Provider Briefing: Corlanor (Ivabradine) Availability in 2026

For cardiologists, heart failure specialists, and primary care providers managing patients on Ivabradine, pharmacy availability challenges continue to be a source of treatment disruption. This briefing covers the current supply landscape, prescribing considerations, and practical tools for ensuring your patients maintain access to this guideline-directed therapy.

Current Shortage Status and Timeline

As of early 2026, Ivabradine (Corlanor) is not listed on the FDA Drug Shortage Database. There is no active manufacturer-level supply disruption affecting production.

However, the distinction between "no official shortage" and "readily available" is meaningful in clinical practice. Patient reports of difficulty locating Ivabradine at retail pharmacies remain common. This pattern has been consistent since the drug's US launch in 2015, driven primarily by distribution logistics rather than manufacturing constraints.

Key Timeline

• 2015: FDA approval of Corlanor (brand, Amgen) for chronic heart failure
• 2019: Generic Ivabradine approved; multiple ANDA holders enter market
• 2020-2023: Gradual improvement in generic availability; intermittent reports of localized stocking gaps
• 2024-2026: Stabilized generic supply from multiple manufacturers; brand-name Corlanor continues to be available but less commonly stocked at retail

Prescribing Implications

The availability challenge with Ivabradine has several implications for prescribing practice:

Generic Substitution

Unless there is a specific clinical reason to require brand-name Corlanor, prescribing generic Ivabradine improves the likelihood that your patient's pharmacy can fill the prescription. Writing "substitution permitted" or leaving the DAW field blank facilitates this.

Generic Ivabradine is available in the same strengths as brand (5 mg and 7.5 mg tablets) and is rated as therapeutically equivalent (AB-rated) by the FDA.

Pharmacy Selection

Directing patients to pharmacies known to stock Ivabradine can prevent treatment gaps. Consider maintaining a short list of pharmacies in your area — particularly specialty pharmacies and independent pharmacies that serve your cardiology patient population — that reliably carry Ivabradine.

Mail-order pharmacy options through major PBMs generally have consistent Ivabradine availability and may offer cost advantages for 90-day supplies.

Prior Authorization Considerations

Most payers require prior authorization for Ivabradine. Key documentation points to streamline approvals:

• Documented LVEF ≤35% (echocardiogram report)
• Resting heart rate ≥70 bpm in sinus rhythm (documented in clinic notes)
• Current maximally tolerated beta-blocker therapy with specific drug and dose documented, or documented contraindication/intolerance to beta-blockers
• NYHA Class II-IV heart failure diagnosis

Having this documentation readily available can reduce PA turnaround from days to hours.

Availability Picture: Brand vs. Generic

The availability landscape breaks down as follows:

• Brand-name Corlanor (Amgen): Available but less commonly stocked at retail. AWP approximately $550-$600/month. Most patients encounter brand only through specialty pharmacy channels or specific insurance formulary requirements.
• Generic Ivabradine: Multiple manufacturers (including Alembic, Zydus, and others). More widely available at retail. Cash price $80-$250/month; with discount programs, potentially lower. Greater pharmacy willingness to stock due to lower acquisition cost.

Cost and Access Barriers

Cost remains a significant barrier to Ivabradine adherence. For your patients who are struggling:

Commercially Insured Patients

• Amgen Savings Card: Reduces Corlanor copay to as low as $10-$25/month for eligible commercially insured patients
• Discount cards (GoodRx, SingleCare, etc.): Can reduce generic Ivabradine cash price to $60-$150/month at participating pharmacies
• 90-day mail-order: Often provides per-unit cost savings

Medicare/Medicaid Patients

• Manufacturer copay cards are not valid for government insurance
• Amgen Safety Net Foundation: Provides free medication to qualifying uninsured or underinsured patients (income ≤300% FPL). Website: amgensafetynetfoundation.com
• Medicare Part D placement varies; generic typically Tier 3-4
• Extra Help/Low-Income Subsidy can significantly reduce Part D copays

For a patient-facing resource on savings, refer patients to our guide on saving money on Corlanor.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder offers a pharmacy availability search that providers and staff can use to identify nearby pharmacies stocking Ivabradine. This is particularly useful when your patient calls saying their pharmacy is out of stock — your staff can quickly search for alternatives and redirect the prescription.

Clinical Decision Support

When considering Ivabradine initiation or continuation, key clinical parameters to monitor:

• Heart rate: Target resting HR 50-60 bpm. Titrate dose at 2-week intervals.
• Starting dose: 5 mg BID (2.5 mg BID if conduction concerns or bradycardia risk)
• Maximum dose: 7.5 mg BID
• Dose reduction triggers: Resting HR <50 bpm, symptomatic bradycardia, or phosphene complaints
• Contraindication check: Concomitant strong CYP3A4 inhibitors, Diltiazem, Verapamil, acute decompensated HF, severe hepatic impairment, pregnancy

For detailed drug interaction information, see Corlanor drug interactions.

Alternative Therapy Considerations

If Ivabradine truly cannot be obtained for a patient, clinical alternatives depend on the treatment gap:

• Beta-blocker optimization: Ensure maximally tolerated dose of evidence-based beta-blocker (Metoprolol Succinate, Carvedilol, or Bisoprolol)
• GDMT optimization: Ensure patient is on ARNI (Sacubitril/Valsartan), SGLT2 inhibitor (Empagliflozin or Dapagliflozin), and MRA (Spironolactone or Eplerenone) per guidelines
• Digoxin: May provide some rate control, though without the mortality data supporting Ivabradine in HFrEF

For more on alternatives, see alternatives to Corlanor.

Looking Ahead

The Ivabradine availability picture is likely to continue improving as generic competition matures. Key developments to watch:

• Additional generic manufacturers entering the market may further reduce costs and improve retail availability
• Potential expansion of value-based insurance designs that reduce cost-sharing for evidence-based heart failure therapies
• Growing awareness among retail pharmacies of heart failure GDMT medications, driven by increased HFrEF prescribing volume

Final Thoughts

Ivabradine remains an important component of guideline-directed medical therapy for appropriate HFrEF patients. While retail availability challenges persist, they are manageable with proactive prescribing practices: favoring generic, directing patients to stocked pharmacies, maintaining PA documentation, and leveraging tools like Medfinder to identify real-time pharmacy availability.

For a complementary resource on helping patients navigate pharmacy challenges, see our provider's guide to helping patients find Corlanor.