Procor

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Procor

Quick Facts: Procor

Property Description
Active ingredient Amiodarone Hydrochloride
Form Oral Tablets, Injectable Solution
Pharmacological class Antiarrhythmic Agent (Class III)
Common Use Stabilizing life-threatening heart rhythm disorders
Origin Synthetic (Benzofuran Derivative)

Procor: Definition and Role as an Antiarrhythmic Agent

Procor is a prescription-only medicine whose active ingredient is Amiodarone Hydrochloride, an agent clinically recognized for its effectiveness in stabilizing severe heart rhythm disturbances. It is classified as an antiarrhythmic agent, predominantly belonging to the Class III antiarrhythmic group under the Vaughan Williams classification system.

The drug's fundamental therapeutic role is to electrically stabilize the heart, making it vital for patients facing dangerous, chaotic forms of cardiac arrhythmias. Its classification as an antiarrhythmic on the List of Essential Medicines further attests to its critical role in managing these conditions.


Composition and Form: Amiodarone’s Unique Type

The active substance, Amiodarone Hydrochloride, is a synthetic compound structurally defined as an iodine-rich benzofuran derivative. This high iodine content is a unique structural feature of Amiodarone within its class. The medication is available for two principal administration types: Oral Tablets, used for long-term maintenance therapy, and a sterile Injectable Solution, which is reserved for intravenous administration in acute clinical settings.


How Amiodarone Stabilizes the Heart's Electrical Activity

Amiodarone functions effectively as a multichannel blocker, influencing several key ion channels that regulate the electrical currents in heart muscle cells. Its main mechanism principle is to prolong electrical recovery, which increases the time required for heart tissue to electrically reset itself after a beat, helping prevent chaotic electrical firing.

This comprehensive action, which includes the blockade of potassium, sodium, and calcium channels, provides robust, generalized stabilization to the cardiac tissue, ensuring the heart maintains a controlled, steady rhythm.

Regulatory References

  1. Amiodarone: MedlinePlus Drug Information
  2. Amiodarone - WHO Essential Medicines List

What side effects are possible with Procor?

Possible Side Effects and Safety Information

The safety profile of Procor (Ivabradine) is officially structured by government regulatory agencies, defining the expected adverse reactions and mandatory limitations for use. Adverse reactions are classified based on their statistical frequency and categorized by the body systems they affect.


Adverse Reaction Frequency Classification

Adverse reactions are formally listed by their likelihood of occurrence:

  • Very Common (Affecting more than 1 in 10 people): The most frequently reported effect is Luminous phenomena (Phosphenes), which are documented as often being transient.
  • Common (Affecting up to 1 in 10 people): These include Bradycardia (slowed heart rate), Headache, Dizziness, Vision blurred, and the development of Atrial fibrillation.
  • Uncommon (Affecting up to 1 in 100 people): Effects such as Diplopia, other forms of visual impairment, Hypotension, and episodes of increased blood pressure have been documented.

Serious Reactions and Safety Constraints

Regulatory documents highlight several serious adverse reactions and strict constraints on use. Clinically significant reactions include the potential for Persistent Symptomatic Bradycardia and an increased risk of Atrial fibrillation in certain populations. Treatment is contraindicated (must not be used) in several circumstances, including if the resting heart rate is below 60 beats per minute prior to starting treatment, in cases of Severe Hypotension or Cardiogenic shock, and for patients with Severe Hepatic Insufficiency. Caution is also specified for patients with Retinitis Pigmentosa. Furthermore, the medicine is contraindicated during pregnancy and breastfeeding, requiring women of childbearing potential to use effective contraception.

Overdose and Emergency Response

Overdose and When to Seek Help

The following information summarizes the essential overdose profile for Procor, strictly based on official regulatory documentation.

Documented Overdose Manifestations

Official labeling describes a range of symptoms that may occur following the accidental intake of a dosage higher than prescribed. These manifestations affect several key physiological systems:

  • Central Nervous System (CNS): Symptoms may include feeling dizzy, faint, or experiencing confusion or tiredness.
  • Cardiovascular System: A serious manifestation is the slowing of the heart rate, known as bradycardia.
  • Hepatic System: Overdose is associated with potential damage to the liver.
  • Gastrointestinal System: Vomiting has also been reported as a symptom of overdose.

Required Emergency Action

Immediate medical intervention is required for all suspected overdose situations.

If you have accidentally taken a higher dosage of Procor, or if a child has accidentally swallowed the medicine, you must take the following action immediately:

  • Refer immediately to a doctor or proceed directly to a hospital emergency room.
  • Bring the package of the medicine with you to the medical professional or facility.

This explicit instruction emphasizes the potentially serious, life-threatening nature of the documented overdose symptoms.

Therapeutic Uses of Procor

Procor, with the active substance ivabradine, is primarily used to help manage specific cardiac conditions by modulating the heart rate. Its therapeutic role includes the treatment of two main areas in adults: chronic stable angina pectoris (chest pain) and long-term heart failure.

In the case of stable angina, this medication may be used to address the frequency of episodes and provide potential relief of symptoms. For heart failure patients, it is associated with a potential to help manage the condition and may lead to an overall improvement in symptoms. The medicine is commonly reserved for use when other standard treatments, such as beta-blockers, are unsuitable or where the patient is not responding sufficiently.

Quick Fact: Relief for Chest Pain

Regulatory References

  1. European Medicines Agency therapeutic overview

Eligibility and Restrictions for Use

The eligibility for using Procor (Ivabradine) is strictly defined by regulatory bodies, primarily based on the patient's existing cardiac electrical status and overall clinical condition. This medicine is approved for adults with specific types of chronic stable angina or chronic heart failure (CHF) and for pediatric patients ge 6 months of age with heart failure due to dilated cardiomyopathy.

Contraindicated Populations

Procor is contraindicated and must not be used in the following populations as established by official labeling:

  • Patients with a resting heart rate below mathbf70 beats per minute (bpm) prior to treatment, or those with clinically significant bradycardia.
  • Patients with acute decompensated heart failure or unstable angina.
  • Individuals with severe hypotension (blood pressure < 90/50 mmHg) or severe hepatic impairment.
  • Patients with certain conduction disorders, including Sick sinus syndrome or mathbf3^rd-degree AV block (unless a functioning pacemaker is present).
  • Women who are pregnant, breastfeeding, or of reproductive potential who are not using effective contraception.

Age and Condition Restrictions

Population / Condition Regulatory Status
Pediatric patients < 6 months Safety and efficacy not established
Severe Renal Impairment (CrCl < 15 mL/min) Use with precaution (lack of data)
Atrial Fibrillation Not recommended
Patients ge 75 years Lower starting dose considered

What should I know about interactions with other medicines?

Official Interaction Profile

The interaction profile of Procor (Ivabradine) is primarily defined by its metabolism through the Cytochrome P450 3A4 (CYP3A4) enzyme and its direct effect on the heart rate, as documented in government regulatory sources.

Contraindicated Combinations and Substances

Classification Examples of Prohibited Products
Strong CYP3A4 Inhibitors Azole antifungals (e.g., ketoconazole), macrolide antibiotics (e.g., clarithromycin), HIV protease inhibitors, and nefazodone.
Heart Rate-Reducing Calcium Channel Blockers Verapamil and Diltiazem.

Co-administration with these contraindicated substances can result in a significant increase in Ivabradine plasma concentrations, which may exacerbate bradycardia and conduction disturbances.

Other Documented Interactions

  • Exposure Modification: Agents that induce CYP3A4 activity, such as rifampicin or the herbal product St. John’s Wort, decrease Ivabradine plasma concentrations and should be avoided or restricted.
  • Pharmacodynamic Effects: Concomitant use with other Negative Chronotropes (e.g., amiodarone, digoxin, beta-blockers) carries a documented increased risk of bradycardia due to additive heart rate effects.
  • Food and Beverages: Consumption of Grapefruit Juice should be avoided as it is documented to increase systemic exposure.
  • Population Note: Ivabradine is contraindicated for use in patients with severe hepatic impairment due to the anticipated large increase in systemic exposure in this population.
  • Timing Restriction: The use is contraindicated during and for two weeks following treatment with Itraconazole.

Mechanism of Action

Multi-Channel Electrical Stabilization

Procor's core mechanism is the inhibition of multiple voltage-gated ion channels on cardiac cells, primarily targeting potassium ( K^+) channels (Class III effect) but also blocking sodium ( Na^+) channels (Class I effect) and L-type calcium ( Ca^2+) channels (Class IV effect). This multi-channel blockade prolongs the Action Potential Duration (APD) and the Effective Refractory Period (ERP), reducing the tissue's electrical responsiveness.


Modulating Cardiac Conduction Pathways

This domain involves dampening the heart's internal electrical signaling. Blocking Na^+ channels slows the conduction velocity (speed of signal spread), while its non-competitive beta-adrenergic receptor antagonism (Class II effect) and Ca^2+ channel blockade reduce automaticity in the pacemaker (SA) and relay (AV) nodes. This cascade leads to a physiological decrease in heart rate and contributes to the maintenance of regulated electrical activity.


Systemic and Hemodynamic Influence

Beyond its direct electrical effects, the drug's mechanism includes direct action on blood vessels. This effect induces vasodilation (widening of blood vessels), resulting in decreased peripheral vascular resistance. This physiological change affects hemodynamic parameters by decreasing the resistance against which the ventricles pump blood.

Dosage and Administration Information

How Procor (Ivabradine) Is Used

Procor, which contains the active substance Ivabradine, is administered exclusively via the oral route using film-coated tablets or an oral solution. The medicine is taken twice daily, with one dose in the morning and the second in the evening, and is taken with food to ensure consistent intake.

The dosing regimen begins with a standard adult starting dose of 5 mg twice daily. A lower initial dose of 2.5 mg twice daily may be considered for patients with certain pre-existing conduction defects or those over 75 years of age in some regions.

Treatment is procedural and involves scheduled assessment: the dose is adjusted after a two-week interval based on the patient's measured resting heart rate, aiming for a specific target range, and may be increased up to a maximum dose of 7.5 mg twice daily. If a dose is missed, it is advised to skip the missed dose and take the next dose at the usual scheduled time; the dose must not be doubled to compensate.

Specific instructions govern preparation: tablets can be divided for smaller 2.5 mg doses, but must not be crushed or chewed. The oral solution must be measured from a calibrated syringe after emptying the entire ampule into a cup, and any unused solution must be discarded.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Procor (Ivabradine)

The research evidence for Procor (ivabradine) was studied for use in two main areas: the use in patients with chronic stable angina and the use in adult patients living with chronic heart failure where researchers examined clinical event outcomes. This overview summarizes the findings reported in regulatory documents and peer-reviewed scientific literature.


Evidence for Use in Chronic Heart Failure

Studies focusing on Procor for heart failure have included large-scale, long-term, randomized controlled trials (RCTs). These research efforts monitored outcomes reflecting physiological strain or stress, such as the frequency of hospitalization and measures related to survival during defined time intervals, in adults with a reduced left ventricular pumping function.

Studies in Patients with Elevated Heart Rate and Sinus Rhythm

The pivotal heart failure research on Procor was evaluated in studies that examined adult patients who were in a normal sinus rhythm and maintained a resting heart rate of at least 70 beats per minute (≥ 70 bpm). The research so far describes patterns observed in the studies related to a lower reported occurrence of the composite outcome of cardiovascular death or hospitalization for worsening heart failure, compared to the placebo group. This pattern was observed in some studies to be associated with changes measured during the study period related to the hospitalization for worsening heart failure.


Evidence for Use in Chronic Stable Angina

Research was also conducted during periods of increased symptom activity to evaluate Procor's role in chronic stable angina pectoris (chest pain). These trials were typically short-term and research examined outcomes related to physical discomfort and functional imbalance.

Studies primarily monitored outcomes reflecting daily functioning or activity level, particularly focusing on measures taken during exercise stress testing. Findings describe patterns observed in the studies, indicating that for the populations evaluated, there were changes measured during the study period related to both exercise time and episodic or acute changes in symptoms.


What Remains Uncertain in the Research Landscape

While studies describe patterns related to outcomes reflecting daily functioning or activity level and lower hospitalization rates in specific heart failure patients, the certainty remains low for long-term cardiovascular event reduction in the general population of stable angina patients. Research does not determine whether an individual will respond similarly, as findings describe group patterns, not personal outcomes. The results apply only to the populations studied, and data for certain groups remain insufficient, such as for patients with a resting heart rate below the specific study threshold.

Frequently Asked Questions (FAQ)

Common questions about Procor (FAQ)

Q: Do the side effects of Procor usually go away after a while?

A: Official product information indicates that the most commonly reported side effect, Luminous Phenomena (flashes of light or phosphenes), is often transient. This means the effect is frequently temporary.

According to regulatory documents, this visual change generally begins within the first two months of treatment.


Q: Are there any specific vitamins or supplements that interact with Procor?

A: Regulatory information documents a potential interaction with the herbal product St. John’s Wort. This is because St. John's Wort can change the way the body processes the medicine, resulting in a lower amount of Procor in the bloodstream.

Regulatory documents emphasize the importance of communicating all supplements and vitamins to a healthcare provider for a complete safety assessment.


Q: Is there an age limit for who can use Procor?

A: Procor is approved for use in adults and some pediatric patients with certain types of heart failure. Regulatory documents have not identified specific problems that limit its use in older adults.

However, a lower starting dose may be considered for patients 75 years of age and older, according to official prescribing information.


Q: Why is Procor sometimes prescribed with other medications?

A: Official documents address the use of Procor alongside other medications that affect heart rate, known as Negative Chronotropes (e.g., beta-blockers). Taking these medicines together is a documented scenario that carries an increased risk of bradycardia (slowed heart rate).

Official prescribing information describes that co-administration typically occurs under a plan of close clinical monitoring.


Q: Can I use Procor for conditions other than what it was prescribed for?

A: Official warnings state that the use of this medicine should be reserved for its approved indications. This is important because one form of the medicine (Amiodarone) carries a serious safety warning due to the risk of potentially fatal side effects.

The approved indications are specific types of chronic stable angina or chronic heart failure.


Q: Does Procor cure the condition, or does it only manage symptoms?

A: The medicine is described in official documents as playing a role in stabilizing heart rhythm disorders or reducing the risk of hospitalization for worsening heart failure.

The medicine’s approved uses are descriptive of a role in stabilizing and managing symptoms rather than achieving a cure for the underlying condition.


Q: Are there any long-term side effects associated with Procor?

A: Studies and official documentation for Procor report adverse reactions observed during long-term clinical trials.

For the Amiodarone form of the medicine, long-term use is associated with a blue-gray skin discoloration that can develop in sun-exposed areas. This discoloration may take several months to go away after stopping the medicine.


Q: Can Procor cause weight changes?

A: While weight change is not a directly listed side effect for all forms of Procor, official documentation for one form (Amiodarone) notes that unexplained weight loss or weight gain can be a sign of a related health issue, such as thyroid problems.

Regulatory patient counseling emphasizes the importance of reporting significant changes to a healthcare provider.


Q: Can I take Procor with common pain relievers like ibuprofen or Tylenol?

A: Regulatory patient counseling advises discussing all prescription and nonprescription medicines, which includes over-the-counter pain relievers, with a healthcare provider before use.

This is necessary to ensure a full assessment of potential interactions before combining any medications.


Q: Does alcohol interact with Procor?

A: Official patient counseling for Procor mentions that the use of alcohol with certain medicines may cause interactions to occur. Additionally, one form of the medicine (Ivabradine) has a documented alcohol/food interaction.

Regulatory patient guidance highlights the need for a healthcare provider to review alcohol consumption while taking the medicine.


Q: Is it normal to feel [general, non-specific symptom, e.g., tired] when starting Procor?

A: Official safety information lists feeling tired, excessive tiredness, and a lack of energy (fatigue or asthenia) as documented side effects of Procor.

If unusual tiredness is experienced, it is part of the documented safety profile of the medicine.


Q: What should I do if I feel worse after starting Procor?

A: Official patient counseling advises checking with a healthcare provider immediately if symptoms do not start to get better or if they get worse.

Additionally, if new or concerning side effects occur, they should also be reported right away.


Q: Does Procor cause sleepiness or drowsiness?

A: While the product information does not explicitly list 'sleepiness' or 'drowsiness' as side effects, it does document effects like dizziness, lightheadedness, and unusual tiredness.

These effects are related to the central nervous system and may affect alertness.


Q: Is Procor known to interact with birth control pills?

A: Regulatory documents for one form of the medicine (Ivabradine) state that it is contraindicated during pregnancy.

Therefore, women of childbearing potential are required to use effective contraception throughout treatment to prevent pregnancy.


Q: Can I drive or operate machinery while taking Procor?

A: Official patient counseling advises caution when driving or operating machinery. This warning is due to potential vision changes, such as Luminous Phenomena (flashes of light or phosphenes).

Caution is especially relevant when driving at night or in situations with sudden light changes.


Q: Does taking Procor affect lab test results?

A: For one form of the medicine (Amiodarone), regular blood tests are emphasized in official documents. These tests are necessary to check for unwanted effects, particularly those related to the liver and thyroid function.

Official documents state that a healthcare provider will determine which specific tests are necessary.


Q: Is Procor available as a generic version?

A: Yes, the active ingredient in one form of the medicine (Ivabradine) is available as a generic tablet.

The FDA has approved generic versions of this medicine, which is marketed under different brand names.


Q: Does Procor have a Black Box Warning, and what does it mean?

A: One form of the medicine (Amiodarone) carries an FDA Boxed Warning. This is the agency’s most serious warning, used to call attention to serious or potentially fatal health risks.

The warning highlights the risk of serious and potentially fatal toxicity to the lungs (pulmonary) and liver (hepatic).


Q: What happens if I take too much Procor?

A: Symptoms of taking too much Procor can vary but may include a very slow heartbeat (bradycardia), dizziness, and excessive tiredness.

An overdose of the Amiodarone form of the medicine can be fatal and may cause severe low blood pressure. In the event of a suspected overdose, the official guidance emphasizes the need for immediate medical assistance.


Q: Does Procor interact with common cold or flu medications?

A: Official patient counseling advises discussing all nonprescription, or over-the-counter (OTC), medicines with a healthcare provider before use. This includes common cold or flu products.

This communication supports a complete safety assessment for potential interactions.


Q: Is there ongoing research about new uses for Procor?

A: Regulatory-approved indications are for specific heart conditions. However, the scientific literature notes that the medicine has been used experimentally for other conditions, meaning research continues to explore its effects beyond the currently approved uses.


Q: Does Procor have any known effects on mental health or mood?

A: Official safety information lists side effects related to the central nervous system (CNS), such as nervousness, dizziness, and confusion.

These types of documented effects have the potential to influence mood or mental status.


Q: Are there different brand names for the same medicine as Procor?

A: Yes, the active ingredient in one form of the medicine (Ivabradine) is sold under several different brand names depending on the country, including Corlanor and Procoralan.

Generic versions of the tablet form are also available.


Q: What information is most important to share with my healthcare provider before starting Procor?

A: Official patient counseling advises sharing a complete medical history, including any allergies, all other prescription and nonprescription medicines (including supplements), and existing conditions.

It is specifically important to report any history of heart, liver, kidney, or vision problems.


Q: Can Procor cause sensitivity to sunlight?

A: One form of the medicine (Amiodarone) is documented to increase the sensitivity of the skin to sunlight (photosensitivity).

For this form, official patient counseling describes protective measures, such as wearing sunscreen and protective clothing, to reduce sun exposure.

How should Procor be stored and disposed of?

Procor (Amiodarone) must be stored and disposed of according to specific regulatory requirements to ensure potency and safety.

Storage Conditions

  • Temperature and Light: Oral tablets must be stored at Controlled Room Temperature, 20 C to 25 C (68 F to 77 F), and both tablets and the injectable solution must be protected from light.
  • Prohibited Environments: The injectable solution must not be refrigerated or frozen and should be kept away from excessive heat.
  • Packaging: Tablets must be kept in the original, tightly closed container to maintain integrity and stability.

Child-Safety and Disposal

  • Child Safety: All forms of the medication must be stored strictly out of the sight and reach of children.
  • Disposal: Any unused or expired product must be disposed of in accordance with local requirements. Diluted injectable solutions are intended for immediate use, and any remainder should be discarded.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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Equivalent of Procor found in:

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