Drug interactions
Ivabradine + Propranolol
Severity: Moderate
Ivabradine and Propranolol: 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
Both drugs lower heart rate, so combined use increases the risk of symptomatic bradycardia, and possibly conduction disturbances. Although they are commonly combined in heart failure and angina, the effect is additive.
What this interaction means in plain words
Ivabradine and Propranolol 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; Propranolol belongs to Cardiovascular.
Why it happens
Additive heart rate reduction through beta-blockade and inhibition of the sinoatrial If current.
What to do
Monitor heart rate and ECG during initiation and dose titration, and reduce or stop ivabradine if resting heart rate falls persistently below 50 bpm or 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ivabradine and Propranolol, 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 Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
- Arformoterol + Propranolol 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 Propranolol?
MediHelp rates the interaction as moderate. Ivabradine and Propranolol 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. Both drugs lower heart rate, so combined use increases the risk of symptomatic bradycardia, and possibly conduction disturbances. Although they are commonly combined in heart failure and angina, the effect is additive.
How serious is the interaction between Ivabradine and Propranolol?
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 during initiation and dose titration, and reduce or stop ivabradine if resting heart rate falls persistently below 50 bpm or symptoms occur.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol 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.
