Can you take Ivabradine with Quinora?
1 drug interaction and 17 additional warnings found for the following 2 drugs:
- ivabradine
- Quinora (quinidine)
Drug interactions
Major drug interactions
Major:
quiNIDine ivabradine
Applies to: Quinora (quinidine) and ivabradine
Using ivabradine together with quiNIDine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
ivabradine Food/Lifestyle
Applies to: ivabradine
Do not consume grapefruit or grapefruit juice during treatment with ivabradine. Grapefruit juice can significantly increase the blood levels and effects of ivabradine, which may result in excessive slowing of heart rate or other conduction disturbances. Talk to your doctor if you have any questions or concerns. Let your doctor know if you experience significant decreases in heart rate or symptoms such as dizziness, fatigue, or low blood pressure. Also seek medical attention if you develop heart palpitations, chest pressure, or worsened shortness of breath, as these may be symptoms of atrial fibrillation caused by ivabradine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate food/lifestyle interactions
Moderate:
quiNIDine Food/Lifestyle
Applies to: Quinora (quinidine)
Do not consume grapefruit or grapefruit juice during treatment with quiNIDine unless specifically directed otherwise by your doctor. Grapefruit and grapefruit juice can interact with quiNIDine and increase the levels of quiNIDine in your body. If you are already consuming grapefruit products, do not increase or decrease the amount of these products in your diet without first talking to your doctor.
Disease interactions
15 potential interactions Applies to: 12 conditions, including Heart Failure, Arrhythmia, Hypokalemia, Hypotension, and Myasthenia Gravis.
Arrhythmia
Major:
ivabradine
Ivabradine has a major potential interaction with Arrhythmia.
The use of ivabradine is contraindicated in sick sinus syndrome, sinoatrial block, or 3rd degree AV block, unless a functioning demand pacemaker is present, in those patients that are pacemaker dependent (heart rate maintained exclusively by the pacemaker), and in patients with resting heart rate less than 60 bpm prior to treatment.
Glaucoma/Intraocular Hypertension
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Glaucoma/Intraocular Hypertension.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
Heart Block
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Heart Block.
The use of quinidine is contraindicated for use in patients without a functioning artificial pacemaker whose cardiac rhythm is dependent upon a junctional or idioventricular pacemaker, including patients with complete AV block. Therapy with quinidine should be administered with caution in patients with severe sinus-node dysfunction such as sick sinus syndrome, bradycardia-tachycardia syndrome, or second- or third-degree heart block.
Heart Failure
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Heart Failure.
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
Hyperkalemia
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Hyperkalemia.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Hypokalemia
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Hypokalemia.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Hypotension
Major:
ivabradine
Ivabradine has a major potential interaction with Hypotension.
The use of ivabradine is contraindicated in those patients with blood pressure less than 90/50 mmHg.
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Hypotension.
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
Liver Disease
Major:
ivabradine
Ivabradine has a major potential interaction with Liver Disease.
Ivabradine is contraindicated in patients with severe hepatic impairment as it has not been studied in this population and an increase in systemic exposure is anticipated. No dose adjustment is required in patients with mild or moderate hepatic impairment.
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Liver Disease.
Quinidine is primarily metabolized by the liver to active and inactive forms. Hepatic dysfunction causes a slowed metabolism and elimination of the drug which can lead to quinidine toxicity if dosage is not appropriately reduced. Clinical monitoring of hepatic function is recommended.
Magnesium Imbalance
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Magnesium Imbalance.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Myasthenia Gravis
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Myasthenia Gravis.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
Renal Dysfunction
Moderate:
ivabradine
Ivabradine has a moderate potential interaction with Renal Dysfunction.
No dosage adjustment is required for patients with creatinine clearance 15 to 60 mL/min. Care should be exercised when using this agent in patients with creatinine clearance below 15 mL/min as no data are available.
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Renal Dysfunction.
Renal dysfunction causes a slowed elimination of quinidine which can lead to quinidine toxicity if dosage is not appropriately reduced. Therapy with quinidine should be administered cautiously and dosages reduced in patients with compromised renal function. Quinidine is not appreciably removed by hemodialysis.
Urinary Retention
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Urinary Retention.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
More resources
ivabradine
A total of 446 drugs are known to interact with ivabradine.
- Ivabradine is in the drug class miscellaneous cardiovascular agents.
- Ivabradine is used to treat Heart Failure.
Quinora
A total of 669 drugs are known to interact with Quinora.
- Quinora is in the drug class group I antiarrhythmics.
- Quinora is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.