Lancora, known generically as ivabradine, is a medication used primarily for the treatment of chronic heart failure and to reduce the risk of hospitalization due to worsening heart failure in patients with stable symptomatic heart failure and a resting heart rate of at least 70 beats per minute. It can also be prescribed for patients with chronic stable angina who are unable to take beta-blockers. Lancora works by selectively inhibiting the If (funny) current in the sinoatrial node, leading to a reduction in heart rate without affecting myocardial contractility or blood pressure.

Lancora exerts its effects by inhibiting the If current in the sinoatrial node, which is responsible for regulating heart rate. This current is termed “funny” due to its unusual properties compared to other ionic currents in the heart. By blocking this current, Lancora reduces the pacemaker activity, leading to a slower heart rate. This reduction in heart rate allows the heart to pump more efficiently and with less oxygen demand, thereby improving symptoms of heart failure and reducing episodes of angina. Unlike beta-blockers, ivabradine specifically targets heart rate without impacting the force of contraction or systemic blood pressure, making it a unique therapeutic option for patients who are intolerant to or have contraindications for beta-blockers.

Precautions and Warnings with Lancora

Use of Lancora comes with several precautions and warnings. Patients should be aware of the following potential adverse reactions and effects of taking Lancora:

  • Bradycardia: Lancora can cause bradycardia (slowed heart rate). Patients should be monitored for symptoms of bradycardia, such as dizziness, fatigue, and syncope. Dose adjustments may be necessary.
  • Atrial Fibrillation: There is an increased risk of developing atrial fibrillation. Patients should be monitored for signs and symptoms of atrial fibrillation and seek medical attention if they experience palpitations or irregular heartbeat.
  • Visual Disturbances: Lancora may cause transient visual disturbances, mainly luminous phenomena (phosphenes). Patients should be advised about the possibility of experiencing visual symptoms, especially when there are sudden changes in light intensity.
  • Pregnancy and Breastfeeding: Lancora is not recommended during pregnancy and breastfeeding. Women of childbearing potential should use effective contraception while taking Lancora.
  • Hepatic and Renal Impairment: Caution is advised in patients with severe hepatic or renal impairment, and dosage adjustments may be required.

Lancora Side Effects

Patients should report any persistent or severe side effects to their healthcare provider. Monitoring and dose adjustments may be necessary to manage side effects effectively. The following common side effects may occur so ensure to exercise caution if these symptoms persist.

  • Reduced Heart Rate: Patients may experience a significantly reduced heart rate, which can lead to symptoms such as dizziness, fatigue, and light-headedness.
  • Visual Sensations: Luminous phenomena or phosphenes, which are transient visual sensations of enhanced brightness, particularly in conditions of sudden changes in light intensity.
  • Headache: Some patients may experience headaches, which can vary in intensity and duration.
  • Dizziness: Episodes of dizziness, which may affect balance and coordination, particularly when standing up quickly.
  • Fatigue: General feelings of tiredness and lack of energy can occur, impacting daily activities.

Drug Interactions with Lancora

Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs and herbal supplements, to avoid potential interactions and ensure safe use of Lancora.

Lancora may interact with various medications, including:

  • CYP3A4 Inhibitors: Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) can increase ivabradine levels and the risk of bradycardia. Concomitant use is not recommended.
  • CYP3A4 Inducers: Strong CYP3A4 inducers (e.g., rifampicin, phenytoin) can decrease ivabradine levels and reduce its efficacy. Dose adjustments may be necessary.
  • Calcium Channel Blockers: Diltiazem and verapamil, which also lower heart rate, should not be used concurrently with Lancora as they can increase the risk of bradycardia.
  • Beta-blockers: Concomitant use with beta-blockers can enhance the heart rate-lowering effects, necessitating careful monitoring and potential dose adjustments.
  • QT Prolonging Drugs: Medications that prolong the QT interval should be used with caution, as Lancora may increase the risk of arrhythmias.

Strengths and Dosages of Lancora

Dosage may vary depending on the patient’s medical history and response to treatment. It is typically taken once daily, with or without food. Patients should follow their healthcare provider’s instructions regarding dosage and frequency.

Strength (Overall Dosage)Recommended Dosage
5 mg2x daily
7.5 mg2x daily

The initial recommended dose of Lancora is usually 5 mg twice daily, which can be adjusted based on the patient’s heart rate and tolerance. The maintenance dose ranges from 5 mg to 7.5 mg twice daily. Dosage adjustments should be made based on resting heart rate and clinical response, with the goal of maintaining a heart rate between 50 to 60 beats per minute.

Cost of Lancora in America

The cost of Lancora in America varies depending on factors such as dosage strength, quantity, and insurance coverage. As of 2024, the average retail price for a 30-day supply of Lancora (5 mg or 7.5 mg tablets) ranges from $150 to $300. Patients are encouraged to consult their healthcare provider or pharmacist for the most accurate pricing information and to explore potential insurance coverage or assistance programs.

Lancora Alternatives

Alternative medications to Lancora for heart rate control and heart failure management include beta-blockers (e.g., metoprolol, carvedilol), calcium channel blockers (e.g., diltiazem, verapamil), and other heart failure medications such as ACE inhibitors (e.g., enalapril, lisinopril), ARBs (e.g., losartan, valsartan), and aldosterone antagonists (e.g., spironolactone). Beta-blockers are often the first-line treatment for reducing heart rate and managing heart failure symptoms. Calcium channel blockers can be used for patients with contraindications to beta-blockers. Each alternative has its own mechanism of action, efficacy, and safety profile. Patients should discuss with their healthcare provider to determine the most suitable treatment based on their medical history, individual needs, and cost considerations.

Frequently Asked Questions About Lancora

Can Lancora be taken with food?

Yes, Lancora can be taken with or without food. It is important to take it consistently with regard to meals and as directed by your healthcare provider.

What should I do if I miss a dose of Lancora?

If you miss a dose of Lancora, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for a missed one.

Is Lancora safe to use during pregnancy or breastfeeding?

Lancora is not recommended during pregnancy or breastfeeding. Women of childbearing potential should use effective contraception while taking Lancora. Pregnant or breastfeeding women should discuss alternative treatment options with their healthcare provider.

Can Lancora cause allergic reactions?

While allergic reactions to Lancora are rare, patients should seek immediate medical attention if they experience symptoms such as rash, itching, swelling, or difficulty breathing.

Is regular monitoring required while taking Lancora?

Regular monitoring of heart rate and symptoms is recommended while taking Lancora, especially during dose adjustments. Your healthcare provider will advise you on the appropriate monitoring schedule.

Can Lancora be taken with other heart medications?

Yes, Lancora can be taken with other heart medications, but it is important to inform your healthcare provider about all the medications you are taking to avoid potential interactions and ensure safe use.

What should I do if I experience severe side effects from Lancora?

If you experience severe side effects, such as significant bradycardia, unexplained muscle pain, or symptoms of an allergic reaction, seek immediate medical attention. Consult your healthcare provider for any persistent or concerning symptoms to ensure appropriate management and adjustments to your treatment plan.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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