New medicines
Procoralan
 Composition: Ivabradine.
Presentation: Film-coated tablets 5mg and 7.5mg.
Action: Selective sinus node If current inhibitor.
Indication: Symptomatic treatment of chronic stable angina pectoris in
patients with normal sinus rhythm, who have a contraindication or intolerance
to beta-blockers.
Dosage: 5mg twice daily, which can be increased after three or four weeks
to 7.5mg twice daily. If the heart rate decreases persistently below
50 beats per minute at rest, or if symptoms related to bradycardia occur,
dose should be titrated down to 2.5mg twice daily and stopped if necessary.
For elderly patients a starting dose of 2.5mg twice daily should be considered.
Precautions: Atrial fibrillation or other cardiac arrhythmias that interfere
with sinus node function, second degree AV block, concomitant use with
verapamil and diltiazem, use in patients with asymptomatic left ventricular
function, heart failure patients with NYHA class II and patients with
hepatic and renal insufficiency.
Contraindications: Resting heart rate below 60 beats per minute, cardiogenic
shock, acute myocardial infarction, severe hypotension, severe hepatic
insufficiency, sick sinus syndrome, sino-atrial block, heart failure
patients with NYHA class III–IV, patients dependent on a pacemaker,
unstable angina, third degree AV block, concomitant use of QT prolonging
medicines and cytochrome P450 3A4 inhibitors.
Side effects: Very common (>1/10) luminous phenomena (transient enhanced
brightness in a limited area of the visual field). Common (>1/100; <1/10)
bradycardia, first degree AV block, ventricular extrasystoles, headache,
dizziness, blurred vision.
Legal category: POM.
Net price: 56 x 5mg £39, 56 x 7.5mg £39.
Contact details: Servier Laboratories, Gallions, Wexham Springs, Framewood
Road, Wexham SL3 6RL. Telephone 01753 662744.
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