Drug & supplement interaction

Fermented Milk + Diltiazem, Enalapril

Diltiazem, Enalapril brand name: Teczem.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Fermented Milk has a moderate interaction with Diltiazem, Enalapril. Theoretically, fermented milk might increase the risk of hypotension when taken with antihypertensive drugs.

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

Fermented Milk and Diltiazem, Enalapril

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Diltiazem, Enalapril

Diltiazem, Enalapril falls under ANTIHYPERTENSIVE DRUGS — the group Fermented Milk interacts with.

Theoretically, fermented milk might increase the risk of hypotension when taken with antihypertensive drugs.
Clinical research shows that drinking fermented milk can decrease systolic, but not diastolic, blood pressure in some patients.
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

Your medicine combines two blood pressure lowerers: diltiazem (a calcium channel blocker) and enalapril (an ACE inhibitor). Here's the gentle concern with fermented milk like kefir or yogurt drinks. Some studies suggest these fermented dairy products can nudge the top number (systolic) of your blood pressure down a little on their own. Stack that small effect on top of a medicine already lowering your pressure, and in theory the two could add up.

If your pressure dipped too low, you might feel dizzy, lightheaded, or tired, especially when standing up quickly. To be clear, this is a theoretical concern based on how things work, not a strong proven warning, and normal food amounts rarely cause trouble. Still, if you eat a lot of fermented milk, mention it to your pharmacist or doctor so they can keep an eye on your numbers.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Inoue K, Shirai T, Ochiai H, et al. Blood-pressure-lowering effect of a novel fermented milk containing gamma-aminobutyric acid (GABA) in mild hypertensives. Eur J Clin Nutr 2003;57:490-95.
  2. Aihara, K., Kajimoto, O., Hirata, H., Takahashi, R., and Nakamura, Y. Effect of powdered fermented milk with Lactobacillus helveticus on subjects with high-normal blood pressure or mild hypertension. J Am Coll Nutr 2005;24(4):257-265.
  3. Beltrán-Barrientos LM, González-Córdova AF, Hernández-Mendoza A, et al. Randomized double-blind controlled clinical trial of the blood pressure-lowering effect of fermented milk with Lactococcus lactis: A pilot study. J Dairy Sci. 2018;101(4):2819-2825. 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

Fermented Milk Also Interacts With Other Medications

Fermented Milk has 473 moderate known drug interactions in our database — the Diltiazem, Enalapril one above is one of them. If you take anything else, check it against the full list below.

Moderate 473 No known interaction 2,357 (incl. Diltiazem, Enalapril)
Taking anything else?

Check Another of Your Medications Against Fermented Milk

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

Everything else you take

See Every Supplement That Interacts With Diltiazem, Enalapril

This page covers Fermented Milk only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diltiazem, Enalapril page lists 271 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), Asarabacca (major) and Coleus (major).

By severity: 9 major · 220 moderate · 42 minor.

From our pharmacist’s overview on the Diltiazem, Enalapril page

“Anyone taking Teczem (diltiazem with enalapril) for blood pressure should know that most of the 271 supplements with an interaction on file hit the same targets as the drug itself. The bulk either add to its blood-pressure-lowering effect or change how the body handles diltiazem, which is processed by an enzyme called CYP3A4.”

Reviewed by 2 · Jul 18, 2026

Open the Diltiazem, Enalapril interaction page

How much people look this up

Where Fermented Milk and Diltiazem, Enalapril 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 Fermented Milk
Top half

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

29 days ago today
Medication Diltiazem, Enalapril
Top 25%

#555 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 Fermented Milk

What is Fermented Milk?

  • Digestive health
  • Supporting gut bacteria (probiotics)
  • Lactose-related digestive discomfort
  • General nutrition (protein, calcium)
  • Immune support
  • Diarrhea prevention

Fermented milk is a food made by culturing milk with helpful bacteria or yeast, and it provides protein, calcium, and probiotics. It is generally safe for most people and may help digestion and gut health, though benefits depend on the product and strains used. People with milk allergy or weakened immune systems should be cautious.

Read the full Fermented Milk monograph & all interactions
Keep checking

Other Drugs & Fermented Milk

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

0Major
473Moderate
0Minor
2,356No known interaction
473 Moderate 2,356 No interaction
Moderate

473 interactions

Showing 60 of 473 moderate interactions — see all 473 on the Fermented Milk page.

No interaction 2,356 drugs checked — show the list

We also checked Fermented Milk against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,356 medications checked with no known interaction — see the full Fermented Milk list.

See the full Fermented Milk interactions page
See every supplement checked against Diltiazem, Enalapril, ranked by severity
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

Keep exploring
Fermented Milk monograph › Uses, safety, and every drug interaction in one place Diltiazem, Enalapril supplement interactions › Every supplement checked against Diltiazem, Enalapril, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Fermented Milk and Diltiazem, Enalapril Together: Common Questions

Can you take Fermented Milk with Diltiazem, Enalapril?
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 Fermented Milk and Diltiazem, Enalapril 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, Enalapril and Fermented Milk?

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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.