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Isoptin SR and Ivabradine

Determining the interaction of Isoptin SR and Ivabradine and the possibility of their joint administration.

Check result:

Isoptin SR <> Ivabradine

Relevance: 04.09.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Verapamil 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.

Professional:

GENERALLY AVOID: Coadministration with diltiazem or verapamil may significantly increase the plasma concentrations of ivabradine and increase the risk of excessive bradycardia or other conduction disturbances. The mechanism likely involves both inhibition of the CYP450 3A4-mediated metabolism of ivabradine by the calcium channel blockers as well as additive effects of these agents on heart rate, as they all exhibit negative chronotropic properties. According to the product labeling, administration of ivabradine with 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. Clinically, an additional heart rate reduction of 5 beats per minute has been attributed to the interaction.

MANAGEMENT: Concomitant use of ivabradine with diltiazem or verapamil should generally be avoided.

References

Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
"Product Information. Corlanor (ivabradine)." Amgen USA, Thousand Oaks, CA.
Mittal SR "Slow junctional rhythm, QTc prolongation and transient torsades de-pointes following combined use of Ivabradine, Diltiazem and Ranolazine." J Assoc Physicians India 62 (2014): 426-7
MHRA. Medicines and Healthcare Regulatory Agency "Ivabradine: emerging clinical trial evidence of increased cardiovascular risk--carefully monitor for bradycardia. Available from: URL: http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON428305" ([2014 June]):

Isoptin SR

Generic Name: verapamil

Brand name: Calan SR, Isoptin SR, Calan, Verelan, Isoptin, Isoptin IV, Covera-HS, Verelan PM

Synonyms: n.a.

What is Isoptin SR?

Ivabradine

Generic Name: ivabradine

Brand name: Corlanor

Synonyms: n.a.

What is Ivabradine?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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