Drug interactions
Diltiazem + Rivaroxaban
Severity: Moderate
Diltiazem and Rivaroxaban: 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
Diltiazem can raise rivaroxaban exposure and bleeding risk, particularly in patients with renal impairment. The effect is modest in those with normal kidney function.
What this interaction means in plain words
Diltiazem and Rivaroxaban 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.
Diltiazem belongs to Cardiovascular; Rivaroxaban belongs to Cardiovascular.
Why it happens
Diltiazem inhibits CYP3A4 and P-glycoprotein, which both clear rivaroxaban.
What to do
Monitor for bleeding, and in patients with renal impairment use together only if benefit outweighs risk, considering an alternative anticoagulant.
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
Other interactions of Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Diltiazem with Rivaroxaban?
MediHelp rates the interaction as moderate. Diltiazem and Rivaroxaban 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. Diltiazem can raise rivaroxaban exposure and bleeding risk, particularly in patients with renal impairment. The effect is modest in those with normal kidney function.
How serious is the interaction between Diltiazem and Rivaroxaban?
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 for bleeding, and in patients with renal impairment use together only if benefit outweighs risk, considering an alternative anticoagulant.
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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