The Pennine Acute Hospitals
NHS Trust Formulary
2 Cardiovascular system
02-06-03 Other antianginal drugs


Restricted Item Specialist initiation

Ivabradine should only be initiated in people with NYHA class II to IV stable chronic heart failure with systolic dysfunction who:
  • are in sinus rhythm with a heart rate of 75 bpm or more
  • have a left ventricular ejection fraction of 35% or less, AND
  • who have been stable for 4 weeks on optimised standard therapy with ACE inhibitors, beta-blockers and aldosterone antagonists (or when beta-blockers are contra-indicated or not tolerated).
  • Link  NICE TA 267: Ivabradine

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    Ranolazine Ranexa®

    Restricted Item Restricted to cardiac services (PAHT)

    For stable angina where patients are unsuitable for physical therapy or first and second line agents (PAHT).

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    Nicorandil Ikorel®

    Indicated for stable angina only in patients whose angina is inadequately controlled by first-line anti-anginal therapies, or who have a contra-indication or intolerance to first-line therapies, such as beta-blockers and/or calcium channel blockers.
    Link  MHRA Safety Alert: Risk of ulcer complications

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