What Kind of Drug Lowers Heart Rate? A Guide to Medication Classes

October 12, 2025 •

3 min read

According to the American Heart Association, a normal resting heart rate for adults is typically between 60 and 100 beats per minute. A doctor may prescribe a medication to control a heart rate that is consistently too high, directly answering the question: What kind of drug lowers heart rate?.

Quick Summary

This guide details several classes of medication used to reduce heart rate, including beta-blockers, calcium channel blockers, and ivabradine. It explains how these drugs function, their therapeutic applications for managing conditions like arrhythmias and heart failure, and important considerations regarding their side effects and precautions.

Key Points

Beta-blockers: A common drug class that lowers heart rate by blocking the effects of stress hormones like adrenaline.
Calcium channel blockers: The non-dihydropyridine type slows heart rate by blocking calcium entry into heart muscle cells.
Ivabradine: A selective $I_f$ channel blocker that lowers heart rate without affecting blood pressure or contractility.
Digoxin: Increases the heart's pumping strength while also reducing heart rate, used for heart failure and certain arrhythmias.
Not all drugs are the same: The choice of medication depends on the specific heart condition and patient health profile, and they carry different risks and benefits.
Side effects vary: Fatigue, dizziness, and cold extremities are common side effects of beta-blockers, while ivabradine may cause visual disturbances.
Medical supervision is essential: These drugs should never be stopped abruptly or taken without consulting a healthcare provider, as this can be dangerous.

When the heart beats too fast, a condition known as tachycardia, it can put a strain on the heart muscle and increase the risk of serious health complications. Several different classes of medication are available to help manage and lower an elevated heart rate, each working through a unique pharmacological mechanism. The appropriate choice of medication depends on the patient's specific health condition, existing medications, and other cardiovascular factors, and should always be determined by a healthcare provider.

Key Drug Classes That Lower Heart Rate

Beta-Blockers: The 'Fight-or-Flight' Regulators

Beta-blockers are a common class of drugs used to lower heart rate. They reduce the heart's workload by blocking stress hormones like epinephrine and norepinephrine. This causes the heart to beat more slowly and with less force. Beta-blockers treat conditions such as high blood pressure, arrhythmias, angina, heart failure, and prevent repeat heart attacks. Examples include atenolol, metoprolol, and propranolol.

Calcium Channel Blockers: The Heart's Gatekeepers

Non-dihydropyridine calcium channel blockers can lower heart rate by preventing calcium from entering heart muscle cells. This action slows the heart rate and dilates blood vessels. Unlike other calcium channel blockers, drugs like diltiazem and verapamil significantly affect the heart's conduction system. They are used for certain arrhythmias, angina, and high blood pressure.

Ivabradine: The Selective Heart Rate Lowerer

Ivabradine (Corlanor) is an $I_f$ channel blocker that selectively inhibits the pacemaker current in the heart's SA node. This lowers heart rate without affecting blood pressure or heart muscle contraction. It is an option for patients with chronic heart failure and a normal rhythm who cannot tolerate beta-blockers.

Cardiac Glycosides: Enhancing Pump Function

Digoxin (Lanoxin) is a cardiac glycoside used for heart conditions. It increases the heart muscle's contraction force and slows heart rate. Digoxin treats heart failure and controls heart rate in certain arrhythmias like atrial fibrillation. Careful monitoring of blood levels is needed due to potential toxicity.

Comparison of Heart-Rate-Lowering Drugs


Drug Class	Mechanism of Action	Primary Effects	Common Uses	Potential Side Effects
Beta-blockers	Blocks epinephrine and norepinephrine from binding to beta receptors.	Slows heart rate, reduces force of contraction, lowers blood pressure.	Hypertension, angina, heart failure, arrhythmias, post-heart attack.	Fatigue, cold extremities, dizziness, bradycardia, sleep disturbances.
Calcium Channel Blockers	Blocks calcium entry into heart muscle cells and arteries.	Slows heart rate, relaxes blood vessels, lowers blood pressure.	Angina, certain arrhythmias, hypertension.	Dizziness, headache, swelling of ankles/feet, low blood pressure.
Ivabradine	Selectively inhibits the $I_f$ pacemaker current in the sinoatrial node.	Lowers heart rate only, with no effect on blood pressure or contractility.	Chronic heart failure (with specific criteria).	Phosphenes (visual brightness disturbances), bradycardia, atrial fibrillation.
Digoxin	Restricts enzyme affecting sodium/potassium, affecting electrical signals.	Increases heart pumping strength, slows heart rate.	Heart failure, atrial fibrillation.	Digoxin toxicity (fatigue, nausea, irregular heartbeat), visual disturbances.

Important Considerations and Contraindications

Before starting any medication, a doctor will review a patient's medical history. Precautions and contraindications include severe bradycardia or heart block, which are absolute contraindications for many of these drugs. Nonselective beta-blockers should be avoided in patients with asthma or moderate-to-severe COPD due to bronchospasm risk. Beta-blockers can mask low blood sugar symptoms in diabetics. Abrupt discontinuation of beta-blockers is dangerous and can lead to serious cardiac issues.

Conclusion

Understanding what kind of drug lowers heart rate involves recognizing the distinct mechanisms of several key medication classes. Beta-blockers, calcium channel blockers, ivabradine, and cardiac glycosides each offer a different approach with varying effects on blood pressure and heart function. While these medications are important for managing cardiac conditions, they require strict medical supervision due to potential side effects and specific contraindications. Patients must consult their healthcare provider for the most appropriate treatment plan.

Frequently Asked Questions

The most common and widely prescribed drugs to lower heart rate are beta-blockers, such as metoprolol, atenolol, and carvedilol.

No, not all of them do. While beta-blockers and some calcium channel blockers lower both heart rate and blood pressure, drugs like ivabradine are selective heart rate lowerers and do not affect blood pressure.

Beta-blockers are generally not recommended for people with severe bradycardia (slow heart rate), high-grade heart block, decompensated heart failure, or severe asthma.

No, you should never stop taking a heart rate-lowering medication suddenly without consulting your doctor. Abrupt discontinuation, especially with beta-blockers, can cause dangerous rebound effects.

A slow heart rate (bradycardia) is not always a cause for concern. It is common and often normal for well-trained athletes, healthy young adults, and during sleep.

Some natural methods include regular exercise to strengthen the heart, stress reduction techniques like meditation and deep breathing, staying hydrated, and avoiding stimulants like caffeine and tobacco.

Digoxin works by slowing the electrical signals in the heart's AV node, which slows the overall heart rate. It also increases the force of the heart's contractions.

Common side effects include fatigue, cold hands or feet, dizziness, and weight gain. Less common side effects can include depression, trouble sleeping, and sexual dysfunction.

Some calcium channel blockers, especially the non-dihydropyridine types like verapamil and diltiazem, should be used with caution in patients with heart failure, as they can potentially worsen symptoms.