Ivabradine prevents heart rate acceleration in patients with chronic obstructive pulmonary disease and coronary heart disease after salbutamol inhalation

• Published in: Pharmaceuticals (Basel, Switzerland) Switzerland), 2012-04, Vol.5 (4), p.398-404
• Main Authors: Zulkarneev, Rustem, Zagidullin, Naufal, Abdrahmanova, Guzel, Hoppe, Uta C, Zagidullin, Shamil
• Format: Article
• Language: English
• Subjects: CHD; COPD; ivabradine; salbutamol
• ISSN: 1424-8247; 1424-8247
• DOI: 10.3390/ph5040398

Accelerated sinus rhythm is an important side effect of inhaled salbutamol which is especially harmful in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD). Cross-over, randomized, open label study design. 20 patients (18 males and two females) with COPD stage II-IV and comorbide CHD NYHA class I-III were included. Spirometry with 400 mg salbutamol inhalation was performed at two consecutive days of the study. Patients in group I were prescribed 5 mg ivabradine per os 3 h before salbutamol inhalation solely on the first day of the study and patients of group II received 5 mg ivabradine only on the second day of the study. Salbutamol caused a significant increase of HR by 5.5 bpm (95% CI 0.8; 10.2, p < 0.03). After ivabradine ingestion salbutamol did not change HR significantly by -2.4 bpm (-7.0; 2.3, p = 0.33). The attenuation of HR elevation by ivabradine was significant, p < 0.01. Salbutamol alone increased FEV1 by 6.0% (2.7; 9.3, p < 0.01). This effect was not impaired by ivabradine (FEV1 increase by 7.7% (2.8; 12.6, p < 0.01 versus baseline, p = 0.5 versus no ivabradine). Ivabradine 5 mg per os prevents heart rate acceleration after inhalation of 400 mg salbutamol. Ivabradine has no impact on lung function in patients with moderate-to-very-severe COPD and CHD comorbidity.