Two medicines, side by side
Diltiazem vs ivabradine
Diltiazem is labeled for high blood pressure, angina and atrial fibrillation; ivabradine for heart failure. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of diltiazem since 1982 and of ivabradine since 2015. Pharmacies paid $0.144 per diltiazem 24h ER(cd) 120 mg capsule and $0.761 per ivabradine HCl 5 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, diltiazem is a calcium channel blocker and ivabradine a hyperpolarization-activated cyclic nucleotide-gated channel blocker.
Check it at the source: the diltiazem FDA label on DailyMed (effective August 7, 2026); the ivabradine FDA label on DailyMed (effective November 10, 2025).
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
Highlights of the ivabradine record
Ivabradine (Corlanor) · label of November 10, 2025
Used for
From the label: indicationsINDICATIONS AND USAGE Corlanor (ivabradine) is a hyperpolarization-activated cyclic nucleotide-gated channel blocker indicated: To reduce the risk of hospitalization for worsening heart failure in adult patients with stable, symptomatic chronic heart failure with reduced left ventricular ejection fraction. […]
On the market
- Earliest approval on file
- April 15, 2015
- Generic labelers
- 11 labelers
- Pharmacy cost
- $0.761 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 2
Source: FDA drug labels via openFDA (Diltiazem label of August 7, 2026, Ivabradine label of November 10, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do diltiazem and ivabradine differ on the record?
In FDA's classes, diltiazem is a calcium channel blocker and ivabradine a hyperpolarization-activated cyclic nucleotide-gated channel blocker.
How each works, in its label's words: 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.”; Ivabradine, “Corlanor blocks the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel responsible for the cardiac pacemaker I f current, which regulates heart rate.”
Half-life, in each label's words: Diltiazem, “The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours.”; Ivabradine, “Ivabradine plasma levels decline with a distribution half-life of 2 hours and an effective half-life of approximately 6 …”
Generics: diltiazem since 1992; ivabradine since 2021 (Drugs@FDA).
| Diltiazem | Ivabradine | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation | Heart failure |
| Pharmacologic class | Calcium Channel Blocker | Hyperpolarization-activated Cyclic Nucleotide-gated Channel Blocker |
| How it works (label) | Mechanisms of Action Hypertension: Diltiazem produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance. | Corlanor blocks the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel responsible for the cardiac pacemaker I f current, which regulates heart rate. |
| Half-life (label) | The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. | Ivabradine plasma levels decline with a distribution half-life of 2 hours and an effective half-life of approximately 6 hours. |
| Earliest approval on file (Drugs@FDA) | November 5, 1982 | April 15, 2015 |
| First generic approved | November 5, 1992 | December 30, 2021 |
| Generic labelers (NDC) | 50 labelers | 11 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.144 per capsule (Diltiazem 24h ER(cd) 120 mg capsule) | $0.761 per tablet (Ivabradine HCl 5 mg tablet) |
| 12-month price change | -4% | -75% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 29 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 34,213 | 6,817 |
| 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?
Diltiazem label, drug interactionsConcurrent use of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances.
Ivabradine label, drug interactionsAvoid concomitant use of moderate CYP3A4 inhibitors when using Corlanor. Examples of moderate CYP3A4 inhibitors include diltiazem, verapamil, and grapefruit juice [ s ee Warnings and Precautions ( 5.3 ) and Clinical Pharmacology ( 12.3 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to diltiazem
- every medicine labeled for the same conditions