Drug interactions
Amiodarone + Diltiazem
Severity: Major
Amiodarone and Diltiazem: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining these drugs can cause marked bradycardia, sinus arrest, AV block and reduced cardiac output. Diltiazem may also raise amiodarone exposure.
What this interaction means in plain words
Amiodarone and Diltiazem can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Diltiazem belongs to Cardiovascular.
Why it happens
Additive suppression of sinus and AV nodal conduction, with CYP3A4 inhibition by diltiazem increasing amiodarone levels.
What to do
Avoid if possible; if used, monitor ECG and heart rate closely, especially at initiation, and be ready to reduce doses or stop one agent.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Diltiazem?
MediHelp rates the interaction as major. Amiodarone and Diltiazem can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining these drugs can cause marked bradycardia, sinus arrest, AV block and reduced cardiac output. Diltiazem may also raise amiodarone exposure.
How serious is the interaction between Amiodarone and Diltiazem?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if used, monitor ECG and heart rate closely, especially at initiation, and be ready to reduce doses or stop one agent.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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