Drug interactions
Carbamazepine + Ivabradine
Severity: Major
Carbamazepine and Ivabradine: major interaction.
Last updated Sources: US FDA label
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
Carbamazepine is a strong CYP3A4 inducer and can markedly lower ivabradine levels, risking loss of effect.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Ivabradine belongs to Cardiovascular.
Why it happens
Potent CYP3A4 induction by carbamazepine accelerates ivabradine metabolism.
What to do
Avoid the combination; strong CYP3A4 inducers are not recommended. Use a non-inducing antiepileptic if possible.
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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References
Other interactions of Ivabradine
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Ivabradine?
MediHelp rates the interaction as major. Carbamazepine 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. Carbamazepine is a strong CYP3A4 inducer and can markedly lower ivabradine levels, risking loss of effect.
How serious is the interaction between Carbamazepine 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; strong CYP3A4 inducers are not recommended. Use a non-inducing antiepileptic if possible.
What other medicines interact with Ivabradine?
MediHelp also lists interactions of Ivabradine with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Ivabradine page.
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