Ivabradine and Diltiazem Interaction
Drug interaction information between Ivabradine and Diltiazem.
Ivabradine and Diltiazem have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Ivabradine and Diltiazem. 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
Diltiazem increases the amount of ivabradine in your body, which can slow your heart rate down to a dangerous level.
What To Do
Do not take these two medications at the same time.
FDA Label Information
Ivabradine : Concurrent use of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Avoid concomitant use of ivabradine and diltiazem.
Ivabradine Also Interacts With
- Darunavir major
- Itraconazole major
- Nirmatrelvir/Ritonavir major
- Voriconazole major
- Digoxin moderate
Diltiazem Also Interacts With
- Ezetimibe major
- Ezetimibe/Simvastatin major
- Simvastatin major
- Theophylline major
- Rifampin moderate
Frequently Asked Questions
Can I take Ivabradine and Diltiazem together?
This is a moderate interaction. Do not take these two medications at the same time.
How serious is the interaction between Ivabradine and Diltiazem?
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 Diltiazem interact?
Diltiazem increases the amount of ivabradine in your body, which can slow your heart rate down to a dangerous level.
Understanding the Ivabradine and Diltiazem 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 Diltiazem belongs to the Calcium Channel Blocker class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Diltiazem increases the amount of ivabradine in your body, which can slow your heart rate down to a dangerous level. 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 Diltiazem has 46. 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: Do not take these two medications at the same time. 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 Diltiazem 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.