How Does Corlanor Slow Your Heart Rate?

If your doctor has prescribed Corlanor (ivabradine) for heart failure, you might be wondering: how does it actually work? Understanding what's happening in your body can make you feel more confident about your treatment.

The short answer: Corlanor slows your heart rate by targeting the heart's natural pacemaker — and it does this without affecting your blood pressure or how strongly your heart pumps. Here's how.

What Corlanor Does in Your Body

Your heart has a built-in pacemaker called the sinoatrial (SA) node. This tiny cluster of cells generates electrical signals that tell your heart when to beat. The speed of these signals determines your heart rate.

The SA node uses special channels called HCN channels (hyperpolarization-activated cyclic nucleotide-gated channels) to control the timing of each heartbeat. These channels carry what scientists call the "funny current" or If current — named because it behaves differently from other electrical currents in the heart.

Corlanor works by selectively blocking these HCN channels. When the funny current is reduced, the SA node fires more slowly, and your heart rate decreases.

Think of it like this: if your heart's pacemaker is a metronome, Corlanor turns the dial to a slower tempo — without changing the volume or strength of each beat.

How Long Does Corlanor Take to Work?

Corlanor starts lowering your heart rate relatively quickly:

• First dose: You may notice a lower heart rate within hours of your first dose.
• Full effect: The medication reaches steady levels in your blood within about 5 days of regular dosing.
• Dose adjustment: Your doctor will check your heart rate after about 2 weeks and adjust your dose if needed.

It's important to take Corlanor twice daily with meals, as food helps your body absorb it properly. For details on dosing, see our guide on Corlanor uses and dosage.

How Long Does Corlanor Last?

Corlanor has a half-life of about 6 hours, which means it's effectively working around the clock when you take it twice daily. After you stop taking it, the effects wear off within about 1–2 days.

This is why it's important not to miss doses. If your heart rate isn't being controlled consistently, the benefits of the medication are reduced.

What Makes Corlanor Different From Other Heart Medications?

This is where Corlanor really stands out. Let's compare it to the most common heart rate-lowering medications:

Corlanor vs. Beta-Blockers

Beta-blockers (like metoprolol, carvedilol, and bisoprolol) are the first-line treatment for heart failure. They lower heart rate, but they also:

• Lower blood pressure
• Reduce how strongly the heart contracts
• Affect the lungs and airways

Corlanor only lowers heart rate. It doesn't touch blood pressure, heart strength, or the lungs. This makes it useful for patients who:

• Are already on the maximum beta-blocker dose but still have a heart rate above 70 bpm
• Can't tolerate beta-blockers due to low blood pressure, fatigue, or breathing issues

In most cases, Corlanor is added on top of a beta-blocker, not as a replacement.

Corlanor vs. Calcium Channel Blockers

Some calcium channel blockers (like diltiazem and verapamil) also slow heart rate, but they lower blood pressure and reduce heart contractility. In fact, diltiazem and verapamil are contraindicated with Corlanor because of additive effects and drug interactions. Learn more in our drug interactions guide.

Corlanor vs. Digoxin

Digoxin can slow heart rate and has been used in heart failure for decades. However, it works through a completely different mechanism (sodium-potassium pump inhibition) and does not reduce mortality or hospitalization the way Corlanor has been shown to in clinical trials.

Why Does Heart Rate Matter in Heart Failure?

You might wonder why slowing the heart rate helps with heart failure. Here's the simple explanation:

When your heart is weakened by heart failure, it tries to compensate by beating faster. But a faster heart rate actually makes things worse over time — the heart doesn't have enough time to fill with blood between beats, and it uses more oxygen and energy.

By slowing the heart rate, Corlanor gives the heart more time to fill and pump efficiently. Clinical studies have shown that this leads to fewer hospitalizations for worsening heart failure.

The Phosphene Connection

You may have heard about an unusual side effect of Corlanor: phosphenes, or brief flashes of light. This happens because HCN channels aren't only in your heart — they're also in your retina (the light-sensitive tissue in your eyes).

When Corlanor blocks HCN channels in the retina, it can briefly change how your eyes process light, causing flashes or halos. This effect is harmless and usually goes away within a few months. Read more about Corlanor side effects.

Final Thoughts

Corlanor works by selectively targeting the heart's natural pacemaker to slow your heart rate — and only your heart rate. It doesn't lower blood pressure, weaken heart contractions, or affect your lungs. This unique mechanism makes it a valuable tool for managing heart failure when beta-blockers alone aren't enough.

If you have a Corlanor prescription and need help finding it at a pharmacy, MedFinder can show you which pharmacies near you have it in stock.