藥物交互作用
Clarithromycin + Ivabradine
嚴重程度: 禁忌併用
Clarithromycin and Ivabradine: contraindicated interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Clarithromycin is a strong CYP3A4 inhibitor that reduces first-pass and systemic metabolism of ivabradine, leading to excess heart rate lowering.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
- Corlanor (ivabradine) Prescribing Information - Contraindications — FDA Label
- Procoralan (ivabradine) Summary of Product Characteristics — EMA SmPC
Ivabradine 的其他交互作用
Clarithromycin 的其他交互作用
常見問題
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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