Drug interactions
Ivabradine + Nebivolol
Severity: Moderate
Ivabradine and Nebivolol: 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
Ivabradine lowers heart rate by inhibiting the sinus node, and nebivolol also slows heart rate through beta-1 blockade. Together they can cause excessive bradycardia, and in some patients conduction disturbances or symptomatic hypotension.
What this interaction means in plain words
Ivabradine and Nebivolol 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.
Ivabradine belongs to Cardiovascular; Nebivolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic effects through different mechanisms (If channel inhibition and beta-adrenergic blockade).
What to do
Monitor heart rate and ECG, especially when starting or increasing either drug. Reduce the dose or stop ivabradine if the resting heart rate falls below about 50 bpm or bradycardic symptoms occur.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol Major
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 Ivabradine with Nebivolol?
MediHelp rates the interaction as moderate. Ivabradine and Nebivolol 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. Ivabradine lowers heart rate by inhibiting the sinus node, and nebivolol also slows heart rate through beta-1 blockade. Together they can cause excessive bradycardia, and in some patients conduction disturbances or symptomatic hypotension.
How serious is the interaction between Ivabradine and Nebivolol?
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 ECG, especially when starting or increasing either drug. Reduce the dose or stop ivabradine if the resting heart rate falls below about 50 bpm or bradycardic symptoms occur.
What other medicines interact with Nebivolol?
MediHelp also lists interactions of Nebivolol with, for example, Acebutolol, Aldesleukin, Amiodarone. The full list is on the Nebivolol page.
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