What Is Ivabradine? Uses, Dosage, and What You Need to Know in 2026

Ivabradine is a prescription medication used to treat heart failure with reduced ejection fraction (HFrEF). It's one of the newer additions to heart failure treatment and works through a mechanism that no other drug uses: selectively slowing the heart rate without affecting blood pressure or how forcefully the heart pumps. This overview covers everything patients and caregivers need to know about Ivabradine in plain language.

Brand Name vs. Generic

Brand name: Corlanor (made by Amgen)

Generic name: Ivabradine (also ivabradine HCl tablets)

Drug class: HCN (hyperpolarization-activated cyclic nucleotide-gated) channel blocker — first and only in its class in the US

FDA approval: April 15, 2015

Controlled substance: No — not DEA scheduled

What Is Ivabradine Used For?

Ivabradine has two FDA-approved uses:

Heart failure in adults: Reduces the risk of hospitalization for worsening heart failure in adults with stable, symptomatic chronic heart failure with left ventricular ejection fraction (LVEF) ≤35%, who are in sinus rhythm with a resting heart rate of ≥70 bpm, and are on the maximum tolerated dose of a beta-blocker (or cannot take beta-blockers).

Heart failure in children (6 months and older): Treatment of stable symptomatic heart failure due to dilated cardiomyopathy (DCM).

Off-label uses (not FDA-approved but used by some clinicians):

Inappropriate sinus tachycardia (IST) — abnormally fast heart rate without a clear cause

Postural orthostatic tachycardia syndrome (POTS) — heart rate rises dramatically when standing up

Available Dosage Forms

Tablets: 5 mg and 7.5 mg (for adults and children weighing ≥40 kg)

Oral solution: 5 mg/5 mL (1 mg/mL) in unit-dose ampules — for pediatric patients

How to Take Ivabradine

Always take with food: Food slows the absorption and reduces peak blood levels, which is important for tolerability.

Twice daily (BID): Taken morning and evening with meals.

Starting dose for adults: 5 mg twice daily (2.5 mg BID for those with conduction abnormalities or bradycardia risk).

Dose adjustments: Your doctor checks your heart rate at 2 weeks and adjusts the dose. Maximum adult dose is 7.5 mg twice daily.

Avoid grapefruit: Grapefruit and grapefruit juice inhibit the enzyme that breaks down Ivabradine and can cause dangerous blood level increases.

Who Should NOT Take Ivabradine?

Ivabradine is contraindicated (should not be used) in people with:

Acute decompensated (worsening) heart failure

Resting heart rate below 60 bpm before starting treatment

Low blood pressure (clinically significant hypotension)

Sick sinus syndrome or 3rd degree AV block (without a pacemaker)

Severe liver disease

Atrial fibrillation or flutter

Pregnancy (teratogenic — causes fetal harm in animal studies)

Concurrent use of strong CYP3A4 inhibitors (certain antibiotics, antifungals, HIV medications)

What Does Ivabradine Cost?

Without insurance (Corlanor brand): $800–$900/month at retail

Generic Ivabradine with GoodRx: As low as ~$55–$150/month

With insurance: $0–$60 copay (after PA approval)

The Bottom Line

Ivabradine is a well-tolerated, guideline-recommended medication for a specific type of heart failure patient. It's been available since 2015 and has a strong clinical evidence base. If you're curious about how it works at a mechanistic level, see How Does Ivabradine Work? Mechanism of Action Explained.