Drug interactions
Ivabradine + Zileuton
Severity: Moderate
Ivabradine and Zileuton: 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
Ivabradine is a CYP3A4 substrate, and increased exposure can cause excessive bradycardia, conduction disturbances and visual symptoms. Zileuton is only a weak CYP3A4 inhibitor, so the effect is likely modest, but ivabradine has a narrow margin for heart rate effects.
What this interaction means in plain words
Ivabradine and Zileuton 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; Zileuton belongs to Respiratory.
Why it happens
Weak CYP3A4 inhibition by zileuton may increase ivabradine plasma concentrations.
What to do
Monitor heart rate and ECG after starting zileuton and reduce the ivabradine dose if bradycardia develops. Use a different treatment for asthma if heart rate falls markedly.
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?
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Other interactions of Zileuton
- Fezolinetant + Zileuton Contraindicated
- Pimozide + Zileuton Contraindicated
- Alosetron + Zileuton Major
- Clozapine + Zileuton Major
- Lomitapide + Zileuton Major
- Lonafarnib + Zileuton 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 Zileuton?
MediHelp rates the interaction as moderate. Ivabradine and Zileuton 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 is a CYP3A4 substrate, and increased exposure can cause excessive bradycardia, conduction disturbances and visual symptoms. Zileuton is only a weak CYP3A4 inhibitor, so the effect is likely modest, but ivabradine has a narrow margin for heart rate effects.
How serious is the interaction between Ivabradine and Zileuton?
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 after starting zileuton and reduce the ivabradine dose if bradycardia develops. Use a different treatment for asthma if heart rate falls markedly.
What other medicines interact with Zileuton?
MediHelp also lists interactions of Zileuton with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Zileuton page.
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