Compatibility «Ivabradine» and «Dexamethasone»

• Interactions Ivabradine with Dexamethasone

  • Dangerous interactions
    • ⓘ Concomitant use of strong CYP3A4 inhibitors is contraindicated (see 'Contraindications').
    • ⓘ The simultaneous use of ivabradine with strong inhibitors of the CYP3A4 isoenzyme, such as antifungal agents of the azole group (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin for oral administration, josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone is contraindicated (see 'Contraindications').
  • Negative interactions
    • ⓘ Simultaneous use of CYP3A4 inhibitors increases the concentration of ivabradine in blood plasma, and the use of CYP3A4 inducers reduces it.
    • ⓘ Concomitant use of moderate CYP3A4 inhibitors and ivabradine should be avoided.
    • ⓘ Simultaneous use of CYP3A4 inducers and ivabradine should be avoided.
    • ⓘ Ivabradine is metabolized in the liver with the participation of cytochrome P450 isoenzymes (CYP3A4 isoenzyme) and is a very weak inhibitor of this cytochrome.
    • ⓘ At the same time, inhibitors and inducers of the CYP3A4 isoenzyme can interact with ivabradine and have a clinically significant effect on its metabolism and pharmacokinetic properties.
    • ⓘ It was found that inhibitors of the CYP3A4 isoenzyme increase, and inducers of the CYP3A4 isoenzyme decrease the plasma concentrations of ivabradine.
    • ⓘ Strong inhibitors of the CYP3A4 isoenzyme - ketoconazole (200 mg 1 time per day) or josamycin (1 g 2 times per day) increase the average concentrations of ivabradine in blood plasma by 7-8 times.
    • ⓘ Moderate inhibitors of the CYP3A4 isoenzyme.
    • ⓘ The use of ivabradine in combination with other moderate inhibitors of the CYP3A4 isoenzyme (for example, fluconazole) is possible provided that the resting heart rate is more than 60 beats.
    • ⓘ Inducers of the CYP3A4 isoenzyme, such as rifampicin, barbiturates, phenytoin and herbal remedies containing St. John's wort, when used together, may lead to a decrease in blood concentration and activity of ivabradine and require the selection of a higher dose of ivabradine.
    • ⓘ Simultaneous use of ivabradine (CYP3A4 substrate) and dexamethasone (CYP3A4 inducer) should be avoided.
    • ⓘ Concomitant use may reduce the concentration of ivabradine in blood plasma and lead to ineffective treatment.
  • No interactions
    • ⓘ Ivabradine has no significant effect on the metabolism and plasma concentrations of other substrates (strong, moderate and weak inhibitors) of cytochrome CYP3A4.
  • Unclear interactions
    • ⓘ The effect of concomitantly administered drugs (inhibitors, substrates, CYP3A4 inducers and other concomitantly administered drugs) on the pharmacokinetics of ivabradine has been studied in several single- and multiple-dose studies.
    • ⓘ Ivabradine is mainly metabolized with the participation of CYP3A4.
    • ⓘ Examples of strong CYP3A4 inhibitors include azole antifungal drugs (e.g., itraconazole), macrolide antibiotics (e.g., clarithromycin, telithromycin), HIV protease inhibitors (e.g., nelfinavir) and nefazodone.
    • ⓘ Examples of moderate CYP3A4 inhibitors include diltiazem, verapamil, and grapefruit juice (see Precautions).
    • ⓘ Examples of CYP3A4 inducers include St. John's wort, rifampicin, barbiturates, and phenytoin.
    • ⓘ Cytochrome P4503A4 (isoenzyme CYP3A4).
    • ⓘ Ivabradine.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine