Drug interactions
Istradefylline + Ivabradine
Severity: Moderate
Istradefylline 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
Istradefylline at 40 mg daily can raise exposure to CYP3A4 substrates, and ivabradine is a CYP3A4 substrate. Higher ivabradine levels may cause excessive bradycardia and visual symptoms.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Ivabradine belongs to Cardiovascular.
Why it happens
Dose-dependent CYP3A4 inhibition by istradefylline decreasing ivabradine metabolism.
What to do
Monitor heart rate and symptoms of bradycardia when starting or increasing istradefylline. Reduce the ivabradine dose or the istradefylline dose if bradycardia develops.
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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Ivabradine?
MediHelp rates the interaction as moderate. Istradefylline 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. Istradefylline at 40 mg daily can raise exposure to CYP3A4 substrates, and ivabradine is a CYP3A4 substrate. Higher ivabradine levels may cause excessive bradycardia and visual symptoms.
How serious is the interaction between Istradefylline 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 symptoms of bradycardia when starting or increasing istradefylline. Reduce the ivabradine dose or the istradefylline dose if bradycardia develops.
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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