Does diltiazem (Calcium Channel Blocker) cause Gastroesophageal Reflux Disease (GERD)?

From the Guidelines

Diltiazem can potentially cause or worsen GERD in some patients. This calcium channel blocker, commonly used to treat high blood pressure and certain heart conditions, may relax the lower esophageal sphincter (LES), which is the muscle that prevents stomach acid from flowing back into the esophagus [ 1 ]. When the LES is relaxed, acid reflux is more likely to occur, leading to GERD symptoms such as heartburn, regurgitation, and chest discomfort. According to the study, calcium channel-blocking agents, such as diltiazem, are listed as potential risk factors for GERD [ 1 ]. If you're taking diltiazem and experiencing new or worsening GERD symptoms, it's essential to discuss this with your healthcare provider. They may consider adjusting your medication, recommending lifestyle modifications (such as avoiding large meals before bedtime, elevating the head of your bed, and avoiding trigger foods), or prescribing medications to manage GERD symptoms. Don't stop taking diltiazem without medical guidance, as abruptly discontinuing this medication could lead to serious cardiovascular effects.

Some key points to consider:

• The study highlights the importance of identifying and managing risk factors for GERD, including medications like diltiazem [ 1 ].
• The diagnosis of GERD can be challenging, and a combination of diagnostic tests, such as 24-h esophageal pH monitoring and barium esophagography, may be necessary to confirm the diagnosis [ 1 ].
• Treatment of GERD typically involves lifestyle modifications and medications to reduce acid reflux and alleviate symptoms [ 1 ].
• It's crucial to work with your healthcare provider to manage GERD symptoms and adjust your medication regimen as needed to minimize the risk of complications [ 1 ].

From the FDA Drug Label

Gastrointestinal: Anorexia, constipation, diarrhea, dysgeusia, dyspepsia, The FDA drug label does not answer the question.

From the Research

Diltiazem and GERD

• The relationship between diltiazem and gastroesophageal reflux disease (GERD) is explored in several studies 2, 3.
• A study published in the British journal of clinical pharmacology found that diltiazem appears to be the least likely of the calcium antagonists to precipitate or exacerbate reflux symptoms 2.
• The study analyzed 371 participants and found that 12.5% of patients taking diltiazem reported a worsening of reflux symptoms, which was the lowest among the calcium antagonists tested 2.
• Another study published in The Turkish journal of gastroenterology investigated the relationships between GERD and medications, including calcium channel blockers like diltiazem 3.
• However, the study does not provide specific information on the relationship between diltiazem and GERD.

Risk Factors for GERD

• Several studies identify risk factors for GERD, including lifestyle and dietary factors 4, 5.
• A study published in Roczniki Panstwowego Zakladu Higieny found that lifestyle risk factors, such as excessive body weight, moderate/high alcohol consumption, smoking, and lack of regular physical activity, may contribute to GERD symptoms 4.
• Another study published in JAMA found that obesity, tobacco smoking, and genetic predisposition increase the risk of developing GERD 5.

Calcium Channel Blockers and GERD

• Calcium channel blockers, including diltiazem, may contribute to GERD by reducing lower esophageal sphincter pressure (LESP) or affecting esophagogastric motility 3.
• However, the study published in the British journal of clinical pharmacology found that diltiazem was the least likely to precipitate or exacerbate reflux symptoms among the calcium antagonists tested 2.