STOP — Contraindicated
FDA contraindication on ivabradine label. Strong CYP3A4 inhibitors are contraindicated. Can cause severe symptomatic bradycardia.
Evidence level: STRONG
Clarithromycin can dramatically increase ivabradine (Corlanor) levels, causing your heart rate to drop dangerously low. The FDA says these must not be used together.
Clarithromycin is a strong CYP3A4 inhibitor. Ivabradine is metabolized by CYP3A4. FDA ivabradine label contraindicates strong CYP3A4 inhibitors. Can cause excessive bradycardia.
If you take Corlanor and need an antibiotic, do not use clarithromycin. Azithromycin or other antibiotics are safer alternatives.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Ivabradine follows its normal schedule. Complete the full antibiotic course as prescribed.
Higher risk for: those with liver or renal impairment, elderly, concurrent use of nephrotoxic or hepatotoxic drugs, history of C. difficile infection, or those on narrow therapeutic index medications (warfarin, digoxin).
Very slow heart rate, dizziness, fainting, visual disturbances (luminous phenomena/phosphenes), extreme fatigue, shortness of breath
Use non-CYP3A4-inhibiting antibiotics. If clarithromycin is essential, temporarily discontinue ivabradine.
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Clarithromycin can dramatically increase ivabradine (Corlanor) levels, causing your heart rate to drop dangerously low. The FDA says these must not be used together.
Follow each medication's specific timing instructions. Clarithromycin — check if it requires an empty stomach or should be taken with food. Ivabradine follows its normal schedule. Complete the full antibiotic course as prescribed.
Very slow heart rate, dizziness, fainting, visual disturbances (luminous phenomena/phosphenes), extreme fatigue, shortness of breath
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Use non-CYP3A4-inhibiting antibiotics. If clarithromycin is essential, temporarily discontinue ivabradine.
Or browse the full interaction database (121,000+ pairs).