Ivabradine interactions
Full monograph for IvabradineCheck it against another medicine
Medicines
257 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Abiraterone Acetate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Alfuzosin Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Amiodarone Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Amisulpride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Amitriptyline Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxide | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Apalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of ivabradine and its active N-desmethylated… | 6 sources — open the full entry |
| Aprepitant | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 9 sources — open the full entry |
| Arsenic Trioxide | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Artemether + Lumefantrine | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong…2 documented mechanisms | 13 sources — open the full entry |
| Asenapine Maleate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Atomoxetine Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Azithromycin DihydratebaseOphthalmic | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocaine | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by…2 documented mechanisms | 15 sources — open the full entry |
| Betamethasone + Clotrimazole | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 9 sources — open the full entry |
| Betamethasone + Clotrimazole + Gentamicin | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 9 sources — open the full entry |
| Bicalutamide | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Cabozantinib | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of ivabradine and its active N-desmethylated… | 6 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by the… | 9 sources — open the full entry |
| Chloroquine Phosphate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Chlorpromazine Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Cilostazol | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Major | Metabolism · Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong…2 documented mechanisms | 25 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Citalopram Hydrobromide | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by the… | 9 sources — open the full entry |
| Clobetasol Propionate + Ofloxacin + Ornidazole + Terbinafine | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Clomipramine Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| ClotrimazoleEar dropEye ointmentTopicalVaginal tablet | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 9 sources — open the full entry |
| Clotrimazole + Hydrocortisone | Major | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 9 sources — open the full entry |
| Clozapine | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Crizotinib | Major | Metabolism · Synergy | Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by… | 5 sources — open the full entry |
| Dasatinib | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Daunorubicin | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Degarelix Acetate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Deutetrabenazine | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Dexamethasone + Levofloxacin | Major | Metabolism · Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong…2 documented mechanisms | 25 sources — open the full entry |
| Diltiazem Hydrochloride | Major | Metabolism | Coadministration with diltiazem or verapamil may significantly increase the plasma concentrations of ivabradine and increase the risk of excessive bradycardia… | 16 sources — open the full entry |
| Doxepin (Oral) | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Doxepin (Topical) | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Doxorubicin Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Doxorubicin Hydrochloride Liposome | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Efavirenz | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of ivabradine and its active N-desmethylated… | 6 sources — open the full entry |
| Epirubicin Hydrochloride | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Eribulin Mesylate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| ErythromycinLotionOral | Major | Metabolism · Synergy | Coadministration with moderate inhibitors of CYP450 3A4 such as erythromycin may significantly increase the plasma concentrations of ivabradine, which is… | 13 sources — open the full entry |
| Escitalopram Oxalate | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
Food & lifestyle
grapefruit juice
MajorMetabolism
Grapefruit juice may significantly increase the plasma concentrations of ivabradine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.
What to do: Patients treated with ivabradine should avoid or limit consumption of grapefruit or grapefruit juice. The manufacturer recommends taking ivabradine with meals to reduce variability in exposure.
3 sources
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):
Conditions
Conditions in which Ivabradine needs care, as documented in this source.
Cardiac Conduction System Disease
MajorThe use of ivabradine is contraindicated in sick sinus syndrome, sinoatrial block, or 3rd degree AV block, unless a functioning demand pacemaker is present, in those patients that are pacemaker dependent (heart rate maintained exclusively by the pacemaker), and in patients with resting heart rate less than 60 bpm prior to treatment.
1 source
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):
Heart Failure
MajorThe use of ivabradine is contraindicated in acute decompensated heart failure.
1 source
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):
Hepatic Insufficiency
MajorIvabradine is contraindicated in patients with severe hepatic impairment as it has not been studied in this population and an increase in systemic exposure is anticipated. No dose adjustment is required in patients with mild or moderate hepatic impairment.
1 source
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):
Hypotension
MajorThe use of ivabradine is contraindicated in those patients with blood pressure less than 90/50 mmHg.
1 source
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):
Kidney Diseases
ModerateNo dosage adjustment is required for patients with creatinine clearance 15 to 60 mL/min. Care should be exercised when using this agent in patients with creatinine clearance below 15 mL/min as no data are available.
1 source
- "Product Information. Corlanor (ivabradine)." Amgen USA (2015):