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Clarithromycin + Ivabradine

Gravità: Controindicata

Clarithromycin and Ivabradine: contraindicated interaction.

Ultimo aggiornamento Fonti: US FDA label

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Sintesi

Clarithromycin markedly increases ivabradine exposure, which can cause severe bradycardia, conduction disturbances and symptomatic hypotension. Clarithromycin itself can prolong the QT interval. Ivabradine labeling contraindicates concomitant use with strong CYP3A4 inhibitors.

Cosa significa questa interazione in parole semplici

Clarithromycin and Ivabradine 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.

Clarithromycin belongs to Anti Bacterial; Ivabradine belongs to Cardiovascular.

Livello di evidenza: High

Perché avviene

Clarithromycin is a strong CYP3A4 inhibitor that reduces first-pass and systemic metabolism of ivabradine, leading to excess heart rate lowering.

Cosa fare

Do not combine. Choose an antibiotic that does not inhibit CYP3A4, such as azithromycin (with QT awareness) or a non-macrolide agent appropriate to the infection.

Cosa chiedere al farmacista

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Riferimenti

Domande frequenti

Can I take Clarithromycin with Ivabradine?

MediHelp rates the interaction as contraindicated. Clarithromycin and Ivabradine 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. Clarithromycin markedly increases ivabradine exposure, which can cause severe bradycardia, conduction disturbances and symptomatic hypotension. Clarithromycin itself can prolong the QT interval. Ivabradine labeling contraindicates concomitant use with strong CYP3A4 inhibitors.

How serious is the interaction between Clarithromycin and Ivabradine?

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 combine. Choose an antibiotic that does not inhibit CYP3A4, such as azithromycin (with QT awareness) or a non-macrolide agent appropriate to the infection.

What other medicines interact with Ivabradine?

MediHelp also lists interactions of Ivabradine with, for example, Atazanavir, Cobicistat, Conivaptan. The full list is on the Ivabradine page.

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