Lancora: Uses, Side Effects and Dosage

What LANCORA is used for:

LANCORA is a medication used to treat stable chronic heart failure. LANCORA should be used in adults who have a heart rate that is equal to or above 77 beats per minute. LANCORA will be used in combination with standard heart failure therapy. LANCORA will only be prescribed by healthcare professionals who are experienced in treating heart failure.

How LANCORA works:

LANCORA works on specific cells in the heart to slow down your heart rate.

The ingredients in LANCORA are:

Medicinal ingredient: ivabradine (as ivabradine hydrochloride)

Non-medicinal ingredients:

Core tablet: colloidal anhydrous silica, lactose monohydrate, magnesium stearate, maize starch, maltodextrin.

Tablet coating: hypromellose, macrogol 6000, glycerol, magnesium stearate, red iron oxide (E172), titanium dioxide (E171), yellow iron oxide (E172).

LANCORA comes in the following dosage form(s):

• 5mg film-coated tablets:

  • tablets are salmon-coloured and are rod shaped.

• engraved with “5” on one face and on the other.
• The 5 mg tablet can be broken in half to make two halves of 2.5 mg each.
• 7.5mg film-coated tablets:
• tablets are salmon-coloured and triangular.

• engraved with “7.5” on one face and on the other.

Do not use LANCORA if:

• you are allergic to ivabradine or any of the other ingredients of LANCORA
• your resting heart rate before treatment is too slow (below 70 beats per minute)

• you have a heart condition or heart disease such as:

  • a recent heart attack
  • your heart suddenly can’t pump enough blood (cardiogenic shock)
  • severe heart failure that requires you to be in the hospital for treatment
  • problems with the rhythm of your heart or the electrical system in your heart (congenital long QT syndrome, sick sinus syndrome, sino-atrial block, third degree atrioventricular block)
  • very low blood pressure (<90/50 mmHg)
  • you need a pacemaker to beat your heart for you
• you have severe liver problems

• you are taking the following medications:

  • ketoconazole, itraconazole (to treat fungal infections)
  • clarithromycin, josamycin (antibiotics)
  • nelfinavir, ritonavir, atazanavir (to treat HIV infections)
  • nefazodone (to treat depression)
  • diltiazem, verapamil (used for high blood pressure or angina)

• you are a woman able to have children and not using reliable contraception; you are pregnant or trying to become pregnant or breast-feeding

• you are lactose intolerant or have a rare hereditary disease that means you should not have milk. LANCORA contains lactose, a natural ingredient in milk. These diseases include:

  • Galactose intolerance
  • Lapp lactase deficiency
  • Glucose-galactose malabsorption.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take LANCORA. Talk about any health conditions or problems you may have, including if you:

• have heart problems such as:

  • irregular heartbeat or heart rhythm
  • an abnormally rapid heart rate
  • unexpected fainting
  • heart palpitations (feeling like your heart has skipped a beat or added an extra beat)
  • increase in chest pain
  • lower than normal level of potassium in your blood
  • one of the valves in your heart is more narrow (aortic stenosis)
  • a heart device such as a pacemaker, cardioverter defibrillator or cardiac resynchronizer
  • high or low blood pressure
  • a reduced heart rate with shortness of breath or tiredness. This could mean that your heart slowed down too much.
  • severe heart failure or heart failure with an electrocardiogram (ECG) abnormality called ‘bundle branch block’
• have a family history of problems of electrocardiogram (ECG) abnormality called “Long QT syndrome”
• have had a recent stroke
• have moderate liver problems
• have severe kidney problems.

Other warnings you should know about:

Risk of harm to fetus:

If you are a woman of child-bearing potential, you should use appropriate birth control measures to avoid getting pregnant while taking LANCORA. If you get pregnant while taking LANCORA, your fetus could be harmed or could die.

Monitoring before taking LANCORA and when your dose is changed:

Your healthcare professional will monitor your heart rate on at least three separate visits before you start treatment with LANCORA and whenever your dose is changed. Your healthcare professional may also monitor your heart rate and rhythm at other times during your treatment.

Blood pressuring monitoring:

If you have high blood pressure and need treatment with LANCORA, your healthcare professional:

• will regularly monitor your blood pressure.
• may need to change your blood pressure medication.

Irregular heart rhythm:

LANCORA may cause an irregular heart rhythm. This has happened more in patients taking certain medications like amiodarone. Your healthcare professional will monitor your heart rhythm and the electrical system of your heart with an electrocardiogram (ECG).

Tell your healthcare professional if you have any of the following symptoms of an irregular heart rhythm:

• fast or irregular heartbeat
• feeling like your heart is skipping a beat
• thumping in your chest
• discomfort, pain or pressure in your chest
• shortness of breath
• less ability to exercise
• feeling tired, weak, dizzy or light-headed
• confusion

Abnormally slow heart rate:

LANCORA may lower your heart rate too much. This may happen more in patients:

• taking other heart rate lowering drugs
• who are elderly (75 years of age or older).

Your healthcare professional will monitor your heart rate. Tell your healthcare professional if you have any of the following symptoms of a heart rate that is too low:

• nearly fainting or fainting
• weakness or fatigue
• dizziness
• shortness of breath
• chest pain
• feeling confused or having memory problems

Effects on Vision:

LANCORA may cause temporary visual symptoms. You may:

• have blurry vision
• see halos or stars of light
• see rapid pulses light
• see colored bright lights
• see moving and twisting colours of light
• find that you have moments of brightness that come and go in only certain portions of what you see with your eyes

You may notice that these symptoms happen when there are sudden changes in light intensity in your environment. For example, you may have symptoms if you walk into a bright room from a dark room. These symptoms usually go away on their own. These symptoms typically happen in the first two months of treatment.

Driving and Using Machines:

LANCORA may make you:

• feel dizzy, tired or weak
• have blurry vision
• see spots or stars of light in your eyes
• have other problems with your vision because of halos, patches of brightness in your vision or pulses of light.

Be careful when driving or using machines. Know how you feel while taking LANCORA before you drive or use machines.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with LANCORA:

• diltiazem, verapamil (for high blood pressure or angina)
• ketoconazole, itraconazole, fluconazole (to treat fungal infections)
• rifampicin, clarithromycin, josamycin (antibiotics)
• nelfinavir, atazanavir, ritonavir (to treat HIV infections)
• nefazodone (to treat depression)
• barbiturates (for difficult sleeping or epilepsy)
• phenytoin (for epilepsy)
• St John’s Wort (herbal treatment for depression)

• Medications that may affect the heart rate or the electrical system of the heart, such as:

  • quinidine, disopyramide, ibutilide, sotalol, amiodarone (to treat heart rhythm disorders)
  • pimozide, ziprasidone, imipramine (to treat anxiety, depression, schizophrenia)
  • mefloquine (malarial medication)
  • erythromycin IV (an antibiotic)
  • pentamidine (an antiparasitic medication)
• furosemide, hydrochlorothiazide, indapamide (to treat edema, high blood pressure).
• simvastatin (used to lower cholesterol).

Do not consume grapefruit juice during treatment with LANCORA.

How to take LANCORA:

• You should take LANCORA two times per day:

  • Once in the morning with food, and

  • 12 hours later in the evening with food.
• Always take LANCORA exactly as your healthcare professional has told you. You should check with your healthcare professional if you are not sure.
• Only stop taking LANCORA if your healthcare professional tells you to.
• If you think that the effect of LANCORA is too strong or too weak, talk to your healthcare professional or pharmacist.

Usual dose:

• Your healthcare professional will decide the right dose for you. Your healthcare professional will adjust your dose based on your heart rate.
• The usual recommended starting dose is one 5mg tablet of LANCORA twice a day. Your healthcare professional may increase your dose to one 7.5mg tablet twice a day.
• In some cases, you may start your treatment with a lower dose of 2.5mg twice a day. Your healthcare professional may recommend this dose if you are elderly (75 years of age or older) or are taking some specific medications. To take this dose, you will need to break one 5mg tablet into two, and take one half in the morning with food and the other half in the evening with food.

If you received LANCORA in blister packaging:

Each blister card contains 14 tablets, with two in each row and seven rows in total. Each row has the day of the week on it to help you keep track of your daily doses.

Overdose:

Your heart rate could be very lowered by a large dose of LANCORA. You may feel breathless or tired.

Missed dose:

If you forget to take a dose of LANCORA, take the next dose at the usual time. Do not take a double dose to make up for the forgotten dose.

Possible side effects from using LANCORA:

These are not all the possible side effects you may have when taking LANCORA. If you experience any side effects not listed here, tell your healthcare professional.

• Dizziness
• Visual symptoms (blurred vision, seeing light spots and flashes, etc.)
• Fatigue, malaise, feeling tired and weak
• Nausea, diarrhea
• Constipation, abdominal pain
• Feeling cold in extremities (fingers and toes)
• Joint pain
• Headache, generally during the first month of treatment
• Red and itchy skin
• Muscle spasms

Serious side effects and what to do about them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting side effects

Storage:

• LANCORA should be stored at room temperature (15 to 30°C).
• Use LANCORA before the expiry date stated on the bottle, carton and blister strip. The expiry date refers to the last day of that month.
• Do not throw any medication into the garbage, or down the toilet or sink. Ask your pharmacist how to throw away medications you no longer use. This can help protect the environment.

Keep out of reach and sight of children

If you want more information about LANCORA:

• Talk to your healthcare professional

• Find the full product monograph that is prepared for healthcare professionals and includes the

  • Patient Medication Information by visiting the Health Canada Drug Product Database website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website www.servier.ca; or by calling 1-800-363-6093

Date of Authorization: 2025-05-30