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Case report of ivabradine intoxication
François Mathiaux1, Sylvain Dulaurent, Frédéric Julia
11Biological and Forensic Toxicology Unit, Pharmacology and Toxicology Department, University Hospital of Limoges, 2 Avenue Martin-Luther King, 87024 Limoges cedex, France.
Journal of Analytical Toxicology
|April 9, 2014
Summary
A man overdosed on ivabradine, experiencing mild symptoms despite high blood concentrations. This case suggests no direct correlation between ivabradine levels and overdose severity.
Area of Science:
- Pharmacology
- Clinical Toxicology
Background:
- Ivabradine is prescribed for angina and heart failure when beta-blockers are insufficient.
- It functions by selectively inhibiting the If current in the sinoatrial node.
Observation:
- A 47-year-old male presented with drowsiness and mild sinus bradycardia (50 bpm) after ingesting 280 mg of ivabradine.
- He exhibited well-tolerated hypotension (100/50 mmHg) and was discharged on Day 3 with no complications.
Findings:
- A validated liquid chromatography-mass spectrometry method quantified serum ivabradine at 375 µg/L, over 30 times therapeutic levels.
- Despite the high concentration, bradycardia was mild and comparable to therapeutic dosage effects.
Implications:
- This case highlights a potential lack of direct correlation between ivabradine blood concentration and the severity of clinical manifestations in overdose scenarios.
- Further research is needed to understand the pharmacokinetics and pharmacodynamics of ivabradine in overdose.
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