Drug interactions
Diltiazem + Sotalol
Severity: Major
Diltiazem and Sotalol: 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 and sotalol both depress sinus and AV nodal function and contractility. The combination can cause severe bradycardia, AV block, hypotension and heart failure.
What this interaction means in plain words
Diltiazem and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic, dromotropic and inotropic effects from beta-blockade and calcium channel blockade.
What to do
Avoid in patients with conduction disease or left ventricular dysfunction. Otherwise monitor ECG, heart rate and blood pressure closely.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
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 Sotalol?
MediHelp rates the interaction as major. Diltiazem and Sotalol 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 and sotalol both depress sinus and AV nodal function and contractility. The combination can cause severe bradycardia, AV block, hypotension and heart failure.
How serious is the interaction between Diltiazem and Sotalol?
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 in patients with conduction disease or left ventricular dysfunction. Otherwise monitor ECG, heart rate and blood pressure closely.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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