Two medicines, side by side
Diltiazem vs metoprolol
Diltiazem and metoprolol are both labeled for high blood pressure and angina. Drugs@FDA records approvals of diltiazem since 1982 and of metoprolol since 1978. Pharmacies paid $0.144 per diltiazem 24h ER(cd) 120 mg capsule and $0.085 per metoprolol succ ER 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Metoprolol's other strengths are brand-only: $1.20 per mL (Lopressor 10 mg/mL oral solution). In FDA's classes, diltiazem is a calcium channel blocker and metoprolol a beta-adrenergic blocker.
Check it at the source: the diltiazem FDA label on DailyMed (effective August 7, 2026); the metoprolol FDA label on DailyMed (effective March 3, 2026).
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 metoprolol record
Metoprolol (Lopressor) · label of March 3, 2026
Used for
From the label: indicationsTOPROL-XL, metoprolol succinate, is a beta-adrenergic blocker indicated for the treatment of: Hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) Angina Pectoris. […]
On the market
- Earliest approval on file
- August 7, 1978
- Generic labelers
- 74 labelers
- Pharmacy cost
- $0.085 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 39
Source: FDA drug labels via openFDA (Diltiazem label of August 7, 2026, Metoprolol label of March 3, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do diltiazem and metoprolol differ on the record?
In FDA's classes, diltiazem is a calcium channel blocker and metoprolol a beta-adrenergic 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.”; Metoprolol, “Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent.”
Half-life, in each label's words: Diltiazem, “The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours.”; Metoprolol, “Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately …”
Generics: diltiazem since 1992; metoprolol since 1993 (Drugs@FDA).
| Diltiazem | Metoprolol | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation | High blood pressure, Angina, Heart failure, Heart attack and coronary artery disease |
| Pharmacologic class | Calcium Channel Blocker | beta-Adrenergic 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. | Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent. |
| Half-life (label) | The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. | Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. |
| Earliest approval on file (Drugs@FDA) | November 5, 1982 | August 7, 1978 |
| First generic approved | November 5, 1992 | December 21, 1993 |
| Generic labelers (NDC) | 50 labelers | 74 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.144 per capsule (Diltiazem 24h ER(cd) 120 mg capsule) | $0.085 per tablet (Metoprolol succ ER 100 mg tablet) |
| 12-month price change | -4% | -8% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 29 | 39 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 34,213 | 353,609 |
| 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?
Metoprolol label, drug interactionsDigitalis glycosides, clonidine, diltiazem, and verapamil slow atrioventricular conduction and decrease heart rate.
Metoprolol label, warnings and precautionsWorsening cardiac failure may occur. ( 5.2 ) Bronchospastic Disease: Avoid beta-blockers. ( 5.3 ) Concomitant use of glycosides, clonidine, diltiazem and verapamil with beta-blockers can increase the risk of bradycardia.
Source: FDA drug labels via openFDA
What next?
- Alternatives to diltiazem
- every medicine labeled for the same conditions