Drug interactions
Ivabradine + Lenacapavir
Severity: Major
Ivabradine and Lenacapavir: major interaction.
Last updated Sources: UK SmPC
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
Lenacapavir is a moderate CYP3A inhibitor and can raise levels of CYP3A substrates such as ivabradine. This may cause excessive bradycardia and conduction problems, and the effect can persist for months after the last subcutaneous dose.
What this interaction means in plain words
Ivabradine and Lenacapavir 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.
Ivabradine belongs to Cardiovascular; Lenacapavir belongs to Anti Virals.
Why it happens
CYP3A4 inhibition by lenacapavir reducing ivabradine metabolism.
What to do
Avoid the combination where possible, or use a lower ivabradine dose and monitor heart rate and ECG closely. Continue monitoring for months after the last lenacapavir injection.
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
- Ivabradine 2.5 mg film-coated Tablets - SmPC sections 4.3/4.5 (class statement: CYP3A4 inhibitors; "CYP3A4 inhibitors and inducers are liable to interact with ivabradine and influence its metabolism and pharmacokinetics to a clinically significant extent.") — electronic medicines compendium (UK SmPC)
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 Lenacapavir
- Apalutamide + Lenacapavir Contraindicated
- Carbamazepine + Lenacapavir Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
- Flibanserin + Lenacapavir Contraindicated
- Lenacapavir + Phenytoin Contraindicated
- Lenacapavir + Rifampicin Contraindicated
Frequently asked questions
Can I take Ivabradine with Lenacapavir?
MediHelp rates the interaction as major. Ivabradine and Lenacapavir 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. Lenacapavir is a moderate CYP3A inhibitor and can raise levels of CYP3A substrates such as ivabradine. This may cause excessive bradycardia and conduction problems, and the effect can persist for months after the last subcutaneous dose.
How serious is the interaction between Ivabradine and Lenacapavir?
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 where possible, or use a lower ivabradine dose and monitor heart rate and ECG closely. Continue monitoring for months after the last lenacapavir injection.
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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