancora (ivabradine)?

Lancora, also known as ivabradine, is a prescription medication used to treat certain heart conditions. It works by reducing the heart rate, which can help improve symptoms in patients with certain types of chronic heart failure or stable angina. It specifically targets the electrical signals that regulate the heart rate, slowing down the heart’s rhythm. This can alleviate symptoms such as chest pain, shortness of breath, and fatigue.

Lancora (ivabradine)
Lancora
Ivabradine
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Select product strength & quantity:

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Product of Canada.

Shipped from Canada.

Prescription Required.Product of Canada.Shipped from Canada.

What is Lancora (ivabradine)?

Lancora, also known as ivabradine, is a prescription medication used to treat certain heart conditions. It works by reducing the heart rate, which can help improve symptoms in patients with certain types of chronic heart failure or stable angina. It specifically targets the electrical signals that regulate the heart rate, slowing down the heart’s rhythm. This can alleviate symptoms such as chest pain, shortness of breath, and fatigue.

How does Lancora work?

Lancora lowers heart rate by selective and specific inhibition of the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels (f-channels) within the sinoatrial (SA) node. Inhibition of the f-channels disrupts the If ion current flow and prolongs diastolic depolarization, slowing firing in the SA node.

Lancora can also inhibit the retinal current Ih, which is involved in retinal responses to bright lights. This is the postulated mechanism that results in the visual side effects of the medication.

Dosage and How to Use

Lancora is available in the following dosage forms:

  • 5 mg film-coated tablet
  • 7.5 mg film-coated tablet

Lancora should be taken twice daily, once with the morning meal and once with the evening meal. It must be taken with food.

Storage

Store at room temperature (25ºC or 77ºF). Temperature excursions are permitted between 15ºC and 30ºC (59ºF and 86ºF).

Overdosage

If overdosage amounts of Lancora are ingested, seek medical attention immediately. Lancora overdose may lead to severe and prolonged bradycardia. Cardiac pacing may be required if there is poor hemodynamic tolerance. Intravenous (IV) fluids, atropine, IV beta-stimulating agents, and other supportive treatments may be considered.

Side Effects

The most common side effects of Lancora are:

  • Temporary brightness in parts of the field of vision, also known as phosphenes
    • Use caution while driving or operating machinery where sudden changes in light can happen, especially at night.
  • Increased blood pressure

Rare but more severe side effects are:

  • Bradycardia (slowed heart rate)
    • Tell your doctor if you have the following:
      • Slowing heart rate
      • Dizziness
      • Fatigue, lack of energy
  • Irregular or rapid heartbeat (atrial fibrillation or heart rhythm problems)
    • Tell your doctor if you have any of the following symptoms of an irregular or fast heartbeat:
      • Heart is pounding (palpitations)
      • Chest pressure
      • Worsening shortness of breath
      • Fainting or near fainting
  • Signs of an allergic reaction
    • Rash
    • Hives
    • Itching
    • Redness
    • Swollen
    • Trouble breathing or swallowing

This is not a comprehensive list of all the possible side effects. Please reach out to your doctor or pharmacist for more information. Contact your doctor or seek medical attention immediately if you are experiencing a severe side effect.

Warnings & Precautions

Atrial fibrillation

  • Lancora can increase the risk of atrial fibrillation. Cardiac rhythm should be monitored, and discontinue treatment if atrial fibrillation develops.

Bradycardia and conduction disturbances

  • Bradycardia, sinus arrest, and heart block have occurred in patients taking Lancora. Heart rate should be monitored during initiation and any dosage increase. Bradycardia may increase the risk of QT prolongation and torsade de pointes.

Visual disturbances

  • Lancora affects retinal function, although there is no evidence of long-lasting effects. Lancora should be discontinued if an unexpected deterioration in visual function occurs. Use caution in patients with retinitis pigmentosa.

Fetal toxicity

  • Lancora may cause fetal toxicity when given to pregnant women. Embryo-fetal toxicity and cardiac teratogenicity have been observed in animal studies. Women of reproductive potential must use effective contraception during treatment with Lancora.

Combination with calcium channel blockers

  • Concomitant use of Lancora with verapamil or diltiazem is contraindicated. Verapamil and diltiazem increase exposure to Lancora and have additive heart rate-lowering properties.

 Drug Interactions and Other Interactions

Cytochrome P450-based interactions

  • Concomitant use of CYP3A4 inhibitors increases Lancora plasma concentrations and may exacerbate bradycardia and conduction disturbances. CYP3A4 inducers decrease plasma concentrations and may lead to reduced efficacy of Lancora.
  • Concomitant use with strong CYP3A4 inhibitors is contraindicated. A list of some examples of strong CYP3A4 inhibitors is below:
    • Azole antifungals (e.g., itraconazole)
    • Macrolide antibiotics (e.g., clarithromycin, telithromycin)
    • HIV protease inhibitors (e.g., nelfinavir)
    • Nefazodone
  • Concomitant use with moderate CYP3A4 inhibitors should be avoided. See list of some examples below:
    • Diltiazem and verapamil
    • Grapefruit juice
  • Concomitant use with CYP3A4 inducers should be avoided. See list of some examples below:
    • St. John’s wort
    • Rifampicin
    • Barbiturates
    • Phenytoin

Negative chronotropes

  • The risk of bradycardia increases with coadministration of Lancora with other medications that slow heart rate (e.g., digoxin, amiodarone, beta-blockers).

Pacemakers in adults

  • Lancora dosing is determined by heart rate reduction (target of 50 – 60 beats per minute in adults). Lancora is not recommended in patients with demand pacemakers set to rates ? 60 beats per minute.

Contraindications

Lancora is contraindicated in patients with any of the following:

  • Hypersensitivity to the active substance or any of the excipients
  • Resting heart rate below 70 beats per minute before treatment
  • Cardiogenic shock
  • Acute myocardial infarction
  • Severe hypotension (< 90/50 mmHg)
  • Severe hepatic insufficiency
  • Sick sinus syndrome
  • Sino-atrial block
  • Unstable or acute heart failure
  • Pacemaker dependent
  • Unstable angina
  • 3rd-degree AV-block
  • Combination with strong cytochrome P450 3A4 inhibitors such as azole antifungals (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin per os, josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone
  • Combination with verapamil or diltiazem, which are moderate CYP3A4 inhibitors with heart rate-reducing properties
  • Pregnancy, lactation, and women of childbearing potential not using appropriate contraceptive measures

Frequently Asked Questions

Lancora may cause serious side effects, including:

  • Harm to an unborn baby
    • Women must use effective contraception during treatment with Lancora.
    • Tell your doctor right away if you become pregnant during treatment with Lancora.
  • Increased risk of irregular or rapid heartbeat (atrial fibrillation or heart rhythm problems)
    • Tell your doctor if you feel any of the following symptoms of an irregular or rapid heartbeat:
      • Heart is pounding or racing (palpitations)
      • Chest pressure
      • Worsened shortness of breath
      • Near fainting or fainting
    • Slower than normal heart rate (bradycardia)
      • Tell your doctor if you have a slowing heart rate or one of the following symptoms of a slow heart rate:
        • Dizziness
        • Fatigue
        • Lack of energy

Lancora is a prescription medication used to slow your heartbeat if you have chronic heart failure or chronic stable angina pectoris.

You should not take Lancora if you have any of the following:

  • Symptoms of heart failure that recently worsened
  • Very low blood pressure (hypotension)
  • Certain heart conditions: sick sinus syndrome, sinoatrial block, or 3rd-degree atrioventricular block
  • A slow resting heart rate before treatment with Corlanor
  • Certain liver problems
  • Been prescribed any medicines that can increase the effects of Corlanor

Make sure to inform your doctor about all of your medical conditions, especially if you have any of the following:

  • Have any heart problems, including heart rhythm problems, a slow heart rate, or a heart conduction problem
  • Are breastfeeding or planning to breastfeed. It is not known if Corlanor passes into breast milk
  • Are pregnant or planning to become pregnant

Tell your doctor about all the medications you take, including prescription, over-the-counter, natural supplements, and vitamins.

Lancora must be taken with food and should be taken twice daily, once with your morning meal and once with your evening meal. Take Lancora precisely as directed by your doctor, and do not stop taking Lancora before speaking with your doctor.

The most common side effects of Lancora are:

  • Temporary brightness in parts of the field of vision, also known as phosphenes
    • Use caution while driving or operating machinery where sudden changes in light can happen, especially at night.
  • Increased blood pressure

This is not a comprehensive list of all the possible side effects. Please reach out to your doctor or pharmacist for more information.

  • Bradycardia (slowed heart rate)
    • Tell your doctor if you have the following:
      • Slowing heart rate
      • Dizziness
      • Fatigue, lack of energy
  • Irregular or rapid heartbeat (atrial fibrillation or heart rhythm problems)
    • Tell your doctor if you have any of the following symptoms of an irregular or rapid heartbeat:
      • Heart is pounding (palpitations)
      • Chest pressure
      • Worsening shortness of breath
      • Fainting or near fainting
  • Signs of an allergic reaction
    • Rash
    • Hives
    • Itching
    • Redness
    • Swollen
    • Trouble breathing or swallowing

This is not a comprehensive list of all the possible side effects. Please reach out to your doctor or pharmacist for more information.

The active substance is ivabradine. The other ingredients are:

  • Tablet core: lactose monohydrate, magnesium stearate, maize starch, maltodextrin, and colloidal anhydrous silica
  • Film coating: hypromellose, titanium dioxide, macrogol, glycerol, magnesium stearate, yellow iron oxide, and red iron oxide

Grapefruit and grapefruit juice should be avoided during treatment with Lancora. Grapefruit juice can lead to higher levels of Lancora in your body, leading to adverse reactions.

Lancora is not safe during pregnancy. Talk to your doctor immediately if you become pregnant or are planning on becoming pregnant. Women must use effective contraception during treatment with Lancora.

Lancora is contraindicated in women that are breastfeeding. Animal studies have shown that Lancora is present in breast milk. Please speak with your doctor to determine if you should continue Lancora or breast; do not do both.

Temporary brightness in your field of vision is a common side effect. This usually happens within the first two months of treatment and may go away. Make sure to exercise caution when driving or operating heavy machinery where sudden changes of light can happen, especially at night.

If you miss a dose of Lancora, skip the dose and continue taking the next dose at the scheduled time. Do not take an extra dose to make up for the missed dose.

Do not give this medicine to children and adolescents younger than 18 years. Safety and efficacy data have not been established in this age group.

You should store Lancora at room temperature between 68°F to 77°F (20°C to 25°C)