A 15-year-old female patient with lupus nephritis and heart failure, who had been on long-term treatment with metoprolol and ivabradine, maintained a heart rate of 65-70 beats per minute after admission. On the 14th day of admission, the patient developed a pulmonary aspergillus infection, and after 3 days of adding voriconazole antifungal treatment, the patient experienced severe bradycardia, with her heart rate dropping to 45 beats per minute. The clinical pharmacist, in combination with the patient's combined medication history and pharmacokinetic characteristics, used Naranjo's assessment scale and DIPS score to determine that the adverse reaction was due to the drug interaction between voriconazole and ivabradine, and suggested to continue voriconazole antifungal treatment and discontinue ivabradine. The doctor accepted this suggestion, and the patient's heart rate returned to 65 beats per minute the next day. The clinical pharmacist timely identified and intervened in the adverse reaction induced by the drug interactions, which promoted rational clinical medication and ensured the patient's medication safety.

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