Two medicines, side by side
Diltiazem vs nisoldipine
Diltiazem and nisoldipine are both labeled for high blood pressure. Drugs@FDA records approvals of diltiazem since 1982 and of nisoldipine since 1995. Pharmacies paid $0.144 per diltiazem 24h ER(cd) 120 mg capsule and $5.24 per nisoldipine ER 34 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 nisoldipine a dihydropyridine calcium channel blocker.
Check it at the source: the diltiazem FDA label on DailyMed (effective August 7, 2026); the nisoldipine FDA label on DailyMed (effective March 12, 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 nisoldipine record
Nisoldipine (Sular) · label of March 12, 2026
Used for
From the label: indicationsSULAR is indicated for the treatment of hypertension. It may be used alone or in combination with other anti-hypertensive agents.
On the market
- Earliest approval on file
- February 2, 1995
- Generic labelers
- 1 labeler
- Pharmacy cost
- $5.24 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Source: FDA drug labels via openFDA (Diltiazem label of August 7, 2026, Nisoldipine label of March 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do diltiazem and nisoldipine differ on the record?
In FDA's classes, diltiazem is a calcium channel blocker and nisoldipine 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.”; Nisoldipine, “Mechanism of Action Nisoldipine is a member of the dihydropyridine class of calcium channel antagonists (calcium ion antagonists or slow channel blockers) that inhibit the transmembrane influx of …”
Half-life, in each label's words: Diltiazem, “The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours.”; Nisoldipine, “The terminal elimination half-life (reflecting post absorption clearance of nisoldipine) ranges from 13.7 ± 4.3 hours.”
Generics: diltiazem since 1992; nisoldipine since 2008 (Drugs@FDA).
| Diltiazem | Nisoldipine | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation | High blood pressure |
| 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. | Mechanism of Action Nisoldipine is a member of the dihydropyridine class of calcium channel antagonists (calcium ion antagonists or slow channel blockers) that inhibit the transmembrane influx of calcium into vascular smooth muscle and … |
| Half-life (label) | The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. | The terminal elimination half-life (reflecting post absorption clearance of nisoldipine) ranges from 13.7 ± 4.3 hours. |
| Earliest approval on file (Drugs@FDA) | November 5, 1982 | February 2, 1995 |
| First generic approved | November 5, 1992 | July 25, 2008 |
| Generic labelers (NDC) | 50 labelers | 1 labeler |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.144 per capsule (Diltiazem 24h ER(cd) 120 mg capsule) | $5.24 per tablet (Nisoldipine ER 34 mg tablet) |
| 12-month price change | -4% | -5% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 29 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 34,213 | 1,197 |
| 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