Diltiazem Alternatives for Patients with Possible Ileus

Clinical Considerations and Alternative Medications

• The American Heart Association recommends beta-blockers as preferred first-line agents for rate control in patients with possible ileus, if not contraindicated 1, 2
• For patients with contraindications to beta-blockers and without ileus, the American College of Cardiology suggests diltiazem as an alternative, but with caution 3
• In patients with both beta-blocker contraindications and ileus, the American Heart Association recommends considering digoxin or amiodarone for rate control, with careful monitoring 1, 2
• For hypertension management in patients with evidence of LV dysfunction, heart failure, or diabetes mellitus, the American Heart Association prefers ACE inhibitors or ARBs 4
• Long-acting dihydropyridine CCBs, such as amlodipine or felodipine, may be better tolerated than non-dihydropyridine CCBs in patients with intestinal issues, according to the American College of Cardiology 4
• The European Society of Gastroenterology notes that patients with small intestinal dysmotility may be particularly susceptible to the motility-inhibiting effects of calcium channel blockers 5