Two medicines, side by side
Digoxin vs diltiazem
Digoxin and diltiazem are both labeled for atrial fibrillation. Drugs@FDA records approvals of digoxin since 1954 and of diltiazem since 1982. Pharmacies paid $0.133 per digoxin 125 mcg tablet and $0.144 per diltiazem 24h ER(cd) 120 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, digoxin is a cardiac glycoside and diltiazem a calcium channel blocker.
Check it at the source: the digoxin FDA label on DailyMed (effective December 5, 2024); the diltiazem FDA label on DailyMed (effective August 7, 2026).
Highlights of the digoxin record
Digoxin (Lanoxin) · label of December 5, 2024
Used for
From the label: indicationsLANOXIN is a cardiac glycoside indicated for: Treatment of mild to moderate heart failure in adults. ( 1.1 ) Increasing myocardial contractility in pediatric patients with heart failure. ( 1.2 ) Control of resting ventricular rate in patients with chronic atrial fibrillation in adults. ( 1.3 ) 1.1 Heart Failure in Adults LANOXIN is indicated for the treatment of mild to moderate heart failure in adults. […]
On the market
- Earliest approval on file
- November 16, 1954
- Generic labelers
- 26 labelers
- Pharmacy cost
- $0.133 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Highlights of the diltiazem record
Diltiazem (Cardizem) · label of August 7, 2026
Used for
From the label: indicationsHypertension Tiazac is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive medications. Chronic Stable Angina Tiazac is indicated for the treatment of chronic stable angina.
On the market
- Earliest approval on file
- November 5, 1982
- Generic labelers
- 50 labelers
- Pharmacy cost
- $0.144 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 29
Source: FDA drug labels via openFDA (Digoxin label of December 5, 2024, Diltiazem label of August 7, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do digoxin and diltiazem differ on the record?
In FDA's classes, digoxin is a cardiac glycoside and diltiazem a calcium channel blocker.
How each works, in its label's words: Digoxin, “This enzyme, the “sodium pump,” is responsible for maintaining the intracellular milieu throughout the body by moving sodium ions out of and potassium ions into cells.”; Diltiazem, “Mechanisms of Action Hypertension: Diltiazem produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance.”
Half-life, in each label's words: Digoxin, “In healthy volunteers with normal renal function, digoxin has a half-life of 1.5-2 days.”; Diltiazem, “The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours.”
Generics: digoxin since 1975; diltiazem since 1992 (Drugs@FDA).
| Digoxin | Diltiazem | |
|---|---|---|
| Labeled for | Heart failure, Atrial fibrillation | High blood pressure, Angina, Atrial fibrillation |
| Pharmacologic class | Cardiac Glycoside | Calcium Channel Blocker |
| How it works (label) | All of digoxin’s actions are mediated through its effects on Na-K ATPase. This enzyme, the “sodium pump,” is responsible for maintaining the intracellular milieu throughout the body by moving sodium ions out of and potassium ions into … | Mechanisms of Action Hypertension: Diltiazem produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance. |
| Half-life (label) | In healthy volunteers with normal renal function, digoxin has a half-life of 1.5-2 days. | The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. |
| Earliest approval on file (Drugs@FDA) | November 16, 1954 | November 5, 1982 |
| First generic approved | October 24, 1975 | November 5, 1992 |
| Generic labelers (NDC) | 26 labelers | 50 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.133 per tablet (Digoxin 125 mcg tablet) | $0.144 per capsule (Diltiazem 24h ER(cd) 120 mg capsule) |
| 12-month price change | +20% | -4% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 4 | 29 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 71,335 | 34,213 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Digoxin label, drug interactionsDiltiazem; 20%; NA; Measure serum digoxin concentrations before initiating concomitant drugs. Reduce digoxin concentrations by decreasing the dose by approximately 15-30% or by modifying the dosing frequency and continue monitoring.
Digoxin label, drug interactionsDiltiazem; 20%; NA; Measure serum digoxin concentrations before initiating concomitant drugs. Reduce digoxin dose by approximately 15% to 30% or by modifying the dosing frequency and continue monitoring.
Diltiazem label, drug interactionsAdministration of diltiazem hydrochloride with digoxin in 24 healthy male subjects increased plasma digoxin concentrations approximately 20%.
Diltiazem label, drug interactionsAdministration of CARDIZEM with digoxin in 24 healthy male subjects increased plasma digoxin concentrations approximately 20%.
Source: FDA drug labels via openFDA
What next?
- Alternatives to digoxin
- every medicine labeled for the same conditions