Drug interactions
Atazanavir + Ivabradine
Severity: Contraindicated
Atazanavir and Ivabradine: contraindicated 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
Atazanavir is a strong CYP3A4 inhibitor and can substantially raise ivabradine plasma levels. This increases the risk of excessive bradycardia, conduction disturbances and visual phenomena.
What this interaction means in plain words
Atazanavir and Ivabradine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Atazanavir belongs to Anti Virals; Ivabradine belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated first-pass and hepatic metabolism of ivabradine increases its exposure.
What to do
Do not use together. Select an alternative heart rate-lowering or antiretroviral agent that does not inhibit CYP3A4.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ivabradine
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ivabradine Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Ivabradine?
MediHelp rates the interaction as contraindicated. Atazanavir and Ivabradine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Atazanavir is a strong CYP3A4 inhibitor and can substantially raise ivabradine plasma levels. This increases the risk of excessive bradycardia, conduction disturbances and visual phenomena.
How serious is the interaction between Atazanavir and Ivabradine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together. Select an alternative heart rate-lowering or antiretroviral agent that does not inhibit CYP3A4.
What other medicines interact with Ivabradine?
MediHelp also lists interactions of Ivabradine with, for example, Clarithromycin, Cobicistat, Conivaptan. The full list is on the Ivabradine page.
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