Drug & supplement interaction

Lime + Diltiazem

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

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

Diltiazem falls into 2 drug categories that Lime can interact with; the most serious is rated moderate. Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lime and Diltiazem

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Lime interacts with whole categories of medication. Diltiazem falls into 2 of those categories, so it can interact with Lime in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

PHOTOSENSITIZING DRUGS

1 of 2

Why this applies to Diltiazem

Diltiazem falls under PHOTOSENSITIZING DRUGS — the group Lime interacts with.

Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
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 thing to know about lime and your diltiazem: the concern isn't about your blood pressure or chest pain medicine working differently. Instead, certain natural compounds in concentrated lime oil (the kind in essential oils or strong skin products, not the splash of lime in your food or drink) can make some medications more likely to react with sunlight. Diltiazem has been grouped with drugs that may carry a small phototoxicity risk, meaning your skin could be a little more prone to sunburn or a rash with sun exposure.

To be honest, this is a theoretical concern based only on lab studies, so it's nothing to lose sleep over. Eating lime or drinking it is fine. If you regularly use concentrated lime oil on your skin, just be sun-smart and run it by your pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Naganuma M, Hirose S, Nakayama Y, et al. A study of the phototoxicity of lemon oil. Arch Dermatol Res 1985;278:31-6. . PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Diltiazem also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4. This has been demonstrated in rats treated with sildenafil, a CYP3A4 substrate, and high doses of lime juice.
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 gist for diltiazem: your body relies on a liver enzyme called CYP3A4 to break it down and clear it out. Lab and animal studies suggest the plant compounds in lime juice can slow that same enzyme. If diltiazem clears more slowly, more of it can hang around in your blood, which could nudge its effects up a notch. With this drug that might mean things like lower blood pressure than expected, dizziness, a slower heartbeat, flushing, or swelling in your ankles.

That said, this is based only on animal research using high doses of lime juice, so it's a theoretical concern. A lime wedge in your water or a squeeze on your dinner is very unlikely to cause trouble. If you're using concentrated lime products, just check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin Pharmacol Ther 2003;73:529-37. PubMed
  2. Ademosun AO, Mohammed A, Oboh G, Ajeigbe OF. Influence of lemon (Citrus limon) and lime (Citrus aurantifolia) juices on the erectogenic properties of sildenafil in rats with L-NAME-induced erectile dysfunction. J Food Biochem 2022;46(2):e14074.

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

Lime Also Interacts With Other Medications

Lime has 885 moderate known drug interactions in our database — the Diltiazem one above is among them. If you take anything else, check it against the full list below.

Moderate 885 No known interaction 1,945 (incl. Diltiazem)
Taking anything else?

Check Another of Your Medications Against Lime

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

From our Q&A

Questions About Lime 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 Lime 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 Lime 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 Lime as Part of a Dietary Supplement Product? Check It for Interactions

We hold 322 real supplement products containing Lime, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lime. Your product may carry other ingredients that interact with Diltiazem too, on top of Lime — 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 Lime 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 Lime
Top 25%

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

29 days ago today
Medication Diltiazem
Top 25%

#297 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 Lime

What is Lime?

Lime
  • Source of vitamin C
  • Digestive upset
  • Skin care
  • Mood and aromatherapy
  • Flavoring and food preservation

Lime is a common citrus fruit and a good natural source of vitamin C and plant antioxidants. As a food it is generally safe and enjoyed by most people, but evidence that lime treats any specific health condition is limited. Use the essential oil with care, and check with your pharmacist or doctor before using concentrated lime products for health reasons.

Read the full Lime 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 & Lime

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

0Major
885Moderate
0Minor
1,944No known interaction
885 Moderate 1,944 No interaction
Moderate

885 interactions

Showing 60 of 885 moderate interactions — see all 885 on the Lime page.

No interaction 1,944 drugs checked — show the list

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

Showing the 60 most looked-up of 1,944 medications checked with no known interaction — see the full Lime list.

See the full Lime interactions page
See every supplement checked against Diltiazem, 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
Lime monograph › Uses, safety, and every drug interaction in one place Diltiazem supplement interactions › Every supplement checked against Diltiazem, ranked by severity Diltiazem drug information › The full plain-English guide to this medication 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 Lime and Diltiazem Together: Common Questions

Can you take Lime 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.
Why are there 2 interactions listed for Lime and Diltiazem?
Diltiazem belongs to more than one drug category, and Lime interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Lime 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 Lime?

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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.