Drug interactions
Diltiazem + Lovastatin
Severity: Major
Diltiazem and Lovastatin: 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 raises lovastatin exposure considerably. This increases the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Diltiazem and Lovastatin 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; Lovastatin belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 reduces presystemic and hepatic metabolism of lovastatin.
What to do
Limit lovastatin to the labeled maximum with diltiazem or switch to a statin less dependent on CYP3A4 such as rosuvastatin or pravastatin. Advise patients to report muscle pain or weakness.
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 Lovastatin
- Atazanavir + Lovastatin Contraindicated
- Clarithromycin + Lovastatin Contraindicated
- Cobicistat + Lovastatin Contraindicated
- Conivaptan + Lovastatin Contraindicated
- Darunavir + Lovastatin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lovastatin Contraindicated
Frequently asked questions
Can I take Diltiazem with Lovastatin?
MediHelp rates the interaction as major. Diltiazem and Lovastatin 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 raises lovastatin exposure considerably. This increases the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Diltiazem and Lovastatin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit lovastatin to the labeled maximum with diltiazem or switch to a statin less dependent on CYP3A4 such as rosuvastatin or pravastatin. Advise patients to report muscle pain or weakness.
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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