Diltiazem and Metoprolol and hydrochlorothiazide interaction

Diltiazem and Metoprolol and hydrochlorothiazide: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Diltiazem (Cardizem LA) label · effective 2025-11-11

Moderate

Concomitant use of diltiazem with beta-blockers or digitalis may result in additive effects on cardiac conduction.

Warnings and precautionsby drug classView label on DailyMed
Moderate

• Beta-blockers, digitalis, and other agents known to impair cardiac contractility and conduction may increase risk for hypotension, bradycardia, and heart failure.

Drug interactionsby drug classView label on DailyMed
Minor

Experience with the use of diltiazem in combination with beta-blockers in patients with impaired ventricular function is limited.

Warnings and precautionsby drug classView label on DailyMed

From the Metoprolol and hydrochlorothiazide (METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE) label · effective 2025-01-22

Moderate

Digitalis, Clonidine, and Calcium Channel Blockers: Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate.

Drug interactionsby drug classView label on DailyMed
Minor

Digitalis glycosides, clonidine, diltiazem and verapamil: Bradycardia.

Drug interactionsnames DiltiazemView label on DailyMed
Minor

Because of its relative beta 1 cardio-selectivity, however, metoprolol tartrate may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment.

Warnings and precautionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.