Drug & supplement interaction

Ash + Diltiazem

Diltiazem brand names: Cardizem, Cardizem SR, Diltiaz SR, Cardizem CD, Tiazac, and others.

Moderate Interaction
The bottom line Moderate

Ash has a moderate interaction with Diltiazem. Theoretically, concomitant use of ash seed with antihypertensive drugs might have additive blood pressure lowering effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ash and Diltiazem

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Diltiazem

Diltiazem falls under ANTIHYPERTENSIVE DRUGS — the group Ash interacts with.

Theoretically, concomitant use of ash seed with antihypertensive drugs might have additive blood pressure lowering effects. Animal research shows that ash seed extract can decrease blood pressure. This effect has not been evaluated in humans. Until more is known, use cautiously in patients taking antihypertensive drugs.
Some antihypertensive drugs include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: diltiazem already lowers your blood pressure by relaxing your blood vessels. In animal studies, ash seed extract also seemed to nudge blood pressure down. Put the two together and the worry is that they could add up, pulling your numbers lower than intended.

If that happened, you might feel dizzy or lightheaded, especially standing up, along with tiredness or a slower heartbeat. I want to be straight with you, though: this is theoretical. It comes from lab and animal work, not from people, so we honestly don't know how big the effect is in humans. There's no need to panic. Just loop in your pharmacist or doctor before adding ash, and keep an eye on your home blood pressure readings if you do.

References
  1. Montó F, Arce C, Noguera MA, et al. Action of an extract from the seeds of Fraxinus excelsior L. on metabolic disorders in hypertensive and obese animal models. Food Funct. 2014;5(4):786-96. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ash Also Interacts With Other Medications

Ash has 257 moderate known drug interactions in our database — the Diltiazem one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ash

Covers the 2,830 medications we’ve checked against Ash. Pick one to open its full report.

From our Q&A

Questions About Ash or Diltiazem

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ash or Diltiazem, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Diltiazem

This page covers Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diltiazem page lists 260 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Coleus (major) and Grapefruit (major).

By severity: 7 major · 214 moderate · 39 minor.

From our pharmacist’s overview on the Diltiazem page

“Someone on diltiazem (Cardizem, Tiazac) is usually managing blood pressure, angina, or a fast heart rhythm, so this list deserves genuine care. Seven of the 260 ingredients on file carry a major rating, and two of those are things people actually buy: grapefruit, which blocks the enzyme that clears diltiazem and can push its blood leve…”

Reviewed by 2 · Jul 18, 2026

Open the Diltiazem interaction page

One more smart check

Taking Ash as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Ash, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ash. Your product may carry other ingredients that interact with Diltiazem too, on top of Ash — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ash and Diltiazem Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ash
Steady interest

#845 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Diltiazem
Top 10%

#264 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ash

What is Ash?

Ash
  • Joint pain and arthritis
  • Fever
  • Constipation
  • Fluid retention (diuretic)
  • Bladder and urinary complaints
  • Weight management and blood sugar

Ash (Fraxinus excelsior and related species) is a tree whose leaves, bark, and seeds have a long history in folk medicine for arthritis, fever, and fluid retention. Solid human evidence is limited for nearly all of these uses, so it should not replace proven treatments. Talk with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Ash monograph & all interactions
Medication

About Diltiazem

What Is Diltiazem Used For?

Brand names: Cardizem, Cardizem SR, Diltiaz SR, Cardizem CD, Tiazac, Diltiaz XT, Diltiaz CD, Dilacor, Diltiaz, Cardizem LA, Dilacor XR, Cartia XT, Tiamate, Adizem-SR, Adizem-XL, Angitil SR, Angitil XL, Calcicard CR, Dilcardia SR, Dilzem SR, Dilzem XL, Slozem, Tildiem LA, Tildiem Retard, Viazem XL, Zemtard 120XL, Zemtard 180XL, Zemtard 240XL, Zemtard 300XL

Oral extended-release forms of diltiazem — including Matzim LA, Cardizem LA, Cartia, Cartia XT, Tiadylt ER, and various generic capsules and tablets — are used to treat high blood pressure (hypertension) and chronic stable angina (chest pain brought on by activity). Some capsule formulations, including Cartia, Cartia XT, and certain generics, are also approved for angina due to coronary artery spasm (sudden chest pain caused by a sudden tightening of a coronary artery).

Injectable forms of diltiazem are used in hospital settings to temporarily slow a dangerously fast heart rate in atrial fibrillation or atrial flutter (rapid, irregular heart rhythms), and to restore a normal heart rhythm in paroxysmal supraventricular tachycardia (PSVT) — sudden episodes of a very fast but regular heartbeat originating above the heart's lower chambers.

See full Diltiazem drug information
Keep checking

Other Drugs & Ash

Browse every other medication we’ve checked against Ash — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
257Moderate
0Minor
2,572No known interaction
Moderate

257 interactions

Showing 60 of 257 moderate interactions — see all 257 on the Ash page.

No interaction 2,572 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Ash and Diltiazem Together: Common Questions

Can you take Ash with Diltiazem?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ash and Diltiazem interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Diltiazem and Ash?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.