Drug interactions
Cobicistat + Ivabradine
Severity: Contraindicated
Cobicistat 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
Cobicistat is a potent CYP3A4 inhibitor and markedly increases ivabradine exposure. This can cause severe bradycardia and conduction abnormalities.
What this interaction means in plain words
Cobicistat 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.
Cobicistat belongs to Miscellaneous; Ivabradine belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4, decreasing ivabradine metabolism.
What to do
Avoid the combination. Use an alternative to ivabradine or a booster-free antiviral regimen.
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
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ivabradine Contraindicated
Other interactions of Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
Frequently asked questions
Can I take Cobicistat with Ivabradine?
MediHelp rates the interaction as contraindicated. Cobicistat 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. Cobicistat is a potent CYP3A4 inhibitor and markedly increases ivabradine exposure. This can cause severe bradycardia and conduction abnormalities.
How serious is the interaction between Cobicistat 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: Avoid the combination. Use an alternative to ivabradine or a booster-free antiviral regimen.
What other medicines interact with Ivabradine?
MediHelp also lists interactions of Ivabradine with, for example, Atazanavir, Clarithromycin, Conivaptan. The full list is on the Ivabradine page.
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