Drug interactions
Erythromycin stearate + Ivabradine
Severity: Major
Erythromycin stearate 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
Erythromycin inhibits CYP3A4 and can raise ivabradine exposure. This increases the risk of bradycardia and QT-related effects.
What this interaction means in plain words
Erythromycin stearate 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.
Why it happens
Erythromycin inhibits CYP3A4, reducing ivabradine metabolism.
What to do
Avoid the combination; choose a non-interacting antibiotic such as azithromycin if suitable. If unavoidable, monitor heart rate and ECG.
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 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 Erythromycin stearate with Ivabradine?
MediHelp rates the interaction as major. Erythromycin stearate 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. Erythromycin inhibits CYP3A4 and can raise ivabradine exposure. This increases the risk of bradycardia and QT-related effects.
How serious is the interaction between Erythromycin stearate 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; choose a non-interacting antibiotic such as azithromycin if suitable. If unavoidable, monitor heart rate and ECG.
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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