Drug interactions
Ivabradine + Nevirapine
Severity: Moderate
Ivabradine and Nevirapine: 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
Nevirapine, a moderate CYP3A4 inducer, may reduce ivabradine plasma concentrations and weaken its heart-rate-lowering effect. Loss of efficacy may leave angina or heart failure symptoms undertreated.
What this interaction means in plain words
Ivabradine and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Nevirapine induces CYP3A4, the main metabolic pathway of ivabradine, lowering its exposure.
What to do
Monitor resting heart rate and symptoms and titrate ivabradine to effect within the labeled dose range. Consider an alternative antiretroviral if heart rate control is inadequate.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ivabradine and Nevirapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine 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 Nevirapine?
MediHelp rates the interaction as moderate. Ivabradine and Nevirapine 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. Nevirapine, a moderate CYP3A4 inducer, may reduce ivabradine plasma concentrations and weaken its heart-rate-lowering effect. Loss of efficacy may leave angina or heart failure symptoms undertreated.
How serious is the interaction between Ivabradine and Nevirapine?
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 resting heart rate and symptoms and titrate ivabradine to effect within the labeled dose range. Consider an alternative antiretroviral if heart rate control is inadequate.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
