Diltiazem

Posted by mmicahk @mmicahk, May 5, 2025

I've been slowly having fatigue for a few years now, but the last year it has been getting worse.

I was diagnosed with obstructive HCM a year ago and started metoprolol back in November 2024 after an incident of sepsis in the hospital. My fatigue was getting worse since then, so my cardiologist had me back off to half my dose in February after seeing my resting heart rate is between 40-50bpm.

The fatigue hasn't gotten better so he wants me to stop taking metoprolol and see if the fatigue goes away. He said if it does, the backup would be Diltiazem to try next.

Has anyone had this medication and/or gone through this process of trying different medications?

I have some angina, but mostly just fatigue (which could be related to anything). My heart rate has been weirdly all over the place lately. It was fairly low/stable from November through March and then started getting weird the last month. Simple task of getting up to walk to the fridge could go from a 50bpm to 120bpm. No dizziness but feel my heart racing so I check.

My cardiologist is local to me, but I'll be seeing a second opinion in June in a more specialized heart center at Kaiser (Santa Clara) with a cardiologist that was at Stanford's HCM center.

Part of me is wondering if I just wait to make any changes until then but I had not heard of this medication so was wondering of others experience.

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) Support Group.

Linda, Volunteer Mentor | @walkinggirl | Dec 10, 2025

In reply to @normanchester "@sjm46 thank you very much I'm going to try to make it through the Christmas holidays,..." + (show)

@normanchester May I suggest to perhaps make your appointment NOW because often it takes a while to "get in." That may add an extra peace of mind for you to better enjoy the holidays.

normanchester | @normanchester | Dec 10, 2025

Thank you

nm80 | @nm80 | Jan 13 1:29pm

Would like to understand better what possible effects Diltiazem might be expected to have. I have read all the online info but prefer to hear from real people and their personal experience.

I had seen a new MD a few months ago and when he took my pulse (sitting for some time prior) it was 100 bpm. He thought it was too high. He suggested I take the 180 ER Diltiazem which I did for three months. I have never been diagnosed with HBP so wondered over time what the drug was actually doing and finally stopped it after 3 months.

Related or not, I seem to be having more episodes of lightheadedness, that feeling of pre-fainting. I just sit down til it passes. I am at day 8 of wearing a Zio heart monitor (which is a fabulous device IMO as it can barely be felt and has a very low profile..so comfortable!) so after I finish the 14 days, I hope to get more insight. I did wear an older more clunky monitor a few months back that basically fell off after 8 days. It did show 16 episodes of tachycardia, with the episode with fastest heart rate being 280bpm. I found that alarming but my cardiologist at the time shrugged her shoulders and said if I wanted, I could get the implantable loop recorder for two years!

Learning about the Zio, I pushed to get it but had to switch insurers to obtain a referral (previous cardiologist said they did not do business with Zio, which to this day makes no sense).

If anyone has any feedback or experiences to share, that would be most welcome. I can’t get in to my new cardiologist until April 1st!

stayhealthy2 | @stayhealthy2 | Feb 1 4:26pm

I was taking Metropolol and was changed to Diltiazem many months ago (along with Camzyos which has made a huge positive difference in my life.) My blood pressure was varied also but finally realized it does vary normally with activity and quit being so attentive to it. Problem solved.