Drug interactions
Ivabradine + Levoketoconazole
Severity: Contraindicated
Ivabradine and Levoketoconazole: contraindicated 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
Levoketoconazole is a strong CYP3A4 inhibitor, like ketoconazole, and substantially increases ivabradine exposure. This can lead to severe bradycardia and conduction abnormalities.
What this interaction means in plain words
Ivabradine and Levoketoconazole 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.
Ivabradine belongs to Cardiovascular; Levoketoconazole belongs to Endocrine.
Why it happens
Potent CYP3A4 inhibition decreases ivabradine first-pass and systemic clearance.
What to do
Do not combine. Choose an alternative to ivabradine while levoketoconazole is needed.
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?
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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
Other interactions of Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Ivabradine with Levoketoconazole?
MediHelp rates the interaction as contraindicated. Ivabradine and Levoketoconazole 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. Levoketoconazole is a strong CYP3A4 inhibitor, like ketoconazole, and substantially increases ivabradine exposure. This can lead to severe bradycardia and conduction abnormalities.
How serious is the interaction between Ivabradine and Levoketoconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine. Choose an alternative to ivabradine while levoketoconazole is needed.
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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