Drug interactions
Digoxin + Ivabradine
Severity: Moderate
Digoxin and Ivabradine: moderate 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
Both drugs slow heart rate, so combining them can cause additive bradycardia and conduction disturbances. Ivabradine is also associated with atrial fibrillation, which complicates rate assessment in digoxin-treated patients.
What this interaction means in plain words
Digoxin and Ivabradine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Digoxin belongs to Cardiovascular; Ivabradine belongs to Cardiovascular.
Why it happens
Additive heart rate lowering: ivabradine inhibits the sinus node If current while digoxin increases vagal tone and slows AV conduction.
What to do
Monitor heart rate and ECG, particularly when starting or titrating either drug. Reduce the dose or stop ivabradine if symptomatic bradycardia occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin Major
Frequently asked questions
Can I take Digoxin with Ivabradine?
MediHelp rates the interaction as moderate. Digoxin and Ivabradine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs slow heart rate, so combining them can cause additive bradycardia and conduction disturbances. Ivabradine is also associated with atrial fibrillation, which complicates rate assessment in digoxin-treated patients.
How serious is the interaction between Digoxin and Ivabradine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate and ECG, particularly when starting or titrating either drug. Reduce the dose or stop ivabradine if symptomatic bradycardia occurs.
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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