Diltiazem and Ivabradine interaction
Diltiazem and Ivabradine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Diltiazem (DILTIAZEM HYDROCHLORIDE in SODIUM CHLORIDE) label · effective 2025-04-15
• Ivabradine: Avoid concomitant use.
Ivabradine May exacerbate bradycardia and conduction disturbances.
From the Ivabradine (Corlanor) label · effective 2025-11-10
Concurrent use of verapamil or diltiazem will increase Corlanor exposure, may themselves contribute to heart rate lowering, and should be avoided [see Clinical Pharmacology ( 12.3 )] .
…bradycardia [see Warnings and Precautions ( 5.3 )] • Severe hepatic impairment [see Use in Specific Populations ( 8.6 )] • Pacemaker dependence (heart rate maintained exclusively by the pacemaker) [see Drug Interactions ( 7.3 )] • Concomitant use of strong cytochrome P450 3A4 (CYP3A4) inhibitors [see Drug Interactions ( 7.1 )] Acute decompensated heart failure ( 4 )
In combination with strong cytochrome CYP3A4 inhibitors ( 4 )
DRUG INTERACTIONS Avoid CYP3A4 inhibitors or inducers.
The concomitant use of strong CYP3A4 inhibitors is contraindicated [ s ee Contraindications ( 4 ) and Clinical Pharmacology ( 12.3 )] .
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.