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. 10 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
- 10
- Moderate
- 3
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 (10)
- 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 + Nexterone (Amiodarone Hci)— Concomitant use can potentiate electrophysiologic and hemodynamic effects, resulting in bradycardia, sinus arrest, and A…
- 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 (3)
- 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 + Nonselective Beta-Adrenergic Antagonists— Negative chronotropes that increase risk of bradycardia with ivabradine. Monitor heart rate.