Drug & supplement interaction

Lime + Diltiazem, Enalapril

Diltiazem, Enalapril brand name: Teczem.

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

Diltiazem, Enalapril 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, Enalapril

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, Enalapril 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, Enalapril

Diltiazem, Enalapril 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 this combo: it isn't about lime changing how your body handles Teczem (the diltiazem and enalapril combo). Instead, it's about your skin. Lime oil, especially the concentrated essential oil applied to skin, contains compounds that can make skin more sensitive to sunlight. Some blood pressure medicines like this one can do the same thing, so in theory the two together might raise your odds of a sunburn-like reaction or rash.

I'll be honest, this is a theoretical concern based only on lab work, not real patient reports. Squeezing lime in your drink or on your food won't cause a problem. If you use lime essential oil on your skin, just use sunscreen and check with 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, Enalapril 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

This combination pill pairs diltiazem (a blood pressure and heart rate medicine handled in part by the CYP3A4 enzyme) with enalapril. The concern on file is that compounds in lime juice may slow that enzyme, which in theory could let diltiazem build up a bit more than usual. If that happened, you might notice more of its known effects, like dizziness, a slower heartbeat, swollen ankles, or feeling unusually tired.

That said, this is based only on animal research using high doses of lime juice, not real-world cases in people. A squeeze of lime on your food is very unlikely to cause trouble. I'd just check with your pharmacist or doctor before using concentrated lime products, and never change your dose on your own.

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, Enalapril 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, Enalapril)
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.

Everything else you take

See Every Supplement That Interacts With Diltiazem, Enalapril

This page covers Lime 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

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, Enalapril 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, 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 Lime
Top 25%

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

29 days ago today
Medication Diltiazem, Enalapril
Steady interest

#1,820 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
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, 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
Lime 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 Lime and Diltiazem, Enalapril Together: Common Questions

Can you take Lime 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.
Why are there 2 interactions listed for Lime and Diltiazem, Enalapril?
Diltiazem, Enalapril 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, 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 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.