Drug interactions
Diltiazem + Eliglustat
Severity: Major
Diltiazem and Eliglustat: major interaction.
Last updated Sources: UK SmPC
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 can raise eliglustat concentrations, which may prolong PR, QTc and QRS intervals and cause arrhythmia. The effect is larger in CYP2D6 poor or intermediate metabolizers and in those with cardiac disease.
What this interaction means in plain words
Diltiazem and Eliglustat 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; Eliglustat belongs to Miscellaneous.
Why it happens
Diltiazem inhibits CYP3A4, a secondary elimination pathway for eliglustat, which is mainly metabolized by CYP2D6.
What to do
In extensive metabolizers, reduce eliglustat to 84 mg once daily and monitor ECG. Avoid in intermediate or poor CYP2D6 metabolizers.
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 Eliglustat
- Amiodarone + Eliglustat Contraindicated
- Clarithromycin + Eliglustat Contraindicated
- Dronedarone + Eliglustat Contraindicated
- Eliglustat + Itraconazole Contraindicated
- Eliglustat + Ketoconazole Contraindicated
- Eliglustat + Pimozide Contraindicated
Frequently asked questions
Can I take Diltiazem with Eliglustat?
MediHelp rates the interaction as major. Diltiazem and Eliglustat 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 can raise eliglustat concentrations, which may prolong PR, QTc and QRS intervals and cause arrhythmia. The effect is larger in CYP2D6 poor or intermediate metabolizers and in those with cardiac disease.
How serious is the interaction between Diltiazem and Eliglustat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: In extensive metabolizers, reduce eliglustat to 84 mg once daily and monitor ECG. Avoid in intermediate or poor CYP2D6 metabolizers.
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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