Drug interactions
Diltiazem + Nitroglycerin rectal
Severity: Moderate
Diltiazem and Nitroglycerin rectal: 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
Calcium channel blockers combined with organic nitrates can cause additive vasodilation, leading to orthostatic hypotension, dizziness and syncope. Reflex effects may be blunted by diltiazem's heart rate lowering action.
What this interaction means in plain words
Diltiazem and Nitroglycerin rectal 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.
Why it happens
Additive pharmacodynamic vasodilation through different pathways (calcium channel blockade and nitric oxide-mediated smooth muscle relaxation).
What to do
Monitor blood pressure and orthostatic symptoms, particularly after initiation or dose changes. Advise patients to rise slowly and adjust doses if 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
Frequently asked questions
Can I take Diltiazem with Nitroglycerin rectal?
MediHelp rates the interaction as moderate. Diltiazem and Nitroglycerin rectal 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. Calcium channel blockers combined with organic nitrates can cause additive vasodilation, leading to orthostatic hypotension, dizziness and syncope. Reflex effects may be blunted by diltiazem's heart rate lowering action.
How serious is the interaction between Diltiazem and Nitroglycerin rectal?
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 blood pressure and orthostatic symptoms, particularly after initiation or dose changes. Advise patients to rise slowly and adjust doses if 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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