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Drug interactions

Darunavir + Ivabradine

Severity: Contraindicated

Darunavir 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

Darunavir, particularly when boosted with ritonavir or cobicistat, strongly inhibits CYP3A4 and increases ivabradine levels. The result may be profound bradycardia and conduction block.

What this interaction means in plain words

Darunavir 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.

Darunavir belongs to Anti Virals; Ivabradine belongs to Cardiovascular.

Evidence level: Moderate

Why it happens

CYP3A4 inhibition reduces ivabradine metabolism and increases exposure.

What to do

Avoid concurrent use. Choose a different heart rate-lowering therapy while on a darunavir-based 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Darunavir with Ivabradine?

MediHelp rates the interaction as contraindicated. Darunavir 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. Darunavir, particularly when boosted with ritonavir or cobicistat, strongly inhibits CYP3A4 and increases ivabradine levels. The result may be profound bradycardia and conduction block.

How serious is the interaction between Darunavir 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 concurrent use. Choose a different heart rate-lowering therapy while on a darunavir-based regimen.

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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