NutriStack
Diltiazem and Resveratrol, a caution.
Resveratrol is a mechanism-based inhibitor of CYP3A4 and a P-glycoprotein blocker. In rats, oral resveratrol increased diltiazem AUC and Cmax 1.5-fold by inhibiting both intestinal CYP3A and efflux transport. The extrapolated human effect would amplify diltiazem's bradycardia and hypotension, particularly when patients use high-dose resveratrol supplements (250-1000 mg/day).
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Diltiazem and Resveratrol
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Resveratrol is a mechanism-based inhibitor of CYP3A4 and a P-glycoprotein blocker. In rats, oral resveratrol increased diltiazem AUC and Cmax 1.5-fold by inhibiting both intestinal CYP3A and efflux transport. The extrapolated human effect would amplify diltiazem's bradycardia and hypotension, particularly when patients use high-dose resveratrol supplements (250-1000 mg/day).
Mechanism. Resveratrol inhibits CYP3A4 (the primary diltiazem-metabolizing enzyme) and intestinal P-gp, raising bioavailability and slowing clearance. Reduced metabolism increases parent drug exposure and AV-nodal blockade.
Recommendation. Avoid high-dose resveratrol supplements while on diltiazem. If you do use resveratrol, separate doses by at least 4 hours, check pulse and blood pressure for 2 weeks, and reduce or stop the supplement if your HR drops below 50 bpm or you become lightheaded.
Minimum separation. 240
Sources (2)
- Hong SP, Choi DH, Choi JS. Effects of resveratrol on the pharmacokinetics of diltiazem and its major metabolite, desacetyldiltiazem, in rats. Cardiovasc Ther. 2008;26(4):269-75. PMID 19035878
- Mills TA, Kawji MM, Cataldo VD, et al. Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs. J La State Med Soc. 2004;156(6):327-31. PMID 15688675
Stack Score
How this pair moves the number.
Effect on the composite score
If both Diltiazem and Resveratrol are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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