Drug interactions
Ivabradine + Rifabutin
Severity: Major
Ivabradine and Rifabutin: major interaction.
Last updated Sources: US FDA label
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
Rifabutin induces CYP3A4 and is expected to reduce ivabradine exposure, although less than rifampicin. Loss of therapeutic effect may result.
What this interaction means in plain words
Ivabradine and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ivabradine belongs to Cardiovascular; Rifabutin belongs to Anti Bacterial.
Why it happens
CYP3A4 induction by rifabutin increases ivabradine clearance.
What to do
Avoid if possible. If necessary, monitor heart rate and titrate ivabradine to effect.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Ivabradine
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Ivabradine with Rifabutin?
MediHelp rates the interaction as major. Ivabradine and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifabutin induces CYP3A4 and is expected to reduce ivabradine exposure, although less than rifampicin. Loss of therapeutic effect may result.
How serious is the interaction between Ivabradine and Rifabutin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible. If necessary, monitor heart rate and titrate ivabradine to effect.
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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