Diltiazem with Moricizine Interaction Details
Brand Names Associated with Diltiazem
- Cardizem®
- Cardizem® CD
- Cardizem® LA
- Cardizem® SR
- Cartia® XT
- Dilacor® XR
- Dilt-CD®
- Diltiazem
- Diltzac®
- Taztia® XT
- Teczem® (as a combination product containing Diltiazem, Enalapril)
- Tiamate®
- Tiazac®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Increased moricizine concentrations and decreased diltiazem concentrations
Interaction Summary
A controlled study observed a significant two way pharmacokinetic interaction between moricizine and diltiazem. Coadministration resulted in increased moricizine area under the concentration-time curve (AUC), increased moricizine maximum plasma concentration (Cmax), and decreased moricizine oral clearance. For diltiazem, coadministration resulted in decreased AUC, decreased Cmax, and decreased half-life.
Severity
Moderate
Onset
Delayed
Evidence
Probable
How To Manage Interaction
A cautious approach is advisable during coadministration of moricizine and diltiazem due to the possibility of increased moricizine concentrations and decreased diltiazem concentrations. Dosage adjustments of both drugs may be required to achieve optimal therapeutic effect.
Mechanism Of Interaction
Diltiazem inhibition of moricizine metabolism and moricizine induction of diltiazem metabolism
Literature Reports
A) In an open-label, nonrandomized study of 24 healthy male volunteers, the pharmacokinetic interactions of moricizine and diltiazem were examined. Sixteen subjects who completed the study received treatment in three phases. The subjects received moricizine 250 mg every eight hours for seven days followed by a 12 day washout period, diltiazem 60 mg every eight hours for seven days, and moricizine 250 mg plus diltiazem 60 mg every eight hours for seven days. During coadministration of moricizine and diltiazem, moricizine maximum concentration (Cmax) and the area under the concentration-time curve (AUC) were both significantly increased by 88.9% and 121.1%, respectively. Mean oral clearance of moricizine decreased by 54%. For diltiazem pharmacokinetic parameters, mean Cmax was decreased by 36% an AUC was decreased by 36% when given with moricizine, while oral clearance of diltiazem was significantly decreased by approximately 52%. Half-life of diltiazem also decreased from 4.6 hours +/- 1.3 hours to 3.6 hours +/- 0.7 hours during coadministration with moricizine. The authors postulated that the opposing interaction between moricizine and diltiazem may have been due to diltiazem inhibition of moricizine metabolism and moricizine induction of diltiazem metabolism .
Diltiazem Overview
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Diltiazem is used to treat high blood pressure and to control angina (chest pain). Diltiazem is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart.
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High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.