Corlanor (Ivabradine Tablets) and Crizotinib

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Crizotinib may 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. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

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 moderate CYP450 3A4 inhibitors (e.g., diltiazem, verapamil, grapefruit juice) has been shown to increase ivabradine systemic exposure (AUC) by approximately 2- to 3-fold. Elevated plasma levels of ivabradine may increase the risk of excessive bradycardia and conduction disturbances.

GENERALLY AVOID: Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that can prolong the QT interval. In clinical studies, the rate of bradycardia was 6.0% versus 1.3% per patient-year for ivabradine compared to placebo. At recommended dosages of ivabradine, heart rate reduction is approximately 10 beats per minute at rest and during exercise. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Concomitant use of ivabradine with moderate CYP450 3A4 inhibitors that can also prolong the QT interval such as crizotinib, dronedarone, fluconazole, lefamulin (when administered orally), and mifepristone should generally be avoided. If coadministration is required, a dosage reduction of ivabradine should be considered. Some authorities recommend initiating ivabradine at a dosage of 2.5 mg twice daily when used with moderate CYP450 3A4 inhibitors, provided the resting heart rate is at or above 70 beats per minute and frequent cardiac monitoring is performed. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

Corlanor (Ivabradine Tablets)

Generic Name: ivabradine

Brand name: Corlanor

Synonyms: Corlanor

What is Corlanor (Ivabradine Tablets)?

Crizotinib

Generic Name: crizotinib

Brand name: Xalkori

Synonyms: n.a.

What is Crizotinib?