Drug interactions
Diltiazem + Dronedarone
Severity: Major
Diltiazem and Dronedarone: 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 inhibits CYP3A4 and raises dronedarone exposure, and both drugs slow heart rate and AV conduction. The combination may cause bradycardia, AV block and hypotension.
What this interaction means in plain words
Diltiazem and Dronedarone 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; Dronedarone belongs to Cardiovascular.
Why it happens
CYP3A4 inhibition by diltiazem increases dronedarone levels, with additive pharmacodynamic effects on nodal conduction.
What to do
Start diltiazem at a low dose and increase only after an ECG shows good tolerance. Monitor heart rate, PR interval 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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Diltiazem with Dronedarone?
MediHelp rates the interaction as major. Diltiazem and Dronedarone 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 inhibits CYP3A4 and raises dronedarone exposure, and both drugs slow heart rate and AV conduction. The combination may cause bradycardia, AV block and hypotension.
How serious is the interaction between Diltiazem and Dronedarone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start diltiazem at a low dose and increase only after an ECG shows good tolerance. Monitor heart rate, PR interval and blood pressure.
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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