Drug interactions
Diltiazem + Disopyramide
Severity: Major
Diltiazem and Disopyramide: 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
Disopyramide has negative inotropic and conduction effects that add to those of diltiazem, and diltiazem may raise disopyramide levels. This can precipitate heart failure, bradycardia, AV block and hypotension.
What this interaction means in plain words
Diltiazem and Disopyramide 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 belongs to Cardiovascular; Disopyramide belongs to Cardiovascular.
Why it happens
Additive negative inotropic and dromotropic effects, plus CYP3A4 inhibition reducing disopyramide metabolism.
What to do
Avoid the combination where possible, especially with impaired ventricular function. If used, monitor ECG, blood pressure and disopyramide levels, and reduce the dose as needed.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Other interactions of Disopyramide
- Amisulpride + Disopyramide Contraindicated
- Desipramine + Disopyramide Contraindicated
- Disopyramide + Dronedarone Contraindicated
- Disopyramide + Itraconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
- Disopyramide + Maprotiline Contraindicated
Frequently asked questions
Can I take Diltiazem with Disopyramide?
MediHelp rates the interaction as major. Diltiazem and Disopyramide 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. Disopyramide has negative inotropic and conduction effects that add to those of diltiazem, and diltiazem may raise disopyramide levels. This can precipitate heart failure, bradycardia, AV block and hypotension.
How serious is the interaction between Diltiazem and Disopyramide?
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 the combination where possible, especially with impaired ventricular function. If used, monitor ECG, blood pressure and disopyramide levels, and reduce the dose as needed.
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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