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Drug interactions

Ivabradine + Lopinavir

Severity: Contraindicated

Ivabradine and Lopinavir: 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

Lopinavir is co-formulated with ritonavir, which strongly inhibits CYP3A4 and increases ivabradine levels. Excessive bradycardia and conduction disturbances may follow.

What this interaction means in plain words

Ivabradine and Lopinavir 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; Lopinavir belongs to Anti Virals.

Evidence level: Moderate

Why it happens

Ritonavir-boosted lopinavir inhibits CYP3A4, reducing ivabradine metabolism.

What to do

Avoid use together and select an alternative therapy for heart rate control.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Ivabradine with Lopinavir?

MediHelp rates the interaction as contraindicated. Ivabradine and Lopinavir 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. Lopinavir is co-formulated with ritonavir, which strongly inhibits CYP3A4 and increases ivabradine levels. Excessive bradycardia and conduction disturbances may follow.

How serious is the interaction between Ivabradine and Lopinavir?

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 use together and select an alternative therapy for heart rate control.

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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