Drug interactions
Diltiazem + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Diltiazem and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
The ritonavir-boosted regimen strongly inhibits CYP3A4 and can raise diltiazem exposure. This may produce bradycardia, hypotension and conduction abnormalities.
What this interaction means in plain words
Diltiazem and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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.
Why it happens
Ritonavir and paritaprevir inhibit CYP3A4-mediated diltiazem metabolism.
What to do
Start with a reduced diltiazem dose and monitor heart rate, blood pressure and ECG, titrating to effect. Consider an alternative agent if control is difficult.
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
Frequently asked questions
Can I take Diltiazem with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Diltiazem and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. The ritonavir-boosted regimen strongly inhibits CYP3A4 and can raise diltiazem exposure. This may produce bradycardia, hypotension and conduction abnormalities.
How serious is the interaction between Diltiazem and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a reduced diltiazem dose and monitor heart rate, blood pressure and ECG, titrating to effect. Consider an alternative agent if control is difficult.
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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