Drug interactions
Diltiazem + Rifapentine
Severity: Major
Diltiazem and Rifapentine: 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
Rifapentine induces CYP3A4 and can markedly lower diltiazem concentrations, risking loss of blood pressure, angina or heart rate control.
What this interaction means in plain words
Diltiazem and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and possibly P-glycoprotein) increases diltiazem clearance.
What to do
Monitor blood pressure and heart rate closely and increase the diltiazem dose or use an alternative agent if needed. Readjust the dose when rifapentine is stopped.
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 Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Diltiazem with Rifapentine?
MediHelp rates the interaction as major. Diltiazem and Rifapentine 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. Rifapentine induces CYP3A4 and can markedly lower diltiazem concentrations, risking loss of blood pressure, angina or heart rate control.
How serious is the interaction between Diltiazem and Rifapentine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate closely and increase the diltiazem dose or use an alternative agent if needed. Readjust the dose when rifapentine is stopped.
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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