Drug interactions
Ivabradine + Posaconazole
Severity: Contraindicated
Ivabradine and Posaconazole: contraindicated 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
Posaconazole strongly inhibits CYP3A4 and can markedly raise ivabradine exposure. This increases the risk of excessive bradycardia, conduction disturbances and visual phenomena.
What this interaction means in plain words
Ivabradine and Posaconazole 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; Posaconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated ivabradine metabolism.
What to do
Do not coadminister; use an alternative antifungal or a different heart rate-lowering strategy.
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
- Noxafil 100 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (class statement: CYP3A4 substrates; "Posaconazole is a potent inhibitor of CYP3A4. Co-administration of posaconazole with CYP3A4 substrates may result in large increases in exposure to CYP3A4 subst") — electronic medicines compendium (UK SmPC)
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
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 Posaconazole?
MediHelp rates the interaction as contraindicated. Ivabradine and Posaconazole 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. Posaconazole strongly inhibits CYP3A4 and can markedly raise ivabradine exposure. This increases the risk of excessive bradycardia, conduction disturbances and visual phenomena.
How serious is the interaction between Ivabradine and Posaconazole?
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 coadminister; use an alternative antifungal or a different heart rate-lowering strategy.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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