Drug interactions
Aprepitant + Ivabradine
Severity: Major
Aprepitant and Ivabradine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aprepitant, a moderate CYP3A4 inhibitor, can increase ivabradine exposure. This may cause excessive bradycardia, conduction disturbances and visual symptoms.
What this interaction means in plain words
Aprepitant and Ivabradine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aprepitant belongs to Gastrointestinal Tract; Ivabradine belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated ivabradine metabolism by aprepitant.
What to do
Avoid the combination where possible, or monitor heart rate and ECG closely and lower the ivabradine dose if bradycardia occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Ivabradine
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
Frequently asked questions
Can I take Aprepitant with Ivabradine?
MediHelp rates the interaction as major. Aprepitant and Ivabradine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Aprepitant, a moderate CYP3A4 inhibitor, can increase ivabradine exposure. This may cause excessive bradycardia, conduction disturbances and visual symptoms.
How serious is the interaction between Aprepitant and Ivabradine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible, or monitor heart rate and ECG closely and lower the ivabradine dose if bradycardia occurs.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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