Drug interactions
Diltiazem + Ivabradine
Severity: Contraindicated
Diltiazem 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
Diltiazem increases ivabradine exposure and also lowers heart rate itself. The combination can cause marked bradycardia, conduction block and related symptoms such as dizziness or syncope.
What this interaction means in plain words
Diltiazem 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.
Diltiazem belongs to Cardiovascular; Ivabradine belongs to Cardiovascular.
Why it happens
Moderate CYP3A4 inhibition raises ivabradine concentrations, with additive sinus node slowing from both drugs.
What to do
Avoid the combination; labeling advises against ivabradine with diltiazem or verapamil. Choose an alternative antianginal or heart failure strategy.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Diltiazem and Ivabradine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
- Amifostine + Diltiazem Major
Other interactions of Ivabradine
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ivabradine Contraindicated
Frequently asked questions
Can I take Diltiazem with Ivabradine?
MediHelp rates the interaction as contraindicated. Diltiazem 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. Diltiazem increases ivabradine exposure and also lowers heart rate itself. The combination can cause marked bradycardia, conduction block and related symptoms such as dizziness or syncope.
How serious is the interaction between Diltiazem 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; labeling advises against ivabradine with diltiazem or verapamil. Choose an alternative antianginal or heart failure strategy.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Lomitapide, Lonafarnib. The full list is on the Diltiazem page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
