Comprehensive Product Description Guide: Generic Coralan (Ivabradine)

What is Generic Coralan used for
Generic Coralan (Ivabradine) is a heart rate-lowering medicine used to treat chronic stable angina and heart failure. It works by selectively inhibiting the I_f current in the sinoatrial node, reducing heart rate without affecting blood pressure or myocardial contractility.

Generic Coralan (Ivabradine Hydrochloride)

Ivabradine Hydrochloride

Other Popular or Common Names:
Brand Name Equivalent: Coralan (original by Servier)

Generic Names: Ivabradine, Ivabradine HCl

Therapeutic Class: Heart rate-lowering agent

Common Terms: Ivabradine tablets, Generic Coralan, Heart failure heart rate control

Pharmacological Class: Selective sinus node I_f channel inhibitor

Therapeutic Class: Cardiovascular agent

Regulatory Class (AU): Schedule 4 (S4) – Prescription Only Medicine

Ivabradine selectively inhibits the I_f (funny) current in the sinoatrial (SA) node—the heart’s natural pacemaker. This results in heart rate reduction without affecting contractility, intracardiac conduction, or ventricular repolarization. It improves oxygen balance and reduces myocardial workload, making it effective in chronic angina and heart failure.

Chronic Stable Angina in patients with normal sinus rhythm who cannot tolerate or are inadequately controlled on beta-blockers

Chronic Heart Failure with reduced ejection fraction (HFrEF) in combination with standard therapy (ACE inhibitors, beta-blockers, diuretics)

Initial Dose:

Adults: 5 mg orally twice daily with meals

Maintenance Dose:

Adjusted to 7.5 mg twice daily if heart rate >60 bpm; reduced to 2.5 mg twice daily if <50 bpm

Monitoring:

Resting heart rate, ECG, blood pressure

Elderly: Start at 2.5 mg twice daily

Hepatic impairment: Use with caution

Renal impairment: No adjustment required for mild to moderate cases

Form: Oral tablets

Strengths Available: 2.5 mg, 5 mg, 7.5 mg

Packaging: Blister pack of 14 or 28 tablets

Storage: Store below 25°C, keep in original packaging

Contraindications:
Resting heart rate <60 bpm

Acute decompensated heart failure

Sinoatrial block, sick sinus syndrome

Pacemaker dependence

Severe hypotension (BP <90/50 mmHg)

Severe hepatic impairment

Pregnancy and breastfeeding

Hypersensitivity to ivabradine or excipients

Precautions:
Use with caution in atrial fibrillation risk

Monitor for bradycardia

Avoid in patients with congenital QT syndrome

Not recommended in combination with strong CYP3A4 inhibitors (e.g., ketoconazole, diltiazem)

Bradycardia

Luminous phenomena (phosphenes)

Headache

Dizziness

Visual disturbances

Less Common:
Atrial fibrillation

Hypertension

Gastrointestinal discomfort

Severe bradycardia

QT prolongation

AV block

Allergic reactions

Warnings and Cautions:
Regular heart rate monitoring is essential

Discontinue if atrial fibrillation occurs

Avoid grapefruit juice (CYP3A4 inhibitor)

Not a replacement for beta-blockers unless contraindicated or not tolerated

Avoid in pregnancy (Category D – embryotoxic in animal studies)

Contraindicated with:

Potent CYP3A4 inhibitors: Clarithromycin, ketoconazole, itraconazole

Caution with:

Diltiazem, verapamil (risk of bradycardia)

Antiarrhythmics (increased QT risk)

Grapefruit juice (CYP3A4 inhibition)

SHIFT Trial (The Lancet, 2010): Ivabradine reduced the composite endpoint of cardiovascular death or heart failure hospitalization in patients with symptomatic HFrEF.

BEAUTIFUL Study: Demonstrated efficacy in stable coronary artery disease with left ventricular dysfunction.

Meta-analyses confirm reduction in hospitalization and mortality when added to standard heart failure therapy in select patients.

Frequently Asked Questions (FAQs)
Q: How quickly does Generic Coralan work?
A: Ivabradine begins lowering heart rate within 2 hours of administration, with steady effects in 3–4 days.

Q: Can I take Ivabradine with food?
A: Yes, it should be taken with meals for optimal absorption and tolerance.

Q: Can Ivabradine replace beta-blockers?
A: No. It's used when beta-blockers are contraindicated or not tolerated. It's often added to existing therapy.

Q: Does Ivabradine cause fatigue like beta-blockers?
A: It is less likely to cause fatigue or hypotension as it doesn’t affect contractility.

Q: Can I use this in pregnancy?
A: No. Ivabradine is contraindicated in pregnancy due to embryotoxicity risk.

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