Ivabradine and Digoxin Interaction
Drug interaction information between Ivabradine and Digoxin.
Ivabradine and Digoxin have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Ivabradine and Digoxin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Both of these medications work to slow down the heart. When taken together, they can cause the heart rate to drop to a level that is too slow.
What To Do
Your doctor should check your pulse and heart rate often. Contact your doctor if you feel unusually weak, dizzy, or short of breath.
FDA Label Information
Hyperpolarization-activated cyclic nucleotide-gated channel blocker Ivabradine Can increase the risk of bradycardia.
Ivabradine Also Interacts With
- Darunavir major
- Itraconazole major
- Nirmatrelvir/Ritonavir major
- Voriconazole major
- Diltiazem moderate
Digoxin Also Interacts With
- Nicardipine major
- Posaconazole major
- Sotalol moderate
- Dofetilide moderate
- Dopamine moderate
Frequently Asked Questions
Can I take Ivabradine and Digoxin together?
This is a moderate interaction. Your doctor should check your pulse and heart rate often. Contact your doctor if you feel unusually weak, dizzy, or short of breath.
How serious is the interaction between Ivabradine and Digoxin?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Ivabradine and Digoxin interact?
Both of these medications work to slow down the heart. When taken together, they can cause the heart rate to drop to a level that is too slow.
Understanding the Ivabradine and Digoxin Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Ivabradine belongs to the HCN Channel Blocker class and Digoxin belongs to the Cardiac Glycoside class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Both of these medications work to slow down the heart. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Ivabradine has 10 total documented interactions on file in this dataset, and Digoxin has 120. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should check your pulse and heart rate often. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Ivabradine or Digoxin based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.