You should not use ivabradine if you have severe liver disease, very low blood pressure, a slow resting heart rate, a serious heart condition such as "sick sinus syndrome" or 3rd-degree "AV block" (unless you have a pacemaker), or if you depend on a pacemaker to control your heart rate.
Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.
Ivabradine may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.
Ivabradine can cause serious heart rhythm problems. Call your doctor at once if you have chest pressure, racing or pounding heartbeats, very slow heartbeats, weakness, tiredness, severe dizziness, or shortness of breath that is worse than usual.
If your baby is taking ivabradine, watch for symptoms of feeding problems, trouble breathing, or turning blue.
Before taking this medicine
You should not use ivabradine if you are allergic to it, or if you have:
a serious heart condition such as "sick sinus syndrome" or 3rd-degree "AV block" (unless you have a pacemaker);
heart failure symptoms that recently got worse;
very low blood pressure;
a slow resting heart rate;
severe liver disease; or
if you depend on a pacemaker to control your heart rate.
Some medicines can cause unwanted or dangerous effects when used with ivabradine. Your doctor may need to change your treatment plan if you use any of the following drugs:
an antibiotic or antifungal medicine;
an antidepressant;
antiviral medicine to treat hepatitis C or HIV/AIDS; or
other heart medicine or blood pressure medication (such as amiodarone, digoxin, diltiazem, or verapamil).
Tell your doctor if you have any other heart problems not being treated with ivabradine.
Taking ivabradine during pregnancy may harm an unborn baby or lead to premature birth. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.
You should not breastfeed while using  ivabradine.
How should I take ivabradine?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Ivabradine is usually taken 2 times per day with food. Avoid grapefruit or grapefruit juice.
Tell your doctor if you have trouble swallowing a ivabradine tablet.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Each plastic ampule is for one use only. Throw it away after one use, even if there is still medicine left inside.
If a child taking ivabradine spits outs the medicine shortly after taking, do not give another dose. Wait until the next scheduled dose time to give the medicine again.
You may also need to take another medicine called a beta-blocker. Use all medications as directed and read all medication guides you receive. Do not stop taking your medication or change your doses without your doctor's advice.
Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).
Store at room temperature away from moisture, heat, and light. Keep the ampules of liquid ivabradine in the foil pouch and use the medicine right away after opening.
What happens if I miss a dose?
Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
