Drug interactions
Ivabradine + Sotalol
Severity: Major
Ivabradine and Sotalol: major 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
Both drugs slow heart rate, raising the risk of bradycardia and conduction disturbances. Sotalol also prolongs the QT interval, and bradycardia increases the risk of torsades de pointes, making this combination more concerning than with other beta-blockers.
What this interaction means in plain words
Ivabradine and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Additive heart rate lowering from If channel inhibition and beta-blockade, with bradycardia amplifying sotalol-related QT-prolongation risk.
What to do
Avoid the combination where possible, or monitor heart rate and ECG (QTc) closely. Keep potassium and magnesium normal and reduce or stop one drug if marked bradycardia occurs.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol 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 Sotalol?
MediHelp rates the interaction as major. Ivabradine and Sotalol 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. Both drugs slow heart rate, raising the risk of bradycardia and conduction disturbances. Sotalol also prolongs the QT interval, and bradycardia increases the risk of torsades de pointes, making this combination more concerning than with other beta-blockers.
How serious is the interaction between Ivabradine and Sotalol?
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 the combination where possible, or monitor heart rate and ECG (QTc) closely. Keep potassium and magnesium normal and reduce or stop one drug if marked bradycardia occurs.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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