Ivabradine (Procoralan) alone or with b-blockers in myocardial ischemia

Both ivabradine (Procoralan), the first I(f) current inhibitor of the cardiac pacemaker cells, and b-blockers reduce heart rate and exhibit potent anti-ischemic effects. Although b-blockers are still the first choice of medication to treat patients suffering from myocardial ischemia, numerous experimental and clinical arguments are now available from which to conclude that ivabradine not only is the drug of choice when b-blockers are not well tolerated or contraindicated, but is the drug that can be associated with b-blockers at the commonly used dosage in clinical practice for an optimal therapeutic efficacy in ischemic disease. Heart Metab. 2010;47:30–33.