Diltiazem

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Also indexed as:

Cardizem, Dilacor XR, Diltia XT, Tiazac

Diltiazem is a calcium channel blocker used to treat angina pectoris, heart arrhythmias, and high blood pressure.

Herbs

Summary of Interactions for Diltiazem

Depletion or interference	None known
Adverse interaction	None known
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	DHEA

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Dehydroepiandrosterone (DHEA)

Diltiazem has been shown to raise blood levels of DHEA and DHEA-sulfate in insulin-resistant, obese men with high blood pressure.¹

Interactions with Herbs

Pleurisy root

As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.²

Other Interactions

Food

Diltiazem may be taken with or without food.³ Sustained-release diltiazem products should be swallowed whole, without opening, crushing, or chewing.⁴

In a study of healthy volunteers, ingestion of grapefruit juice at the sametime as diltiazem resulted in higher blood levels of the drug than when it wastaken with water.⁵ Studies withcertain other medications suggest that grapefruit juice may affect drugavailability, even if it is consumed at a different time of the day. Therefore,individuals taking diltiazem should probably avoid grapefruit and grapefruitjuice.

References

1. Beer NA, Jakubowicz DJ, Beer RM, Nestler JE. Disparate effects of insulin reduction with diltiazem on serum dehydroepiandrosterone sulfate levels in obese hypertensive men and women. J Clin Endocrinol Metab 1994;79:1077-81.
2. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
3. Du Souich P, Lery N, Lery L, et al. Influence of food on the bioavailability of diltiazem and two of its metabolites following the administration of conventional tablets and slow-release capsules. Biopharm Drug Dispos 1990;11:137-47.
4. Threlkeld DS, ed. Diuretics and Cardiovasculars, Calcium Channel Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1996, 149r-9t.
5. Christensen H, Asberg A, Holmboe AB, Berg KJ.Coadministration of grapefruit juice increases systemic exposure of diltiazem inhealthy volunteers. Eur J Clin Pharmacol 2002;58:515-20.

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Last Review: 01-21-2009

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