Drug interactions
Cyclosporin + Ivabradine
Severity: Major
Cyclosporin 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
Cyclosporine may increase ivabradine concentrations and enhance its heart-rate-lowering effect. This can cause marked bradycardia, conduction disturbances and atrial fibrillation.
What this interaction means in plain words
Cyclosporin 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.
Cyclosporin belongs to Miscellaneous; Ivabradine belongs to Cardiovascular.
Why it happens
Cyclosporine inhibits CYP3A4, reducing ivabradine metabolism.
What to do
Avoid the combination where possible. If used, monitor heart rate and ECG closely and lower the ivabradine dose according to heart rate.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
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 Cyclosporin with Ivabradine?
MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporine may increase ivabradine concentrations and enhance its heart-rate-lowering effect. This can cause marked bradycardia, conduction disturbances and atrial fibrillation.
How serious is the interaction between Cyclosporin 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. If used, monitor heart rate and ECG closely and lower the ivabradine dose according to heart rate.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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