Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of ivabradine with other drugs that can slow the heart rate such as beta-blockers, calcium channel blockers, and digitalis may increase the risk of excessive bradycardia or other conduction disturbances. Non-cardiac drugs that may also cause bradycardia include atazanavir, fingolimod, lacosamide, lithium, mefloquine, succinylcholine, thalidomide, H2-receptor antagonists, tricyclic antidepressants, and anticholinesterase or cholinergic agents.

MANAGEMENT: Caution is advised when ivabradine is prescribed with other bradycardic drugs. Heart rate should be closely monitored, and the dosage of ivabradine adjusted accordingly. Patients should be advised to report significant decreases in heart rate or symptoms such as dizziness, lightheadedness, fatigue, and hypotension.

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.