Diltiazem

Moderate CYP3A4 inhibitor; concomitant use is contraindicated due to increased risk of hypotension and syncope.

ZEPOSIA should generally not be initiated in patients concurrently treated with diltiazem and a beta blocker due to potential additive effects on heart rate.

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

Concomitant use may cause left ventricular failure, AV conduction disturbances, and complete heart block, especially with impaired cardiac function.

Calcium antagonist that depresses myocardium and inhibits AV conduction; use with care when combined with bisoprolol fumarate.

Moderate CYP3A inhibitor; when combined with a CYP2C9 inhibitor, will likely lead to large increases in bosentan plasma concentrations. Co-administration not recommended.

CYP3A4 inhibitor that increased buspirone AUC and Cmax 5.5 and 4 fold respectively; adverse events more likely.

Diltiazem increased buspirone AUC 5.5-fold and Cmax 4-fold; adverse events attributable to buspirone may be more likely during concomitant administration.

Moderate CYP3A4 inhibitor increases cilostazol exposure. Requires cilostazol dose reduction to 50 mg twice daily.

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with clonidine and diltiazem concomitantly.

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with concomitant use of clonidine and diltiazem.

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with concurrent use of clonidine and diltiazem.

Moderate or strong CYP3A4 inhibitor; reduce EMFLAZA dose to one third of recommended dosage when used concomitantly.

Hypotension risk with concomitant erythromycin use. CYP3A4-metabolized calcium channel blocker.

Do not exceed 10 mg/10 mg ezetimibe and simvastatin tablets daily due to increased myopathy risk.

Heart rate-slowing calcium channel blocker. Concomitant use during fingolimod initiation may result in severe bradycardia or heart block.

Heart rate-slowing calcium channel blocker. Concomitant use during fingolimod initiation may cause severe bradycardia or heart block. Consider switching.

Heart rate-slowing calcium channel blocker; risk of severe bradycardia or heart block during TASCENSO ODT initiation.

Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations; avoid concomitant use.

Concomitant use can increase risk of bradycardia or hypotension due to slowed atrioventricular conduction and decreased heart rate.

Increases risk of myopathy/rhabdomyolysis, particularly with higher doses of lovastatin.

Moderate CYP3A4 inhibitor increases lurasidone exposure. Lurasidone dose should be reduced to half the original level.

Concomitant use increases risk of bradycardia. Both agents slow atrioventricular conduction and decrease heart rate.

Calcium channel blocker slows atrioventricular conduction and decreases heart rate; concomitant use with metoprolol increases bradycardia risk.

Calcium channel blocker that slows AV conduction and decreases heart rate; concomitant use with metoprolol increases bradycardia risk.

Calcium channel blocker that slows atrioventricular conduction and decreases heart rate; concomitant use with metoprolol increases risk of bradycardia.

Concomitant use increases risk of bradycardia due to additive negative chronotropic effects.

Calcium channel blocker that slows atrioventricular conduction; concomitant use with metoprolol can increase risk of bradycardia.

Calcium channel blocker that may cause excessive reductions in heart rate, blood pressure, and cardiac contractility.

Calcium channel blocker may cause excessive reductions in heart rate, blood pressure, and cardiac contractility.

Heart rate lowering calcium channel blocker; should generally not be initiated with PONVORY due to additive heart rate reduction.

Coadministration in cardiac disease patients associated with bradycardia, hypotension, high degree heart block, and heart failure.

Diltiazem significantly decreases quinidine clearance and increases half-life, requiring monitoring of quinidine levels.

Calcium channel blocker that increases risk of myopathy and rhabdomyolysis. Do not exceed simvastatin 10 mg daily.

Heart-rate lowering calcium channel blocker; treatment with siponimod should generally not be initiated due to additive heart rate effects.

Calcium channel blocker; concomitant use increases risk of bradycardia and hypotension.

Left ventricular failure and AV conduction disturbances reported with concomitant use; additive effects in prolonging AV conduction time.

Possible drug interaction with alprazolam based on clinical studies in other benzodiazepines. Caution recommended during coadministration.

Co-administration resulted in 60% increase in amlodipine systemic exposure in elderly hypertensive patients. Monitor for symptoms of hypotension and edema.

Calcium antagonist that may depress myocardium and inhibit AV conduction. Use with caution when combined with bisoprolol.

CYP3A4 inhibitor that increases carbamazepine plasma levels. Close monitoring of carbamazepine levels and dosage adjustment may be required.

Calcium channel blocker may affect ECG and/or blood pressure when used with carvedilol.

Calcium channel blocker that may affect ECG and/or blood pressure when used with carvedilol.

Moderate CYP3A4 inhibitor causing significant increase in colchicine plasma concentration. Monitor for toxicity signs.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Moderate CYP3A4 inhibitor; no dosing adjustments recommended for darifenacin when co-administered with diltiazem.

Increases digoxin serum concentration by 20%. Requires monitoring and dose adjustment.

Moderate to strong CYP3A4 inhibitor can increase plasma concentrations of estrogen or progestin or both.

Moderate or strong CYP3A4 inhibitor that can increase plasma concentrations of estrogen or progestin or both.

Moderate CYP3A4 inhibitor that can increase plasma concentrations of estrogen or progestin.

Significant CYP3A inhibitor; estazolam should be used with caution and appropriate dosage reduction may be needed.

CYP3A4 inhibitor that increases serum concentrations of estradiol and dienogest.

Moderate CYP3A4 inhibitor. No dosing adjustments recommended in the presence of this drug.

Bradycardia with coadministration.

Inhibits P450-3A4 enzyme system, increasing midazolam half-life from 5 to 7 hours and prolonging sedation.

Inhibits P450-3A4 enzyme system, increasing midazolam half-life from 5 to 7 hours, resulting in prolonged sedation.

P450-3A4 inhibitor may result in prolonged sedation. Increases midazolam half-life from 5 to 7 hours.

May result in prolonged sedation due to decreased plasma clearance of midazolam.

Moderate CYP3A inhibitor increasing plasma naldemedine concentrations; monitor for adverse reactions.

Moderate CYP3A4 inhibitor that increases naloxegol concentrations; avoid concomitant use or reduce dosage to 12.5 mg once daily and monitor for adverse reactions.

Concomitant use can potentiate electrophysiologic and hemodynamic effects, resulting in bradycardia, sinus arrest, and AV block.

CYP3A inhibitor that increases nifedipine AUC by factors of 2.2 to 3.1 and C max by factors of 1.7 to 2.0. Caution should be exercised and dose reduction of nifedipine considered.

Moderate CYP3A4 inhibitor and calcium channel blocker that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Significantly decreases quinidine clearance and increases quinidine half-life.

CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Weak/moderate CYP3A4/P-gp inhibitor that may increase sirolimus concentrations. Monitor and adjust dosage as needed.

Strong CYP3A4 inhibitor that may increase midostaurin concentrations and risk of toxicity. Monitor for increased adverse reactions, especially during first week of administration.

Moderate CYP3A4 inhibitor that may increase silodosin concentration. Monitor patients for adverse events.

Moderate CYP3A inhibitor; recommended suvorexant dose is 5 mg, may increase to 10 mg if needed.

Mild or moderate CYP3A inhibitor calcium channel blocker that may affect tacrolimus concentrations. Monitor tacrolimus whole blood trough concentrations.

Data from clinical studies of similar benzodiazepines suggest possible drug interaction with triazolam. Caution recommended.

Moderate CYP3A4 inhibitor that increases voclosporin exposure; dosage reduction of voclosporin required.

Moderate CYP3A4 inhibitor; no dosing adjustments recommended.

Decreases dutasteride clearance and increases dutasteride exposure, but this change is not clinically significant and no dose adjustment is recommended.

CYP3A inhibitor not expected to have significant effect on prasugrel active metabolite pharmacokinetics.

Weak cytochrome P450 3A4 inhibitor with no clinically significant effect on pravastatin pharmacokinetics.

Too little experience with coadministration of flecainide acetate and diltiazem to recommend concomitant use.