Ivabradine and POTS/Dysautonomia

In this blog post, we will be exploring Ivabradine—how it works and how it can help individuals with POTS.

What is POTS?

First, let’s define POTS. Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that falls under the umbrella of dysautonomia—a group of disorders related to dysfunction of the autonomic nervous system. The term “autonomic” refers to the self-governing nature of this system, which controls involuntary functions that we do not consciously regulate. These include breathing, digestion, heart rate, blood pressure, body temperature, sweating, and more.

How Does Ivabradine Work?

Ivabradine is a selective "funny channel" blocker that works by slowing the heart’s natural pacemaker. It does this by inhibiting the electrical current responsible for regulating the heart’s rhythm. By reducing the heart rate by a few beats per minute, Ivabradine decreases the workload on your heart and allows each heartbeat to pump more blood.

Benefits of Ivabradine:

• Heart Rate Control: Ivabradine effectively stabilizes the heart rate, which is especially important for those with dysautonomia experiencing tachycardia.

• Symptom Management: By addressing irregular heart rhythms, Ivabradine can help reduce symptoms such as palpitations, lightheadedness, and exercise intolerance.

• Improved Quality of Life: Better heart rate regulation can enable individuals to participate in more daily activities and lead more active lives.

How Does Ivabradine Help People With POTS?

Ivabradine specifically targets the heart’s natural pacemaker, making it ideal for people with POTS or other forms of dysautonomia. It lowers the heart rate without causing a drop in blood pressure—unlike some other medications such as propranolol. This makes Ivabradine a preferred choice, especially for those who need heart rate control without additional blood pressure concerns.

Ivabradine is also well tolerated and can be used long-term, making it suitable for managing chronic conditions.

Dosage

Typically, Ivabradine starts at 2.5 mg twice daily. The dose can be increased in 2.5 mg increments up to 5 mg or 7.5 mg if necessary. It is usually taken once in the morning and once in the afternoon.

It's important to avoid grapefruit or grapefruit juice unless your healthcare provider advises otherwise, as it can interact with the medication.

Side Effects

A common side effect of Ivabradine is sensitivity to bright lights or seeing flashing lights in your peripheral vision, which usually diminishes after the first two months. It can also cause dizziness and tiredness.

For a comprehensive list of potential side effects, visit: Mayo Clinic - Ivabradine Side Effects.

Conclusion

In summary, Ivabradine can be a valuable tool for managing POTS. By helping to control heart rate and reduce symptoms like palpitations and lightheadedness, Ivabradine offers hope for improved quality of life for those living with the condition.

While using Ivabradine, it’s essential to continue other recommended strategies for managing blood pressure and blood pooling—such as wearing compression clothing, increasing salt intake, and staying well-hydrated.

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For more information visit:

https://www.heartandstroke.ca/heart-disease/treatments/medications/ivabradine

https://www.youtube.com/watch?v=FaL4KrkWcn8