Drug interactions
Atenolol + Diltiazem
Severity: Major
Atenolol and Diltiazem: major interaction.
Last updated Sources: US FDA label
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
Diltiazem and atenolol both depress sinus and AV node function, and diltiazem also has negative inotropic effects. Together they can cause marked bradycardia, AV block, hypotension and heart failure, especially in patients with conduction disease or reduced ejection fraction.
What this interaction means in plain words
Atenolol 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.
Atenolol belongs to Cardiovascular; Diltiazem belongs to Cardiovascular.
Why it happens
Additive negative chronotropic, dromotropic and inotropic effects of calcium channel blockade and beta blockade.
What to do
Avoid in patients with sinus node dysfunction, AV block or reduced ventricular function. Otherwise start at low doses and monitor ECG, heart rate and blood pressure.
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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References
Other interactions of Atenolol
- Amifostine + Atenolol Major
- Amiodarone + Atenolol Major
- Atenolol + Atenolol-chlorthalidone Major
- Atenolol + Betaxolol Major
- Atenolol + Bisoprolol Major
- Atenolol + Carvedilol Major
Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Frequently asked questions
Can I take Atenolol with Diltiazem?
MediHelp rates the interaction as major. Atenolol 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. Diltiazem and atenolol both depress sinus and AV node function, and diltiazem also has negative inotropic effects. Together they can cause marked bradycardia, AV block, hypotension and heart failure, especially in patients with conduction disease or reduced ejection fraction.
How serious is the interaction between Atenolol 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 in patients with sinus node dysfunction, AV block or reduced ventricular function. Otherwise start at low doses and monitor ECG, heart rate and blood pressure.
What other medicines interact with Atenolol?
MediHelp also lists interactions of Atenolol with, for example, Amifostine, Amiodarone, Atenolol-chlorthalidone. The full list is on the Atenolol page.
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