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Drug Interactions between ivabradine and somatrem

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

somatrem ivabradine

Applies to: somatrem and ivabradine

MONITOR: Coadministration with human growth hormone may decrease the plasma concentrations of drugs that are metabolized by CYP450 3A4. Data from an interaction study performed in growth hormone deficient adults suggest that growth hormone (somatropin) administration can increase the clearance of compounds known to be metabolized by cytochrome P450 isoenzymes, especially CYP450 3A4. The clinical significance is unknown.

MANAGEMENT: Caution is advised when human growth hormone is used concurrently with drugs that are known CYP450 3A4 substrates, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever human growth hormone is added to or withdrawn from therapy.

References

  1. (2003) "Product Information. Humatrope (somatropin)." Lilly, Eli and Company
  2. (2004) "Product Information. Zorbtive (somatropin)." Serono Laboratories Inc
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."
View all 4 references

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Drug and food interactions

Major

ivabradine food

Applies to: ivabradine

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of ivabradine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. According to the product labeling, administration with grapefruit juice (quantity unknown) resulted in an approximately twofold increase in ivabradine systemic exposure (AUC). Elevated plasma levels of ivabradine may increase the risk of excessive bradycardia and conduction disturbances.

ADJUST DOSING INTERVAL: Food delays the absorption of ivabradine by approximately 1 hour and increases plasma exposure by 20% to 40% compared to fasting conditions.

MANAGEMENT: Patients treated with ivabradine should avoid or limit consumption of grapefruit or grapefruit juice. The manufacturer recommends taking ivabradine with meals to reduce variability in exposure.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2015) "Product Information. Corlanor (ivabradine)." Amgen USA

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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