Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C27H36N2O5 |
Molecular Weight | 468.5851 |
Optical Activity | ( + ) |
Defined Stereocenters | 1 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
COC1=C(OC)C=C2[C@@H](CN(C)CCCN3CCC4=CC(OC)=C(OC)C=C4CC3=O)CC2=C1
InChI
InChIKey=ACRHBAYQBXXRTO-OAQYLSRUSA-N
InChI=1S/C27H36N2O5/c1-28(17-21-11-20-14-25(33-4)26(34-5)16-22(20)21)8-6-9-29-10-7-18-12-23(31-2)24(32-3)13-19(18)15-27(29)30/h12-14,16,21H,6-11,15,17H2,1-5H3/t21-/m1/s1
DescriptionCurator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/16451297
Curator's Comment: description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/16451297
Ivabradine (CORLANOR®) is a hyperpolarization-activated cyclic nucleotide-gated channel blocker that reduces the spontaneous pacemaker activity of the cardiac sinus node by selectively inhibiting the If-current, resulting in heart rate reduction at concentrations that do not affect other cardiac ionic currents. Specific heart-rate lowering with ivabradine (CORLANOR®) reduces myocardial oxygen demand, simultaneously improving oxygen supply. It has no negative inotropic or lusitropic effects, preserving ventricular contractility, and does not change any major electrophysiological parameters unrelated to heart rate.
CNS Activity
Curator's Comment: Ivabradine (CORLANOR®) can also inhibit the retinal current Ih. Ih is involved in curtailing retinal responses to bright light stimuli. Under triggering circumstances (e.g., rapid changes in luminosity), partial inhibition of Ih by ivabradine (CORLANOR®) may underlie the luminous phenomena experienced by patients. Luminous phenomena (phosphenes) are described as a transient enhanced brightness in a limited area of the visual field.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL1795171 |
2.05 µM [IC50] | ||
Target ID: CHEMBL1795172 |
2.29 µM [IC50] | ||
Target ID: CHEMBL1795173 |
2.51 µM [IC50] | ||
Target ID: CHEMBL1250417 |
2.15 µM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
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Palliative | CORLANOR Approved UseCorlanor is indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with left ventricular ejection fraction ≤ 35%, who are in sinus rhythm with resting heart rate ≥ 70 beats per minute and either are on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use. Corlanor (ivabradine) is a hyperpolarization-activated cyclic nucleotide-gated channel blocker indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with left ventricular ejection fraction ≤ 35%, who are in sinus rhythm with resting heart rate ≥ 70 beats per minute and either are on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use. Launch Date1.429056E12 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
35.98 ng/mL EXPERIMENT https://doi.org/10.1016/j.apsb.2012.01.004 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
IVABRADINE blood | Homo sapiens population: HEALTHY age: UNKNOWN sex: FEMALE / MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
171.19 μg × h/mL EXPERIMENT https://doi.org/10.1016/j.apsb.2012.01.004 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
IVABRADINE blood | Homo sapiens population: HEALTHY age: UNKNOWN sex: FEMALE / MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
5.03 h EXPERIMENT https://doi.org/10.1016/j.apsb.2012.01.004 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
IVABRADINE blood | Homo sapiens population: HEALTHY age: UNKNOWN sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Other AEs: Nausea, Vision disorders... Other AEs: Nausea (1 patient) Sources: Vision disorders (2 patients) Abdominal pain (1 patient) Leg pain (1 patient) Fatigue (1 patient) |
150 mg single, oral Overdose |
unhealthy, 19 years n = 1 Health Status: unhealthy Age Group: 19 years Sex: F Population Size: 1 Sources: |
Other AEs: Dizziness, Nausea... Other AEs: Dizziness (1 patient) Sources: Nausea (1 patient) Vomiting (1 patient) |
250 mg single, oral Overdose |
unknown, 26 years n = 1 Health Status: unknown Age Group: 26 years Sex: F Population Size: 1 Sources: |
|
10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
healthy, 27.7 years n = 9 Health Status: healthy Age Group: 27.7 years Sex: M Population Size: 9 Sources: |
|
280 mg single, oral Overdose |
unhealthy, 47 years n = 1 Health Status: unhealthy Age Group: 47 years Sex: M Population Size: 1 Sources: |
Other AEs: Drowsiness... |
10 mg 1 times / day multiple, intravenous Dose: 10 mg, 1 times / day Route: intravenous Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy, 61 years (range: 59 - 67 years) n = 14 Health Status: unhealthy Condition: low cardiac output syndrome Age Group: 61 years (range: 59 - 67 years) Sex: M+F Population Size: 14 Sources: |
Disc. AE: Bradyarrhythmia, Heart rate decreased... Other AEs: Pulmonary capillary wedge pressure, Sustained ventricular tachycardia... AEs leading to discontinuation/dose reduction: Bradyarrhythmia (1 patient) Other AEs:Heart rate decreased (3 patients) Pulmonary capillary wedge pressure (5 patients) Sources: Sustained ventricular tachycardia (1 patient) |
5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: Page: p. 171 |
unhealthy, adult n = 5477 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 5477 Sources: Page: p. 171 |
Disc. AE: Atrial fibrillation, Heart rate increased... AEs leading to discontinuation/dose reduction: Atrial fibrillation (2.5%) Sources: Page: p. 171Heart rate increased (0.5%) Bradycardia (0.4%) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Abdominal pain | 1 patient | 10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Fatigue | 1 patient | 10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Leg pain | 1 patient | 10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Nausea | 1 patient | 10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Vision disorders | 2 patients | 10 mg 2 times / day steady, oral Highest studied dose Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
unhealthy, 18–70 years n = 9 Health Status: unhealthy Condition: asthma Age Group: 18–70 years Sex: M+F Population Size: 9 Sources: |
Dizziness | 1 patient | 150 mg single, oral Overdose |
unhealthy, 19 years n = 1 Health Status: unhealthy Age Group: 19 years Sex: F Population Size: 1 Sources: |
Nausea | 1 patient | 150 mg single, oral Overdose |
unhealthy, 19 years n = 1 Health Status: unhealthy Age Group: 19 years Sex: F Population Size: 1 Sources: |
Vomiting | 1 patient | 150 mg single, oral Overdose |
unhealthy, 19 years n = 1 Health Status: unhealthy Age Group: 19 years Sex: F Population Size: 1 Sources: |
Drowsiness | 1 patient | 280 mg single, oral Overdose |
unhealthy, 47 years n = 1 Health Status: unhealthy Age Group: 47 years Sex: M Population Size: 1 Sources: |
Sustained ventricular tachycardia | 1 patient | 10 mg 1 times / day multiple, intravenous Dose: 10 mg, 1 times / day Route: intravenous Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy, 61 years (range: 59 - 67 years) n = 14 Health Status: unhealthy Condition: low cardiac output syndrome Age Group: 61 years (range: 59 - 67 years) Sex: M+F Population Size: 14 Sources: |
Bradyarrhythmia | 1 patient Disc. AE |
10 mg 1 times / day multiple, intravenous Dose: 10 mg, 1 times / day Route: intravenous Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy, 61 years (range: 59 - 67 years) n = 14 Health Status: unhealthy Condition: low cardiac output syndrome Age Group: 61 years (range: 59 - 67 years) Sex: M+F Population Size: 14 Sources: |
Heart rate decreased | 3 patients Disc. AE |
10 mg 1 times / day multiple, intravenous Dose: 10 mg, 1 times / day Route: intravenous Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy, 61 years (range: 59 - 67 years) n = 14 Health Status: unhealthy Condition: low cardiac output syndrome Age Group: 61 years (range: 59 - 67 years) Sex: M+F Population Size: 14 Sources: |
Pulmonary capillary wedge pressure | 5 patients | 10 mg 1 times / day multiple, intravenous Dose: 10 mg, 1 times / day Route: intravenous Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy, 61 years (range: 59 - 67 years) n = 14 Health Status: unhealthy Condition: low cardiac output syndrome Age Group: 61 years (range: 59 - 67 years) Sex: M+F Population Size: 14 Sources: |
Bradycardia | 0.4% Disc. AE |
5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: Page: p. 171 |
unhealthy, adult n = 5477 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 5477 Sources: Page: p. 171 |
Heart rate increased | 0.5% Disc. AE |
5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: Page: p. 171 |
unhealthy, adult n = 5477 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 5477 Sources: Page: p. 171 |
Atrial fibrillation | 2.5% Disc. AE |
5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: Page: p. 171 |
unhealthy, adult n = 5477 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 5477 Sources: Page: p. 171 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Drug as victim
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/206143Orig1s000PharmR.pdf#page=57 Page: 57.0 |
||||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/206143Orig1s000PharmR.pdf#page=57 Page: 57.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Optimal design of a population pharmacodynamic experiment for ivabradine. | 2001 Jan |
|
Differential effects of heart rate reduction and beta-blockade on left ventricular relaxation during exercise. | 2002 Feb |
|
Contributions of heart rate and contractility to myocardial oxygen balance during exercise. | 2003 Feb |
|
Heart rate reduction during exercise-induced myocardial ischaemia and stunning. | 2004 Apr |
|
Drug insight: If inhibitors as specific heart-rate-reducing agents. | 2004 Dec |
|
Effect of graded heart rate reduction with ivabradine on myocardial oxygen consumption and diastolic time in exercising dogs. | 2004 Jan |
|
Pharmacokinetics-pharmacodynamics during drug development--an example from Servier: ivabradine. | 2004 Mar-Apr |
|
I(f) channel inhibitor ivabradine lowers heart rate in mice with enhanced sympathoadrenergic activities. | 2004 May |
|
Current and future treatment strategies for refractory angina. | 2004 Oct |
|
Heart rate reduction: a potential target for the treatment of myocardial ischaemia. | 2004 Sep-Oct |
|
[Selection and pharmacological characterisation of Procoralan, a selective inhibitor of the pacemaker If current]. | 2004 Sep-Oct |
|
If at first you don't succeed try ... a new target in the treatment of angina. | 2005 Dec |
|
Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina. | 2005 Dec |
|
Cardiac pacemaker I(f) current and its inhibition by heart rate-reducing agents. | 2005 Jul |
|
Physiology and pharmacology of the cardiac pacemaker ("funny") current. | 2005 Jul |
|
New agent ivabradine (Procoralan) for treatment of chronic stable angina. | 2005 Sep-Oct |
|
[Why it is necessary to reduce heart rate in the treatment of stable angina?]. | 2006 |
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[Ivabradine--the first selective and specific I(f) inhibitor, novel preparation for treatment of stable angina]. | 2006 |
|
Future directions: what data do we need? | 2006 |
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Novel If current inhibitor ivabradine: safety considerations. | 2006 |
|
Clinical effect of 'pure' heart rate slowing with a prototype If current inhibitor: placebo-controlled experience with ivabradine. | 2006 |
|
Clinical perspectives of heart rate slowing for coronary event reduction and heart failure. | 2006 |
|
[A new medicine for treatment of stable angina pectoris]. | 2006 |
|
Bradycardic and proarrhythmic properties of sinus node inhibitors. | 2006 Apr |
|
[Heart rate reduction as a therapeutic strategy: novel options]. | 2006 Dec |
|
[The discovery of the selective If current inhibitor ivabradine (Procoralan): a new therapeutic approach to ischemic heart disease]. | 2006 Jan |
|
Selective and specific I(f) inhibition: new perspectives for the treatment of stable angina. | 2006 Jun |
|
Anti-ischaemic effect of ivabradine. | 2006 May |
|
The discovery of the selective I(f) current inhibitor ivabradine. A new therapeutic approach to ischemic heart disease. | 2006 May |
|
Therapeutic effects of I(f) blockade: evidence and perspective. | 2006 May |
|
Ivabradine: a selective If current inhibitor in the treatment of stable angina. | 2006 Nov |
|
Rationale and design of a randomized, double-blind, placebo-controlled trial of ivabradine in patients with stable coronary artery disease and left ventricular systolic dysfunction: the morBidity-mortality EvAlUaTion of the I(f) inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction (BEAUTIFUL) study. | 2006 Nov |
|
Clinical results of I(f) current inhibition by ivabradine. | 2007 |
|
The funny current: cellular basis for the control of heart rate. | 2007 |
|
If inhibition by Ivabradine. Foreword. | 2007 |
|
Molecular regulation and pharmacology of pacemaker channels. | 2007 |
|
Cellular mechanisms underlying the pharmacological induction of phosphenes. | 2007 Feb |
|
Preservation of coronary reserve by ivabradine-induced reduction in heart rate in infarcted rats is associated with decrease in perivascular collagen. | 2007 Jul |
|
[Selective and specific reduction in the heart rate: a promising direction in the creation of new cardiovascular drugs]. | 2007 Jul-Aug |
|
[Heart rate as a cardiovascular risk factor: potential clinical benefit with ivabradine]. | 2007 May 30 |
|
The heart rate-lowering agent ivabradine inhibits the pacemaker current I(f) in human atrial myocytes. | 2007 Nov |
|
I f inhibition with ivabradine : electrophysiological effects and safety. | 2008 |
|
Heart rate in the pathophysiology of coronary blood flow and myocardial ischaemia: benefit from selective bradycardic agents. | 2008 Apr |
|
Effect of long-term heart rate reduction by If current inhibition on pressure overload-induced heart failure in rats. | 2008 Jan |
Patents
Sample Use Guides
The recommended starting dose of CORLANOR® is 5 mg twice daily with meals.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/16387796
The potential subtype-specificity of the sinus node inhibitors cilobradine, ivabradine, and zatebradine using cyclic nucleotide-gated cation (HCN) channels was tested. All three substances blocked the slow inward current through HCN1, HCN2, HCN3, and HCN4 human channels. There was no subtype-specificity for the steady-state block, with mean IC50 values of 0.99, 2.25, and 1.96 microM for cilobradine, ivabradine, and zatebradine, respectively.
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Classification Tree | Code System | Code | ||
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WHO-ATC |
C07FX06
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FDA ORPHAN DRUG |
511915
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NCI_THESAURUS |
C47793
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WHO-ATC |
C07FX05
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WHO-VATC |
QC01EB17
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FDA ORPHAN DRUG |
631818
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WHO-ATC |
C01EB17
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NDF-RT |
N0000191544
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3H48L0LPZQ
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2357
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C65995
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85969
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CHEMBL471737
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N0000191546
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PRIMARY | Hyperpolarization-activated Cyclic Nucleotide-gated Channel Antagonists [MoA] | ||
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155974-00-8
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DB09083
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85966
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SUB08357MIG
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M6564
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3H48L0LPZQ
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IVABRADINE
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3312
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1649480
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PRIMARY | RxNorm |
ACTIVE MOIETY
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