Drug interactions
Diltiazem + Nirogacestat
Severity: Major
Diltiazem and Nirogacestat: 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 may increase nirogacestat plasma concentrations because nirogacestat is cleared mainly by CYP3A4. Increased exposure may worsen toxicities such as diarrhea, ovarian toxicity, hepatotoxicity and electrolyte disturbances.
What this interaction means in plain words
Diltiazem and Nirogacestat 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; Nirogacestat belongs to Oncology.
Why it happens
Diltiazem inhibits CYP3A4, reducing the metabolic clearance of nirogacestat.
What to do
Avoid concurrent use of moderate CYP3A inhibitors with nirogacestat and choose a non-inhibiting alternative for the cardiovascular indication. If it cannot be avoided, monitor for adverse effects and liver tests and reduce the nirogacestat dose per labeling.
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 Nirogacestat
Frequently asked questions
Can I take Diltiazem with Nirogacestat?
MediHelp rates the interaction as major. Diltiazem and Nirogacestat 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 may increase nirogacestat plasma concentrations because nirogacestat is cleared mainly by CYP3A4. Increased exposure may worsen toxicities such as diarrhea, ovarian toxicity, hepatotoxicity and electrolyte disturbances.
How serious is the interaction between Diltiazem and Nirogacestat?
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 concurrent use of moderate CYP3A inhibitors with nirogacestat and choose a non-inhibiting alternative for the cardiovascular indication. If it cannot be avoided, monitor for adverse effects and liver tests and reduce the nirogacestat dose per labeling.
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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