Summary
Ivabradine is tracked by OSMF as an investigational option for Long COVID; no regulator has approved it for this indication, and most post-viral conditions have no approved disease-modifying therapy at all. ClinicalTrials.gov lists 2 registered trials linking Ivabradine to Long COVID: 1 has completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT05481177, sponsored by Uniformed Services University of the Health Sciences). It plans or enrolled 250 participants. Registration activity spans 2023 to 2024. The literature layer holds 9 publications for this pair: 2 systematic reviews, 1 curated reference and 6 other publications. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
Long COVID / PASC is tracked on the OSMF post-viral programme alongside ME/CFS, Long COVID, POTS and MCAS. Across the programme, 423 candidate agents are logged for Long COVID, most of them preliminary; this page isolates the record for one of them.
Evidence table
| Evidence tier | B · Moderate |
|---|---|
| Evidence score | 30.0 (trials 6.5, literature 13.5, tier 10, approved bonus 0.0) |
| Registered trials | 2 total: 0 recruiting, 0 active / not yet recruiting, 1 completed, 1 other |
| Linked publications | 9 (6 other publications, 2 systematic reviews, 1 curated reference) |
| Agent type | Other (Other / Unclassified) |
| Development stage (any indication) | Investigational |
| Mechanism / class | Neurological / Autonomic |
| Data sources | OSMF therapeutic agent database, ClinicalTrials.gov, PubMed |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT05481177 | Ivabradine for Long-Term Effects of COVID-19 With POTS Cohort Uniformed Services University of the Health Sciences · 2023 | status unknown | Phase 4 | 250 |
| NCT06305806 | RECOVER-AUTONOMIC: Platform Protocol, Appendix B (Ivabradine) Kanecia Obie Zimmerman · 2024 | completed | Phase 2 | 181 |
Published literature
- Curated reference (PACVS Evidence Map) Consistent HR reduction across studies; selective If channel blocker — HR reduction without other cardiovascular effects; COVIVA published Frontiers NPACVS Evidence Map
- Review (PubMed validation search) PubMed record PMID 39658729
- Review (PubMed validation search) PubMed record PMID 37654428
- Review (PubMed validation search) PubMed record PMID 35853576
- Review (PubMed validation search) PubMed record PMID 35771014
- Review (PubMed validation search) PubMed record PMID 35383586
- Case report (PubMed validation search) PubMed record PMID 42191437
- Systematic review (PubMed validation search) PubMed record PMID 39882369
- Systematic review (PubMed validation search) PubMed record PMID 37094584
Mechanism and notes
Recorded mechanism or class: Neurological / Autonomic.
Clinical notes: Observational success ~55% + nested COVIVA RCT. Selective HR reduction without beta effects. 2.5-7.5mg BID. Visual side effects possible. Strong for hyperadrenergic POTS/IST phenotypes.
Safety: Bradycardia, visual phosphenes (luminous phenomena), headache. Contraindicated in sick sinus, severe hypotension, acute decompensated HF. Monitor HR.
Dosing in studies: 2.5–7.5 mg twice daily; titrate to HR; durations in POTS/autonomic studies 4–12 weeks or longer.
Frequently asked questions
Is Ivabradine approved for Long COVID?
Ivabradine is tracked by OSMF as an investigational option for Long COVID; no regulator has approved it for this indication, and most post-viral conditions have no approved disease-modifying therapy at all. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Ivabradine in clinical trials for Long COVID?
ClinicalTrials.gov lists 2 registered trials linking Ivabradine to Long COVID: 1 has completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT05481177, sponsored by Uniformed Services University of the Health Sciences). It plans or enrolled 250 participants. Registration activity spans 2023 to 2024.
What does the evidence show for Ivabradine in Long COVID?
Ivabradine has both completed registered trials and synthesis-level publications linked to Long COVID. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is B (Moderate), taken from the OSMF therapeutic agent database, which grades agents by the volume and design of condition-specific evidence rather than by effect size.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-10-07. Page built 2026-10-07.