Can't fill your Corlanor prescription? Learn about alternatives to Ivabradine for heart failure, including beta-blockers, Entresto, and SGLT2 inhibitors.
If you've been prescribed Corlanor (Ivabradine) for heart failure and you're having trouble finding it at your pharmacy — or if the cost is simply too high — you might be wondering: are there alternatives?
The short answer is that there's no exact replacement for Corlanor, because it's the only drug in its class approved in the United States. But there are other heart failure medications that your doctor may consider, depending on your specific situation.
Important: Never switch or stop heart failure medications on your own. Always talk to your cardiologist before making any changes to your treatment plan.
Corlanor (Ivabradine) is an HCN channel blocker — the only one of its kind approved in the US. It works by blocking the "funny" current (If current) in your heart's natural pacemaker, the sinoatrial (SA) node. This selectively slows your heart rate without affecting the strength of your heart's contractions or your blood pressure.
This is what makes Corlanor unique. Unlike beta-blockers, which also lower heart rate but affect blood pressure and heart contractility, Corlanor only targets heart rate. For a deeper dive, see our article on how Corlanor works.
Corlanor is FDA-approved for adults with stable, symptomatic chronic heart failure who have:
Beta-blockers are the first-line heart rate-lowering medications for heart failure with reduced ejection fraction (HFrEF). In fact, most patients should already be on a maximally tolerated beta-blocker before Corlanor is even considered.
How they work: Beta-blockers block the effects of adrenaline (epinephrine) on the heart, slowing heart rate, reducing blood pressure, and decreasing the heart's workload. The three beta-blockers proven to reduce death in heart failure are:
Key difference from Corlanor: Beta-blockers lower blood pressure and can reduce heart contractility, while Corlanor only affects heart rate. Some patients can't tolerate beta-blockers due to low blood pressure, fatigue, or breathing problems — which is exactly why Corlanor exists as an option.
When this might work: If you're not yet on a maximally tolerated beta-blocker dose, your doctor might increase your beta-blocker before adding Corlanor. If cost or availability is the issue with Corlanor, optimizing your beta-blocker is the first step.
Entresto is a combination medication called an ARNI (angiotensin receptor-neprilysin inhibitor). While it doesn't lower heart rate like Corlanor does, it's a cornerstone of modern heart failure treatment.
How it works: Entresto combines two active ingredients — Sacubitril (which prevents the breakdown of beneficial heart-protective proteins) and Valsartan (which blocks a hormone that constricts blood vessels). Together, they reduce strain on the heart and improve heart failure outcomes.
Key difference from Corlanor: Entresto doesn't directly target heart rate. It works through completely different pathways. However, if your heart failure management needs optimization, adding or adjusting Entresto might be more impactful than Corlanor for some patients.
Cost: Brand-name Entresto runs $500-$700/month, though generic Sacubitril/Valsartan became available in 2025, bringing costs down to approximately $50-$150/month with discount cards.
Empagliflozin (Jardiance) and Dapagliflozin (Farxiga) are SGLT2 inhibitors originally developed for type 2 diabetes that have shown remarkable benefits in heart failure — even in patients without diabetes.
How they work: SGLT2 inhibitors help the kidneys remove excess sugar and sodium from the body, reducing fluid overload and decreasing strain on the heart. They've been shown to reduce heart failure hospitalizations and cardiovascular death.
Key difference from Corlanor: SGLT2 inhibitors don't lower heart rate. They work through kidney and metabolic mechanisms. But they're now part of guideline-directed medical therapy (GDMT) for HFrEF and are used alongside beta-blockers and ARNIs.
Cost: Brand-name Jardiance or Farxiga runs $500-$600/month, though insurance coverage is generally good given their strong clinical evidence. Manufacturer savings programs are available.
Digoxin (Lanoxin) is one of the oldest heart medications still in use. It's a cardiac glycoside that can slow heart rate and improve the heart's pumping efficiency.
How it works: Digoxin increases the strength of heart muscle contractions and slows electrical conduction through the AV node, which reduces heart rate.
Key difference from Corlanor: Digoxin affects heart rate through a different mechanism and also increases contractility. Unlike Corlanor and beta-blockers, Digoxin has not been shown to reduce mortality in heart failure — but it can reduce hospitalizations and improve symptoms.
Important caution: Digoxin has a narrow therapeutic range, meaning the difference between a helpful dose and a toxic dose is small. It requires blood level monitoring. Side effects include nausea, vision changes, and dangerous heart rhythm problems at high levels.
Cost: Generic Digoxin is very inexpensive — typically $4-$15/month.
When this might work: Digoxin is sometimes considered when patients can't take or can't afford other options, or as an add-on therapy. It's not a first-choice replacement for Corlanor, but your doctor may consider it in certain situations.
Some medications lower heart rate but are not appropriate substitutes for Corlanor in heart failure:
If you're struggling to find or afford Corlanor, the most important step is to talk to your cardiologist about your options. They can:
Remember, heart failure treatment works best when multiple medications are used together — each targeting a different pathway. Corlanor is one piece of the puzzle, and your doctor can help you figure out the best combination for your specific situation.
While there's no exact replacement for Corlanor's unique mechanism of action, there are several effective heart failure medications that your doctor may consider. Beta-blockers remain the foundation, and newer drugs like SGLT2 inhibitors and Entresto have transformed heart failure treatment.
Before exploring alternatives, try finding Corlanor in stock using tools like Medfinder, and look into savings programs if cost is the issue. But if you do need to switch, know that you have options — and your cardiologist can guide you to the right one.
You focus on staying healthy. We'll handle the rest.
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