Ivabradine Hydrochloride

TUESDAY, Aug. 12, 2025 -- Ivabradine lowers heart rate (HR) and relieves symptoms of postural orthostatic tachycardia syndrome (POTS), according to a study published online in the July issue of the Journal of Cardiovascular Pharmacology . Michele Marchetta, M.D., from the University of Virginia in Charlottesville, and colleagues reported the effects of HR lowering with ivabradine, a selective I f channel blocker, on symptom burden in patients with POTS. The analysis included 10 patients (average age, 28 years) with POTS. The researchers found that after ivabradine treatment, there was a significant reduction in the change in HR with standing in all patients from 40 to 15 bpm, without significant changes in blood pressure. Additionally, in all patients, the Malmö score was significantly reduced from 86 to 39. There was a correlation between change in HR with standing and the change in Malmö score (R = +0.828; R 2 quadratic = 0.635). Patients also reported improvement in "feeling faint," which decreased by 69 percent, and "chest pain," which decreased by 66 percent. "The mechanisms controlling heart rate with standing appear to be dysfunctional, leading to an excessive increase in heart rate, which is in turn sensed by the brain as a 'danger' signal leading to further release of stress hormone, norepinephrine, and to symptoms that resemble anxiety and panic attacks," coauthor Antonio Abbate, M.D., Ph.D., also from University of Virginia, said in a statement. "When the heart rate is controlled with ivabradine, the loop is inhibited, and patients feel better." One author disclosed ties to Kiniksa, Monterosa Tx, and Novo Nordisk. Abstract/Full Text (subscription or payment may be required)

WEDNESDAY, Aug. 6, 2025 — Some people find that when they stand, their hearts tend to race and they get dizzy and lightheaded. This is due to a rare condition called postural orthostatic tachycardia syndrome , or POTS – and doctors think they’ve found a potential treatment. An established heart failure drug called ivabradine appears to provide lasting relief for people suffering from POTS, according to results from a pilot study. The drug kept POTS patients’ hearts from racing and significantly improved other symptoms while not affecting their overall blood pressure, researchers recently reported in the Journal of Cardiovascular Pharmacology . “These data suggest that the inappropriate increase in heart rate is exactly why patients feel sick, and that reducing the heart rate with a medication that does not affect blood pressure can make a difference in the quality of life,” senior researcher Dr. Antonio Abbate , a cardiologist at University of Virginia Health, said in a news release. POTS is rare, affecting 1% or less of the general population, but it’s become a hot topic on TikTok and other social media, researchers said in background notes. Many patients complain they have trouble getting a diagnosis, because it’s still not clear exactly what causes POTS, researchers said. “Patients go doctor to doctor because the primary care may not be familiar or know what to do. The cardiologist thinks it is not a heart problem – and it indeed it is not,” Abbate said. “The neurologist says there is no issue with the brain – and indeed there isn’t. It's really a ‘software’ problem rather than a ‘hardware’ issue.” Ivabradine ( Corlanor ) is used to prevent heart failure from growing worse. The drug affects the heart’s electrical activity, slowing the heart rate. Given that POTS’ chief feature is a surging heart rate, researchers suspected that ivabradine might be able to help some with the condition. The team gave ivabradine to 10 patients with POTS. The patients’ average age was 28, and 8 of the 10 were women. Results showed that patients given ivabradine had better heart-rate control after they stood up. Prior to treatment with the drug, their heart rates jumped by an average of 40 beats per minute when they stood. After taking ivabradine, the increase was only 15 beats per minute. There also was a 69% decrease in feeling faint and 66% decrease in chest pain, participants reported. This overall improvement suggests that the surging heart rate drives the other symptoms of POTS, researchers said. They suspect that standing might trigger in POTS patients an excessive release of the “fight or flight” hormone norephinephrine, which causes the heart to race. “The mechanisms controlling heart rate with standing appear to be dysfunctional, leading to an excessive increase in heart rate, which is in turn sensed by the brain as a ‘danger’ signal leading to further release of stress hormone, norepinephrine, and to symptoms that resemble anxiety and panic attacks,” Abbate said. “When the heart rate is controlled with ivabradine, the loop is inhibited and patients feel better.” However, more research is needed to confirm these findings and better understand the causes of POTS, researchers said. “Once considered to be purely a compensatory mechanism secondary to low blood pressure, the high heart rate may itself be responsible for the symptoms,” Abbate said. “A better understanding on how heart rate is regulated and how it can affect symptoms may lead to better treatments for patients with POTS.” Sources University of Virginia, news release, July 31, 2025