Metoprolol and Diltiazem Interaction
Drug interaction information between Metoprolol and Diltiazem.
Metoprolol and Diltiazem have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Metoprolol and Diltiazem. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Both of these medicines slow down your heart rate and the electrical signals that tell your heart when to beat. Taking them together can make your heart beat much slower than it should.
FDA Label Information
( 7.3 ) Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. 7.4 Negative Chronotropes Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate.
Metoprolol Also Interacts With
- Theophylline major
- Clonidine moderate
- Verapamil moderate
- Fluoxetine minor
- Paroxetine minor
Diltiazem Also Interacts With
- Ezetimibe major
- Ezetimibe/Simvastatin major
- Simvastatin major
- Theophylline major
- Rifampin moderate
Frequently Asked Questions
What SPL severity band is on file for Metoprolol + Diltiazem?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Diltiazem has 46 labeled pairs on file vs Metoprolol's 18. In the moderate band specifically: Metoprolol has 3 (also Clonidine, Verapamil); Diltiazem has 7 (also Rifampin, Digoxin, Ivabradine, Aprepitant).
What mechanism field is on file for Metoprolol and Diltiazem?
Both of these medicines slow down your heart rate and the electrical signals that tell your heart when to beat. Taking them together can make your heart beat much slower than it should.
Diltiazem carries more major-labeled pairs than Metoprolol
SPL source-record counts only. This page's band is moderate · classes on file: Metoprolol (Beta-Blocker); Diltiazem (Calcium Channel Blocker).
Diltiazem has 4 major-labeled pairs vs Metoprolol's 1. This page itself is in the moderate band, not the major band.
1 major · 3 moderate · 14 minor · 18 total
4 major · 7 moderate · 35 minor · 46 total
- Other moderate peers for Diltiazem
- Rifampin
- Digoxin
- Ivabradine
- Aprepitant
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.