Ivabradine has 23 known drug interactions based on U.S. FDA drug labeling data. Of these, 10 are contraindicated combinations that should be avoided entirely. 9 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Clarithromycin, Diltiazem Hydrochloride, Diltiazem Hydrochloride Extended-Release Tablets. Patients taking Ivabradine should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 23
- Contraindicated
- 10
- Major
- 9
- Moderate
- 4
Contraindicated (10)
- Ivabradine + Clarithromycin— Strong CYP3A4 inhibitor that increases ivabradine plasma concentrations, exacerbating bradycardia and conduction disturb…
- Ivabradine + Diltiazem Hydrochloride— Concurrent use increases ivabradine exposure and may exacerbate bradycardia and conduction disturbances. Avoid concomita…
- Ivabradine + Diltiazem Hydrochloride Extended-Release Tablets— Diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Concomitant use s…
- Ivabradine + Itraconazole— Strong CYP3A4 inhibitor that increases ivabradine plasma concentrations, exacerbating bradycardia and conduction disturb…
- Ivabradine + Levoketoconazole— Concomitant use is contraindicated due to increased risk of QT prolongation and torsades de pointes.
- Ivabradine + Nefazodone— Strong CYP3A4 inhibitor that increases ivabradine plasma concentrations, exacerbating bradycardia and conduction disturb…
- Ivabradine + Nelfinavir— Strong CYP3A4 inhibitor that increases ivabradine plasma concentrations, exacerbating bradycardia and conduction disturb…
- Ivabradine + Telithromycin— Strong CYP3A4 inhibitor that increases ivabradine plasma concentrations, exacerbating bradycardia and conduction disturb…
- Ivabradine + Trandolapril And Verapamil Hydrochloride— Concurrent verapamil use increases ivabradine exposure and may exacerbate bradycardia and conduction disturbances. Avoid…
- Ivabradine + Verapamil Hydrochloride— Concurrent use increases ivabradine exposure and may exacerbate bradycardia and conduction disturbances. Avoid co-admini…
Major (9)
- Ivabradine + Amiodarone Hydrochloride— Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and…
- Ivabradine + Barbiturates— CYP3A4 inducers that decrease ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Diltiazem— Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Grapefruit Juice— Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Phenytoin— CYP3A4 inducer that decreases ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Rifampin— CYP3A4 inducer that decreases ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Siponimod— Drug that may decrease heart rate; treatment with siponimod should generally not be initiated due to additive heart rate…
- Ivabradine + St. John'S Wort— CYP3A4 inducer that decreases ivabradine plasma concentrations; avoid concomitant use.
- Ivabradine + Verapamil— Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations; avoid concomitant use.
Moderate (4)
- Ivabradine + Amiodarone— Negative chronotrope that increases risk of bradycardia with ivabradine. Monitor heart rate.
- Ivabradine + Digoxin— Negative chronotrope that increases risk of bradycardia with ivabradine. Monitor heart rate.
- Ivabradine + Nexterone (Amiodarone Hci)— Concomitant use can potentiate electrophysiologic and hemodynamic effects, resulting in bradycardia, sinus arrest, and A…
- Ivabradine + Nonselective Beta-Adrenergic Antagonists— Negative chronotropes that increase risk of bradycardia with ivabradine. Monitor heart rate.