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Ivabradine Overdose in a Newborn: Precautions of Dispensing in Infants

Pezad Doctor1, William A Scott1, Kaitlin Tindel2

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.

Cardiology Research
|September 21, 2022
PubMed

Insights

Ivabradine overdose occurred in a newborn due to inaccurate dosing, highlighting medication preparation risks in pediatric patients. Careful preparation is crucial for safe ivabradine use in infants with tachyarrhythmias.

Area of Science:

  • Pediatric Cardiology
  • Clinical Pharmacology
  • Neonatal Medicine

Background:

  • Ivabradine is approved for pediatric chronic heart failure and dilated cardiomyopathy.
  • It is used off-label for pediatric automatic tachyarrhythmias like ectopic atrial tachycardia.
  • Adverse effects and toxicity are rarely reported in adults.

Observation:

  • A newborn treated for ectopic atrial tachycardia experienced ivabradine overdose.
  • The overdose resulted from inaccurate weight-based dosing, with the infant receiving 10 times the prescribed amount.
  • Accurate dosing in children necessitates dilution of the oral solution.

Findings:

  • This case details a significant ivabradine overdose in a neonate.
  • The overdose was attributed to errors in medication preparation and dosing accuracy.
  • Supra-physiological toxicity in children is a concern, though rarely documented.

Implications:

  • Highlights critical risks associated with ivabradine prescription and preparation in pediatric populations.
  • Emphasizes the need for meticulous attention to detail in pediatric medication dosing and dilution.
  • Underscores the importance of standardized protocols for preparing ivabradine in neonates and infants.

Keywords:
Ectopic atrial tachycardiaIvabradine toxicityNewbornSinus bradycardia

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