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Drug Interaction Report

2 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Major

chloramphenicol ivabradine

Applies to: chloramphenicol, ivabradine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ivabradine, which is primarily metabolized by the isoenzyme. According to the product labeling, administration of ivabradine with the moderate CYP450 3A4 inhibitor diltiazem (120 mg twice daily) resulted in approximately 3-fold increases in ivabradine peak plasma concentration (Cmax) and systemic exposure (AUC) compared to administration of ivabradine alone. Likewise, administration with verapamil (120 mg twice daily) increased the Cmax and AUC of ivabradine by approximately 2-fold. Grapefruit juice, another moderate CYP450 3A4 inhibitor, increased ivabradine AUC by a little over 2-fold. Elevated plasma levels of ivabradine may increase the risk of excessive bradycardia and conduction disturbances.

MANAGEMENT: Concomitant use of ivabradine with moderate CYP450 3A4 inhibitors should generally be avoided. If coadministration is required, some authorities recommend initiating ivabradine at a dosage of 2.5 mg twice daily, provided the resting heart rate is at or above 70 beats per minute and heart rate is closely monitored.

Drug and food interactions

Major

ivabradine food

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.

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Therapeutic duplication warnings

No duplication 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.


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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.

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Further information

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