Drug interactions
Diltiazem + Fluvoxamine
Severity: Moderate
Diltiazem and Fluvoxamine: moderate 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
Fluvoxamine may raise diltiazem levels, increasing the risk of bradycardia, hypotension and AV block. Cases of marked bradycardia with CYP3A4 inhibitors have been described.
What this interaction means in plain words
Diltiazem and Fluvoxamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Diltiazem belongs to Cardiovascular; Fluvoxamine belongs to Central Nervous System.
Why it happens
Fluvoxamine inhibits CYP3A4 (and other CYP enzymes), reducing diltiazem clearance.
What to do
Monitor heart rate, blood pressure and ECG when starting or changing fluvoxamine, and reduce the diltiazem dose if bradycardia or hypotension occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Diltiazem with Fluvoxamine?
MediHelp rates the interaction as moderate. Diltiazem and Fluvoxamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluvoxamine may raise diltiazem levels, increasing the risk of bradycardia, hypotension and AV block. Cases of marked bradycardia with CYP3A4 inhibitors have been described.
How serious is the interaction between Diltiazem and Fluvoxamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, blood pressure and ECG when starting or changing fluvoxamine, and reduce the diltiazem dose if bradycardia or hypotension occurs.
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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