Two medicines, side by side
Diltiazem vs nicardipine
Diltiazem and nicardipine are both labeled for high blood pressure and angina. Drugs@FDA records approvals of diltiazem since 1982 and of nicardipine since 1988. Pharmacies paid $0.144 per diltiazem 24h ER(cd) 120 mg capsule and $1.12 per nicardipine 20 mg capsule (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 nicardipine a dihydropyridine calcium channel blocker.
Check it at the source: the diltiazem FDA label on DailyMed (effective August 7, 2026); the nicardipine FDA label on DailyMed (effective August 24, 2024).
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 nicardipine record
Nicardipine (Cardene) · label of August 24, 2024
Used for
From the label: indicationsNicardipine hydrochloride injection, USP is a calcium channel blocker indicated for the short-term treatment of hypertension when oral therapy is not feasible. 1.1 Hypertension Nicardipine hydrochloride injection, USP is indicated for the short-term treatment of hypertension when oral therapy is not feasible or desirable. […]
On the market
- Earliest approval on file
- December 21, 1988
- Generic labelers
- 25 labelers
- Pharmacy cost
- $1.12 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Source: FDA drug labels via openFDA (Diltiazem label of August 7, 2026, Nicardipine label of August 24, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do diltiazem and nicardipine differ on the record?
In FDA's classes, diltiazem is a calcium channel blocker and nicardipine a dihydropyridine calcium 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.”; Nicardipine, “Nicardipine inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle without changing serum calcium concentrations.”
Half-life, in each label's words: Diltiazem, “The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours.”; Nicardipine, “Following infusion, nicardipine plasma concentrations decline triexponentially, with a rapid early distribution phase …”
Generics: diltiazem since 1992; nicardipine since 1996 (Drugs@FDA).
| Diltiazem | Nicardipine | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation | High blood pressure, Angina |
| Pharmacologic class | Calcium Channel Blocker | Dihydropyridine Calcium 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. | Nicardipine inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle without changing serum calcium concentrations. |
| Half-life (label) | The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. | Following infusion, nicardipine plasma concentrations decline triexponentially, with a rapid early distribution phase (α-half-life of 3 minutes), an intermediate phase (ß-half-life of 45 minutes), and a slow terminal … |
| Earliest approval on file (Drugs@FDA) | November 5, 1982 | December 21, 1988 |
| First generic approved | November 5, 1992 | July 18, 1996 |
| Generic labelers (NDC) | 50 labelers | 25 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.144 per capsule (Diltiazem 24h ER(cd) 120 mg capsule) | $1.12 per capsule (Nicardipine 20 mg capsule) |
| 12-month price change | -4% | -4% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 29 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 34,213 | 4,340 |
| 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)
What next?
- Alternatives to diltiazem
- every medicine labeled for the same conditions