diltiazem vs verapamil
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of diltiazem and verapamil. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Diltiazem is a medicine that helps lower high blood pressure and prevent chest pain. It belongs to a class of drugs called calcium channel blockers.
Verapamil is a drug that helps to lower blood pressure and treat chest pain (angina) and irregular heartbeats (arrhythmias). It works by relaxing blood vessels and slowing down the heart rate.
Diltiazem is used to treat high blood pressure. It can be used alone or with other blood pressure medicines. Diltiazem also helps manage chronic stable angina (chest pain) and angina caused by spasms in the heart's blood vessels.
Verapamil is used to treat chest pain called angina. This includes angina that happens when you are resting or during normal activity. It is also used to control your heart rate if you have a fast or irregular heartbeat, such as atrial fibrillation or atrial flutter. Verapamil also treats high blood pressure.
Diltiazem works by relaxing blood vessels, which lowers blood pressure. It also reduces the heart's workload, which can prevent chest pain. This medicine blocks calcium from entering heart and blood vessel cells.
Verapamil belongs to a class of drugs called calcium channel blockers. It works by blocking calcium from entering heart and blood vessel cells. This relaxes and widens blood vessels, which lowers blood pressure and makes it easier for the heart to pump.
- • Swelling in your ankles or feet
- • Headache
- • Dizziness
- • Slow heart rate
- • Constipation
- • Constipation
- • Shortness of breath
- • Dizziness
- • Slow heart rate (less than 50 beats per minute)
- • Nausea
- Dyspnoea 3,202
- Fatigue 2,638
- Nausea 2,372
- Pain 2,365
- Dizziness 2,091
- Dyspnoea 356
- Nausea 341
- Drug Interaction 316
- Dizziness 286
- Hypotension 280
Diltiazem can interact with other heart medications. Tell your doctor if you take beta-blockers or digoxin. Using diltiazem with these drugs can cause heart problems. Your doctor may need to adjust your dosages.
You should not take this medicine if you have severe heart problems, very low blood pressure, or certain types of irregular heartbeats without a pacemaker. Talk to your doctor if you have any of these conditions.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if diltiazem will harm your unborn baby. Diltiazem passes into breast milk, so talk to your doctor about breastfeeding while taking this medicine.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if verapamil will harm your unborn baby. Verapamil can pass into breast milk, so talk to your doctor about the best way to feed your baby if you take this medicine.
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How to Read This diltiazem vs verapamil Comparison
diltiazem is classified in the Calcium Channel Blocker drug class, while verapamil sits within the Calcium Channel Blocker class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, diltiazem has 12,668 submissions while verapamil has 1,579. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for diltiazem or verapamil.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.