Ivabradine and metoprolol in fixed dose combination: When, why and how to use it

• Published in: Pharmacological research Vol. 146; p. 104279
• Main Authors: Katsi, V., Skalis, G., Kallistratos, M.S., Tsioufis, K., Makris, T., Manolis, A.J., Tousoulis, D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.08.2019
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Animals; Cardiovascular Agents - therapeutic use; Coronary Artery Disease - drug therapy; Drug Combinations; Fixed dose combination; Heart Rate - drug effects; Humans; Ivabradine; Ivabradine - therapeutic use; Metoprolol; Metoprolol - therapeutic use; Stable angina; Fixed dose combination; Metoprolol; Ivabradine; Stable angina
• ISSN: 1043-6618; 1096-1186
• DOI: 10.1016/j.phrs.2019.104279

[Display omitted] Heart rate is an important factor in coronary artery disease and its manifestations, and as such has been considered as a possible target for therapy. Although in epidemiological, and in less degree, in clinical studies derived indications of a possible pathogenetic role of heart rate in major cardiac diseases, clinical trials did not provided any strong evidence. However, even as a simple risk marker, remains important in the treatment of coronary artery disease and heart failure. Beta-blockers are the drugs most frequently used for heart rate control. However, recent studies constantly find insufficient effectiveness of beta-blockers in heart rate control and go further to question their efficacy on outcomes, making clear the need for an additional therapy. Ivabradine, a pure heart rate inhibitor, added to classic beta-blocker treatment represent the new therapeutic option in stable coronary disease and heart failure.