Diltiazem and Nebivolol interaction
Diltiazem and Nebivolol: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Diltiazem (DILTIAZEM HYDROCHLORIDE in SODIUM CHLORIDE) label · effective 2025-04-15
• Concomitant administration with IV beta-blockers.
Beta-blockers Increased risk of bradycardia, AV block, and depression of contractility.
Beta-blocker may need to be decreased [see Warnings and Precautions (5.1, 5.2)].
• Beta-Blockers: Monitor for bradycardia, AV block, and depression of contractility.
From the Nebivolol (Bystolic) label · effective 2024-08-01
Non-dihydropyridine Calcium Channel Blockers Because of significant negative inotropic and chronotropic effects in patients treated with β-blockers and calcium channel blockers of the verapamil and diltiazem type, monitor the ECG and blood pressure in patients treated concomitantly with these agents.
Verapamil- or diltiazem-type calcium channel blockers may cause excessive reductions in heart rate, blood pressure, and cardiac contractility.
Calcium Channel Blockers BYSTOLIC can exacerbate the effects of myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.