natgillin/translations-raw huggingface dataset:
itraconazole), macrolide antibiotics (such as josamycin, clarithromycin, telithromycin or erythromycin given orally), medicines to treat HIV infections (such as nelfinavir, ritonavir) or nefazodone (medicine to treat depression) or diltiazem, verapamil (used for high blood pressure or angina pectoris); - if you are a woman able to have children and not using reliable contraception; - if you are pregnant or trying to become pregnant; - if you are breast-feeding. 
makrolidne antibiotike (kao što su jozamicin, klaritromicin, telitromicin ili eritromicin koji se primjenjuju oralno), lijekove za liječenje infekcija HIV-om (kao što su nelfinavir, ritonavir) ili nefazodon (lijek za liječenje depresije) ili diltiazem, verapamil (za liječenje visokog krvnog tlaka ili angine pektoris); - ako ste žena koja može zatrudnijeti te ne koristite pouzdanu kontracepciju; - ako ste trudni ili pokušavate zatrudnijeti; - ako dojite.
In a 889-patients randomised placebo-controlled study, ivabradine given on top of atenolol 50 mg o.d. showed additional efficacy on all ETT parameters at the trough of drug activity (12 hours after oral intake). 
U randomiziranom, placebom kontroliranom ispitivanju na 889 bolesnika primjena ivabradina uz postojeću primjenu atenolola u dozi od 50 mg pokazao je dodatnu djelotvornost na sve parametre u testu opterećenja u donjoj točci djelovanja lijeka (12 sati nakon uzimanja peroralno).
If you are being treated for stable angina pectoris 
Ukoliko se liječite od stabilne angine pektoris
Ivabradine was shown not to influence the metabolism and plasma concentrations of other CYP3A4 substrates (mild, moderate and strong inhibitors). 
Pokazalo se da ivabradin ne utječe na metabolizam i plazmatske koncentracije drugih CYP3A4 supstrata (blagi, umjereni i jaki inhibitori).
Corlentor with food and drink Avoid grapefruit juice during treatment with Corlentor. 
Tijekom liječenja s Corlentorom izbjegavajte konzumiranje soka od grejpa..
Concomitant use of ivabradine with heart rate reducing calcium channel blockers such as verapamil or diltiazem is contraindicated (see sections 4.3 and 4.5). 
Kontraindicirana je istodobna primjena s blokatorima kalcijevih kanala koji usporavaju srčanu frekvenciju, kao što su verapamil ili diltiazem (vidjeti dijelove 4.3 i 4.5).
The following adverse reactions have been reported during clinical trials and are ranked using the following frequency: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); not known (cannot be estimated from the available data). 
Tijekom kliničkih ispitivanja zabilježene su slijedeće nuspojave, a prema učestalosti razvrstane su na sljedeći način: vrlo često (≥1/10); često (≥1/100 do <1/10); manje često (≥1/1000 do <1/100); rijetko
Given that the heart rate may fluctuate considerably over time, serial heart rate measurements, ECG or ambulatory 24-hour monitoring should be considered when determining resting heart rate before initiation of ivabradine treatment and in patients on treatment with ivabradine when titration is considered. 
Budući da srčana frekvencija može značajno flukturirati tijekom vremena, mora se razmotriti provođenje serijskog mjerenja srčane frekvencije, putem EKG-a ili ambulantno 24-satno mjerenje, prije početka liječenja ivabradinom kao i u bolesnika koji uzimaju ivabradin kada se razmatra titriranje doze.
Symptomatic treatment of chronic stable angina pectoris 
Simptomatsko liječenje kronične stabilne angine pektoris
It is recommended that the decision to initiate or titrate treatment takes place with the availability of serial heart rate measurements, ECG or ambulatory 24-hour monitoring. 
Preporučeno je da se odluka o početku liječenja ili titriranju doze temelji na serijskom mjerenju srčane frekvencije putem EKG-a ili 24-satnog ambulantnog mjerenja.
The SHIFT study was a large multicentre, international, randomised double-blind placebo controlled outcome trial conducted in 6505 adult patients with stable chronic CHF (for ≥ 4 weeks), NYHA class II to IV, with a reduced left ventricular ejection fraction (LVEF ≤ 35%) and a resting heart rate ≥ 70 bpm. 
Ispitivanje SHIFT, veliko multicentrično, međunarodno, randomizirano, dvostruko slijepo, placebo kontrolirano ispitivanje ishoda, provedeno je na 6505 odraslih bolesnika sa stabilnim kroničnim zatajenjem srca (s trajanjem ≥ 4 tjedana), NYHA stupanj II-IV, sa smanjenom ejekcijskom frakcijom lijeve klijetke (LVEF ≤ 35%) i srčanom frekvencijom u mirovanju ≥ 70/min.
- Renal impairment: the impact of renal impairment (creatinine clearance from 15 to 60 ml/min) on ivabradine pharmacokinetic is minimal, in relation with the low contribution of renal clearance (about 20 %) to total elimination for both ivabradine and its main metabolite S 18982 (see section 
- Oštećenje bubrega: utjecaj oštećenja bubrega (klirens kreatinina od 15 do 60 ml/min) na farmakokinetiku ivabradina je minimalan, srazmjeran niskom doprinosu renalnog klirensa (oko 20%) ukupnoj eliminaciji i ivabridina i njegovog glavnog metabolita
Ivabradine influences on retinal function (see section 5.1). 
Ivabradin utječe na funkciju mrežnice (vidjeti dio 5.1).
Therefore, ivabradine is contra-indicated during pregnancy (see section 4.3). 
Stoga je ivabradin kontraindiciran tijekom trudnoće (vidjeti dio 4.3).
In a 725-patients randomised placebo-controlled study, ivabradine did not show additional efficacy on top of amlodipine at the trough of drug activity (12 hours after oral intake) while an additional efficacy was shown at peak (3-4 hours after oral intake). 
U randomiziranom, placebom kontroliranom ispitivanju na 725 bolesnika pokazalo se da ivabradin nema dodatne djelotvornosti povrh aktivnosti amlodipina pri najnižoj koncentraciji lijeka (12 sati nakon uzimanja peroralno), dok je u vršnoj koncentraciji uočena dodatna djelotvornost (3-4 sata nakon uzimanja peroralno).
In particular, the additional benefit over 5 mg twice daily was established in a reference-controlled study versus atenolol: total exercise duration at trough was increased by about 1 minute after one month of treatment with 5 mg twice daily and further improved by almost 25 seconds after an additional 3-month period with forced titration to 7.5 mg twice daily. 
Napose, dodatna je prednost pred dozom od 5 mg dva puta na dan utvrđena u referentnoj kontroliranoj studiji u odnosu na atenolol: ukupno trajanje fizičkog opterećenja u donjoj točci povećano je za oko 1 minutu nakon mjesec dana liječenja s dozom od 5 mg dva puta na dan, te se i dalje popravljalo za gotovo 25 sekundi nakon dodatnog tromjesečnog razdoblja s ubrzanom titracijom na 7,5 mg dva puta na dan.
In the event of bradycardia with poor haemodynamic tolerance, symptomatic treatment including intravenous betastimulating medicinal products such as isoprenaline may be considered. 
U slučaju bradikardije sa slabom hemodinamskom tolerancijom, može se razmotriti mogućnost simptomatskog liječenja koje uključuje intravensku primjenu stimulatora betaadrenergičnih receptora, kao što je izoprenalin.
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION Date of first authorisation: 25/10/2005 
Datum prvog odobrenja: 25/10/2005
The main pharmacodynamic property of ivabradine in humans is a specific dose dependent reduction in heart rate. 
U ljudi je glavna farmakodinamička osobina ivabradina specifično usporavanje srčane frekvencije koje ovisi o dozi.
Ivabradine is extensively metabolised by the liver and the gut by oxidation through cytochrome P450 3A4 (CYP3A4) only. 
Ivabradin se u velikoj mjeri metabolizira u jetri i crijevu oksidacijom samo putem citokroma P450 3A4 (CYP3A4).
In some cases (e.g. if you are elderly), your doctor may prescribe half the dose i.e., one half 5 mg tablet of Corlentor 5 mg (corresponding to 2.5 mg ivabradine) in the morning and one half 5 mg tablet in the evening. 
U nekim slučajevima (npr. kod starijih osoba) postoji mogućnost da Vam liječnik propiše pola doze, t.j. polovicu tablete od Corlentora 5 mg (što odgovara količini od 2,5 mg ivabradina) ujutro, a drugu polovicu tablete od 5 mg uvečer.
INFORMATION IN BRAILLE CORLENTOR 7.5 mg 
16. PODACI NA BRAILLEOVOM PISMU CORLENTOR 7,5 mg
Annopol 6B - 03-236 Warszawa, Poland Laboratorios Servier, S.L, Avda. 
Annopol 6B - 03-236 Varšava, Poljska Laboratorios Servier, S.L, Avda. de los Madroños, 33 -28043 Madrid, Španjolska
About chronic heart failure : 
O kroničnom zatajenju srca:
In a post-hoc subgroup of patients with symptomatic angina at randomisation (n=1507), no safety signal was identified regarding cardiovascular death, hospitalization for acute MI or heart failure (ivabradine 12.0% versus placebo 15.5%, p=0.05). 
U post-hoc analizi podskupine bolesnika sa simptomatskom anginom pri randomizaciji (n=1507), sigurnost bolesnika nije bila ugrožena glede kardiovaskularne smrtnosti, hospitalizacije zbog akutnog infarkta miokarda ili srčanog popuštanja (ivabradin 12,0% u usporedbi s placebom 15,5%, p=0,005).
INFORMATION IN BRAILLE CORLENTOR 5 mg 
16. PODACI NA BRAILLEOVOM PISMU CORLENTOR 5 mg
- CYP3A4 inducers: CYP3A4 inducers (e.g. rifampicin, barbiturates, phenytoin, Hypericum perforatum [St John's Wort]) may decrease ivabradine exposure and activity. 
- CYP3A4 induktori: CYP3A4 induktori (npr. rifampicin, barbiturati, fenitoin, Hypericum perforatum [Gospina trava]) mogu smanjiti koncentraciju i djelovanje ivabradina.
In the SHIFT trial more patients experienced episodes of increased blood pressure while treated with ivabradine (7.1%) compared to patients treated with placebo (6.1%). 
U ispitivanju SHIFT veći broj bolesnika liječenih ivabradinom doživjelo je epizode povišenog krvnog tlaka (7,1%) u usporedbi sa placebom (6,1%).
Lack of benefit on clinical outcomes in patients with symptomatic chronic stable angina pectoris Ivabradine is indicated only for symptomatic treatment of chronic stable angina pectoris because ivabradine has no benefits on cardiovascular outcomes (e.g. myocardial infarction or cardiovascular death ) (see section 5.1). 
Nedostatak koristi kod kliničkih ishoda u bolesnika sa simptomima kronične stabilne angine pektoris Ivabradin je indiciran samo za simptomatsko liječenje kronične stabilne angine pektoris jer nema koristi kod kardiovaskularnih ishoda (npr. infarkt miokarda ili kardiovaskularna smrtnost) (vidjeti dio 5.1).
Specific drug-drug interaction studies have shown no clinically significant effect of the following medicinal products on pharmacokinetics and pharmacodynamics of ivabradine: proton pump inhibitors (omeprazole, lansoprazole), sildenafil, HMG CoA reductase inhibitors (simvastatin), dihydropyridine calcium channel blockers (amlodipine, lacidipine), digoxin and warfarin. 
Ispitivanja specifičnih interakcija između dva lijeka pokazala su da slijedeći lijekovi nemaju klinički značajan učinak na farmakokinetiku i farmakodinamiku ivabradina: blokatori protonske pumpe (omeprazol, lanzoprazol), sildenafil, inhibitori HMG CoA reduktaze (simvastatin), dihidropiridinski blokatori kalcijevih kanala (amlodipin, lacidipin), digoksin i varfarin.
Ivabradine is a pure heart rate lowering agent, acting by selective and specific inhibition of the cardiac pacemaker If current that controls the spontaneous diastolic depolarisation in the sinus node and regulates heart rate. 
Ivabradin je lijek za usporavanje srčane frekvencije, koji djeluje selektivnom i specifičnom inhibicijom If struje predvodnika srčanog ritma, koji regulira spontanu dijastoličku depolarizaciju u sinusnom čvoru i regulira frekvenciju srca.
METHOD AND ROUTE(S) OF ADMINISTRATION Read the package leaflet before use. 
NAČIN I PUT(EVI) PRIMJENE LIJEKA Prije uporabe pročitati Uputu o lijeku.
mefloquine, halofantrine, pentamidine, cisapride, intravenous erythromycin). 
pentamidin, cisaprid, intravenski eritromicin).
Ivabradine is metabolised by CYP3A4 only and it is a very weak inhibitor of this cytochrome. 
Ivabradin se metabolizira jedino citokromom CYP3A4 i vrlo je slab inhibitor toga citokroma.
In addition there was no clinically significant effect of ivabradine on the pharmacokinetics of simvastatin, amlodipine, lacidipine, on the pharmacokinetics and pharmacodynamics of digoxin, warfarin and on the pharmacodynamics of aspirin. 
Ivabradin nije imao klinički značajan učinak na farmakokinetiku simvastatina, amlodipina, lacidipina, na farmakokinetiku i farmakodinamiku digoksina, varfarina te na farmakodinamiku aspirina.
Do not take Corlentor if you are breast-feeding (see “Do not take Corlentor”). 
Ne uzimajte Corlentor ako dojite (vidjeti “Nemojte uzimati Corlentor”).
Moderate CYP3A4 inhibitors: specific interaction studies in healthy volunteers and patients have shown that the combination of ivabradine with the heart rate reducing agents diltiazem or verapamil resulted in an increase in ivabradine exposure (2 to 3 fold increase in AUC) and an additional heart rate reduction of 5 bpm. 
Umjereni CYP3A4 inhibitori: ispitivanja specifičnih interakcija na zdravim dobrovoljcima i bolesnicima pokazala su da je kombinacija ivabradina s diltiazemom ili verapamilom (lijekovima koji usporavaju srčanu frekvenciju) uzrokovala povećanje koncentracije ivabradina (dvostruko do trostruko povećanje
The main efficacy criterion was the composite of cardiovascular death or non-fatal MI. 
Glavni kriterij djelotvornosti bio je skup kardiovaskularnih smrtnosti ili nefatalni infarkt miokarda.
(see section 5.1) 
(vidjeti dio 4.4).
Cardiac arrhythmias 
Kardiogeni šok
For the different doses, film-coated tablets containing 5 mg and 7.5 mg ivabradine are available. 
Doziranje Za različite doze dostupne su filmom obložene tablete koje sadržavaju 5 mg i 7,5 mg ivabradina.
These data are consistent with the pharmacological effect of ivabradine related to its interaction with hyperpolarisation-activated Ih currents in the retina, which share extensive homology with the cardiac pacemaker If current. 
Ti se podaci slažu s farmakološkim učinkom ivabradina, koji se odnosi na njegovu interakciju s Ih strujama aktiviranim hiperpolarizacijom u mrežnici, koje se u velikoj mjeri podudaraju sa If strujom srčanog predvodnika.
The major active metabolite is the N-desmethylated derivative (S 18982) with an exposure about 40% of that of the parent compound. 
N-desmetilirani derivat (S 18982) s koncentracijom oko 40% koncentracije roditeljske tvari.
The average plasma concentration is 10 ng/ml (CV=38%) at steady-state. 
Prosječna je koncentracija u plazmi u stanju dinamičke ravnoteže 10 ng/ml (CV=38%).
A large outcome study, SIGNIFY, was performed in 19102 patients with coronary artery disease and without clinical heart failure (LVEF > 40%), on top of optimal background therapy. 
Veliko ispitivanje ishoda, SIGNIFY, provedeno je u 19102 bolesnika s koronarnom arterijskom bolešću bez kliničkih znakova zatajenja srca (LVEF <40%) uz optimalnu osnovnuterapiju.
The combination of ivabradine 10 mg twice daily with St John's Wort was shown to reduce ivabradine AUC by half. 
Pokazalo se da se kombinacijom ivabradina u dozi od 10 mg dva puta na dan s Gospinom travom, AUC ivabradina smanjuje za pola.
Rare: Urticaria, itching, skin reddening, feeling unwell. 
Urtikarija (koprivnjača), svrbež, crvenilo kože, opće loše osjećanje.
In pivotal phase III clinical trials the following medicinal products were routinely combined with ivabradine with no evidence of safety concerns: angiotensin converting enzyme inhibitors, angiotensin II antagonists, beta-blockers, diuretics, anti-aldosterone agents, short and long acting nitrates, HMG CoA reductase inhibitors, fibrates, proton pump inhibitors, oral antidiabetics, aspirin and other antiplatelet medicinal products. 
U kliničkim ispitivanjima faze III, slijedeći lijekovi su rutinski primjenjivani s ivabradinom bez štetnih utjecaja: inhibitori konvertaze angiotenzina, antagonisti angiotenzina II, diuretici, nitrati brzog i dugog djelovanja, inhibitori HMG CoA reduktaze, fibrati, blokatori protonske pumpe, oralni antidijabetici, aspirin i antikoagulansi.
A drug utilisation study conducted in several EEA countries aimed at describing the characteristics of ivabradine users, as well as describing the patterns of use of ivabradine, and adherence to the risk minimisation measures. 
Ispitivanje praćenja primjene lijeka u nekoliko država EGP-a s ciljem da se opišu osobine bolesnika koji koriste ivabradin, kao i obrasci primjene ivabradina te lipanj 2018.
The concomitant use of cardiovascular and non cardiovascular QT prolonging medicinal products with ivabradine should be avoided since QT prolongation may be exacerbated by heart rate reduction. 
Potrebno je izbjegavati istodobnu primjenu ivabradina i kardiovaskularnih i ostalih lijekova koji produljuju QT-interval jer se QT-prolongacija može pogoršati uslijed usporenja srčane frekvencije.
A MANUFACTURERS RESPONSIBLE FOR BATCH RELEASE Name and address of the manufacturers responsible for batch release Les Laboratoires Servier Industrie, 905, route de Saran - 45520 Gidy, France Servier (Ireland) Industries Ltd, Gorey Road - Arklow - Co. Wicklow, Ireland Przedsiebiorstwo Farmaceutyczne ANPHARM S.A., ul. 
Les Laboratoires Servier Industrie, 905, route de Saran - 45520 Gidy, Francuska Servier (Ireland) Industries Ltd, Gorey Road - Arklow - Co.
A small statistically significant increase in the PCE was observed in a pre-specified subgroup of patients with angina patients in CCS class II or higher at baseline (n=12049) (annual rates 3.4% versus 2.9%, relative risk ivabradine/placebo 1.18, p=0.018), but not in the subgroup of the overall angina population in CCS class ≥ I (n=14286) (relative risk ivabradine/placebo 1.11, p=0.110). 
Mali, ali statistički značajan porast u PCE zabilježen je u prethodno definiranoj podskupini bolesnika s početno utvrđenom anginom pektoris CCS klase II ili više (n = 12 049) (godišnje stope 3,4% naspram 2,9%, relativni rizik ivabradin/placebo 1,18, p= 0,018), ali ne u podskupini sveukupne populacije bolesnika s anginom pektoris CCS klase ≥I (n = 14 286) (relativni rizik ivabradin/placebo 1,11, p=0,110).
Analysis of heart rate reduction with doses up to 20 mg twice daily indicates a trend towards a plateau effect which is consistent with a reduced risk of severe bradycardia below 40 bpm (see section 4.8). 
Analiza usporenja srčane frekvencije s dozama do 20 mg dva puta na dan, ukazuje na postojanje trenda prema plato učinku, što se slaže sa smanjenim rizikom od teške bradikardije s manje od
The study demonstrated a clinically and statistically significant relative risk reduction of 18% in the rate of the primary composite endpoint of cardiovascular mortality and hospitalisation for worsening heart failure (hazard ratio: 0.82, 95%CI [0.75;0.90] - p<0.0001) apparent within 3 months of initiation of treatment. 
Ovo ispitivanje pokazalo je klinički i statistički značajno smanjenje relativnog rizika od 18% za primarni kompozitni ishod: kardiovaskularna smrtnost i hospitalizacija zbog pogoršanja zatajenja srca (omjer ugroženosti (HR): 0.82, 95%CI [0.75;0.90] - p<0.0001), a što je postalo očito unutar prva 3 mjeseca od početka liječenja.
MARKETING AUTHORISATION NUMBER(S) EU/1/05/317/008-014 
BROJ(EVI) ODOBRENJA ZA STAVLJANJE LIJEKA U PROMET EU/1/05/317/008-014
Treatment of chronic heart failure Ivabradine is indicated in chronic heart failure NYHA II to IV class with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ≥ 75 bpm, in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contraindicated or not tolerated. 
Ivabradin je indiciran u kroničnom zatajenju srca stupnja II do IV NYHA klasifikacije sa sistoličkom disfunkcijom, u bolesnika u sinusnom ritmu sa srčanom frekvencijom ≥ 75 otkucaja u minuti u kombinaciji sa standardnom terapijom uključujući terapiju s beta-blokatorom ili kada je primjena beta blokatora kontraindicirana ili se ne podnosi (vidjeti dio 5.1).
Treatment with ivabradine was associated with an average reduction in heart rate of 15 bpm from a baseline value of 80 bpm. 
Liječenje s ivabradinom je povezano s prosječnim smanjenjem srčane frekvencije za 15 otkucaja u minuti od početnih 80 otkucaja u minuti.
After three to four weeks of treatment, if the patient is still symptomatic, if the initial dose is well tolerated and if resting heart rate remains above 60 bpm, the dose may be increased to the next higher dose in patients receiving 2.5 mg twice daily or 5 mg twice daily. 
Nakon tri do četiri tjedna liječenja, ukoliko su u bolesnika još uvijek prisutni simptomi, ukoliko se početna doza dobro podnosi i ako srčana frekvencija u mirovanju ostaje iznad 60 otkucaja u minuti, doza se može povećati na slijedeću višu dozu u bolesnika koji uzimaju 2,5 mg dva puta na dan ili 5 mg dva puta na dan.
The concomitant use of potent CYP3A4 inhibitors such as azole antifungals (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin per os, josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone is contra-indicated (see section 4.3). 
Istodobna primjena jakih CYP3A4 inhibitora kao što su azolni antimikotici (ketokonazol, itrakonazol), makrolidni antibiotici (klaritromicin, eritromicin per os, jozamicin, telitromicin), inhibitori proteaze HIVa (nelfinavir, ritonavir) i nefazodona je kontraindicirana (vidjeti dio 4.3).
No dose adjustment is required in patients with renal insufficiency and creatinine clearance above 15 ml/min (see section 5.2). 
U bolesnika s oštećenjem funkcije bubrega i klirensom kreatinina iznad 15 ml/min nije potrebno prilagođavati dozu (vidjeti dio 5.2).
If heart rate is between 50 and 60 bpm, the dose of 5 mg twice daily should be maintained. 
Ukoliko je srčana frekvencija između 50 i 60 otkucaja u minuti, potrebno je održavati dozu od 5 mg dva puta na dan.
They particularly occur within the first 2 to 3 months of treatment initiation. 
Osobito se javljaju unutar prva 2 ili 3
The maintenance dose should not exceed 7.5 mg twice daily. 
Doza održavanja ne smije prelaziti 7,5 mg dva puta na dan.
NAME OF THE MARKETING AUTHORISATION HOLDER Les Laboratoires Servier 
ODOBRENJA ZA STAVLJANJE LIJEKA U PROMET Les Laboratoires Servier
Treatment must be discontinued if heart rate remains below 50 bpm or symptoms of bradycardia persist (see section 4.4). 
Liječenje se mora prekinuti ako je srčana frekvencija sporija od 50/min ili simptomi bradikardije ustraju (vidjeti dio 4.4).
Treatment of chronic heart failure 
Liječenje kroničnog zatajenja srca
After two weeks of treatment, the dose can be increased to 7.5 mg twice daily if resting heart rate is persistently above 60 bpm or decreased to 2.5 mg twice daily (one half 5 mg tablet twice daily) if resting heart rate is persistently below 50 bpm or in case of symptoms related to bradycardia such as dizziness, fatigue or hypotension. 
Doza se nakon dva tjedna liječenja može povećati na 7,5 mg dva puta na dan ukoliko je srčana frekvencija u mirovanju stalno iznad 60 otkucaja u minuti ili smanjiti na 2,5 mg dva puta na dan (polovica tablete od 5 mg dva puta dnevno) ukoliko je srčana frekvencija u mirovanju stalno ispod 50 otkucaja u minuti ili nastupe simptomi koji su povezani s bradikardijom, kao što su omaglica, umor ili hipotenzija.
A sustained reduction of heart rate was demonstrated in patients treated with ivabradine for at least one year (n = 713). 
U bolesnika liječenih ivabradinom najmanje godinu dana, pokazalo se produljeno smanjenje srčane frekvencije (n=713).
The antianginal and anti-ischaemic effects of ivabradine were associated with dose-dependent reductions in heart rate and with a significant decrease in rate pressure product (heart rate x systolic blood pressure) at rest and during exercise. 
Antianginalni i antiishemijski učinci ivabradina bili su povezani s usporenjem srčane frekvencije, koje je ovisilo o dozi, te sa značajnim smanjenjem umnoška frekvencije i sistoličkog krvnog tlaka u mirovanju i tijekom fizičkog napora.
Ivabradine must not be initiated in patients with a pre-treatment resting heart rate below 70 beats per minute (see section 4.3). 
Primjena u bolesnika s niskom srčanom frekvencijom Ivabradin se ne smije primjenjivati u bolesnika u kojih je prije liječenja srčana frekvencija u mirovanju sporija od 70 otkucaja u minuti (vidjeti dio 4.3).