Interações medicamentosas
Clarithromycin + Ivabradine
Gravidade: Contraindicada
Clarithromycin and Ivabradine: contraindicated interaction.
Última atualização Fontes: US FDA label
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Resumo
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.
O que esta interação significa em palavras simples
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.
Por que acontece
Clarithromycin is a strong CYP3A4 inhibitor that reduces first-pass and systemic metabolism of ivabradine, leading to excess heart rate lowering.
O que fazer
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.
O que perguntar ao farmacêutico
- 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?
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Referências
- Corlanor (ivabradine) Prescribing Information - Contraindications — FDA Label
- Procoralan (ivabradine) Summary of Product Characteristics — EMA SmPC
Outras interações de Ivabradine
- Atazanavir + Ivabradine Contraindicada
- Cobicistat + Ivabradine Contraindicada
- Conivaptan + Ivabradine Contraindicada
- Darunavir + Ivabradine Contraindicada
- Diltiazem + Ivabradine Contraindicada
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ivabradine Contraindicada
Outras interações de Clarithromycin
- Astemizole + Clarithromycin Contraindicada
- Avanafil + Clarithromycin Contraindicada
- Cisapride + Clarithromycin Contraindicada
- Clarithromycin + Colchicine Contraindicada
- Clarithromycin + Conivaptan Contraindicada
- Clarithromycin + Dihydroergotamine Contraindicada
Perguntas frequentes
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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