Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
CARDIZEM LA vs CADUET
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Cardizem LA (diltiazem) is a calcium channel blocker that inhibits calcium ion influx across cardiac and smooth muscle cells during depolarization, leading to negative inotropic, chronotropic, and dromotropic effects. It dilates coronary and peripheral arteries, reducing systemic vascular resistance and myocardial oxygen demand.
Amlodipine: Dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral vascular resistance. Atorvastatin: HMG-Co A reductase inhibitor that competitively inhibits the conversion of HMG-Co A to mevalonate, reducing cholesterol synthesis in the liver.
Hypertension,Chronic stable angina pectoris,Atrial fibrillation or atrial flutter (rate control),Paroxysmal supraventricular tachycardia (PSVT)
Hypertension,Coronary artery disease,Hyperlipidemia (as adjunct to diet to reduce elevated total-C, LDL-C, apo B, and TG levels, and to increase HDL-C),Prevention of cardiovascular events in patients with multiple risk factors
Oral, 180-360 mg once daily; initiate at 180 mg once daily, titrate to 240 mg, then 300 mg, then 360 mg once daily as needed.
CADUET (amlodipine/atorvastatin) is available as tablets of 2.5/10, 2.5/20, 2.5/40, 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40, and 10/80 mg amlodipine/atorvastatin. Initial dose depends on current antihypertensive and lipid-lowering therapy. Usual starting dose is 5/10 mg orally once daily; titrate at intervals of 2-4 weeks based on blood pressure and LDL-C goals. Maximum daily dose: amlodipine 10 mg; atorvastatin 80 mg.
Terminal elimination half-life: 5-8 hours after oral administration. For extended-release formulations, the half-life is similar but the prolonged absorption phase results in sustained plasma concentrations.
Amlodipine: terminal half-life 30-50 h (enables once-daily dosing). Atorvastatin: terminal half-life ~14 h, but active metabolites (ortho- and para-hydroxy atorvastatin) have half-life 20-30 h; clinically, pharmacodynamic half-life (HMG-Co A reductase inhibition) is ~20-30 h.
Primarily hepatic via CYP3A4; undergoes extensive first-pass metabolism. Metabolites include N-desmethyl diltiazem (active), deacetyl diltiazem, and others.
Amlodipine: Extensively metabolized in the liver via CYP3A4 to inactive metabolites. Atorvastatin: Metabolized in the liver primarily by CYP3A4 to active ortho- and para-hydroxylated metabolites.
Urine (2-4% unchanged, ~40% as metabolites); bile/feces (major route, ~60% as metabolites).
Amlodipine: 60% renal (metabolites), 20-25% biliary/fecal. Atorvastatin: 1% renal (unchanged), 90% biliary/fecal (≥70% as metabolites).
70-80% bound to plasma proteins (mainly albumin).
Amlodipine: ~93% bound to plasma proteins. Atorvastatin: ≥98% bound to plasma proteins (mainly albumin).
3-5 L/kg, indicating extensive tissue distribution.
Amlodipine: Vd ~21 L/kg (large, indicating extensive tissue distribution). Atorvastatin: Vd ~6.2 L/kg (moderately large, suggesting distribution into tissues).
Oral: ~40% due to extensive first-pass metabolism; intravenous: 100%.
Oral: amlodipine 64-90%; atorvastatin ~14% (low due to first-pass metabolism); food reduces rate but not extent of absorption.
No specific dose adjustment is required for decreased GFR; however, use with caution in severe renal impairment (Cr Cl <30 m L/min) due to potential accumulation.
No dosage adjustment required for mild to moderate renal impairment (Cr Cl ≥30 m L/min). For severe renal impairment (Cr Cl <30 m L/min), use atorvastatin with caution; maximum atorvastatin dose is 20 mg daily. Amlodipine is not dialyzable.
Child-Pugh A: no adjustment. Child-Pugh B: reduce dose by 50%. Child-Pugh C: use is not recommended.
Contraindicated in active liver disease or unexplained persistent elevations of serum transaminases. For Child-Pugh Class A or B hepatic impairment: atorvastatin dose should be reduced; maximum atorvastatin dose is 20 mg daily. Amlodipine clearance is decreased; initial amlodipine dose should be 2.5 mg daily. No data for Child-Pugh Class C; use contraindicated.
Safety and efficacy have not been established in pediatric patients; no standard pediatric dosing available.
Not recommended for pediatric patients. Safety and efficacy in children <10 years have not been established. For patients 10-17 years with heterozygous familial hypercholesterolemia, atorvastatin monotherapy is used; CADUET is not indicated.
Initiate at low end of dosing range (180 mg once daily) and titrate slowly due to increased risk of hypotension, bradycardia, and reduced hepatic clearance.
Elderly patients (≥65 years) may have increased sensitivity to amlodipine; start at the lower end of dosing range (2.5 mg amlodipine component). Atorvastatin dose adjustment not required based on age alone. Monitor for hypotension and other adverse effects.
None.
HMG-Co A reductase inhibitors (statins) can cause fetal harm; use in pregnant women is contraindicated. Caduet contains atorvastatin; therefore, it is contraindicated in pregnant women.
Conduction abnormalities: May worsen sinus node dysfunction or AV block, especially in elderly or with beta-blockers.,Heart failure: Use with caution in patients with reduced left ventricular function.,Hypotension: May cause symptomatic hypotension, especially with concurrent vasodilators.,Hepatic impairment: Diltiazem is hepatically metabolized; use with caution in patients with hepatic impairment.,Abrupt withdrawal: May precipitate angina or hypertension exacerbation; taper dose.,Beta-blocker coadministration: Increased risk of bradycardia, AV block, and hypotension.
Myopathy/Rhabdomyolysis: Risk increased with higher doses, age >65, renal impairment, hypothyroidism, and concurrent use of CYP3A4 inhibitors or other drugs that cause myopathy.,Hepatic effects: Elevated liver enzymes; perform liver function tests before initiation and as clinically indicated.,Fetal toxicity: May cause fetal harm; advise females of reproductive age to use effective contraception.,Peripheral edema: More common with higher doses of amlodipine, especially in females.,Hypotension: In patients with severe aortic stenosis.
Sick sinus syndrome (unless pacemaker present),Second- or third-degree AV block (unless pacemaker present),Systolic blood pressure <90 mm Hg,Acute myocardial infarction with pulmonary congestion,Known hypersensitivity to diltiazem,Concurrent use with rifampin (enzyme inducer reduces effectiveness)
Active liver disease or unexplained persistent elevations of hepatic transaminases,Pregnancy,Breastfeeding (due to potential for serious adverse reactions in nursing infants),Hypersensitivity to amlodipine, atorvastatin, or any component of the formulation
Avoid grapefruit and grapefruit juice as they inhibit CYP3A4 and may increase diltiazem levels. Limit alcohol intake due to additive vasodilation and hypotension risk. No specific food restrictions otherwise, but maintain a heart-healthy diet low in sodium and saturated fats to support blood pressure and angina management.
Avoid grapefruit and grapefruit juice as they increase atorvastatin plasma concentrations and risk of adverse effects. No significant food interactions with amlodipine.
Category C. First trimester: No adequate studies in humans; animal studies show embryotoxicity and fetotoxicity at high doses. Second and third trimesters: Risk of fetal bradycardia, hypotension, and growth restriction; avoid use if possible.
FDA Pregnancy Category X. Amlodipine: No evidence of teratogenicity in animal studies, but limited human data; atorvastatin: contraindicated in pregnancy as HMG-Co A reductase inhibitors are associated with fetal abnormalities, including skeletal and CNS defects. First trimester: Atorvastatin is contraindicated; risk of congenital anomalies. Second/third trimester: Avoid exposure; potential for fetal toxicity. Effective contraception required for women of childbearing potential.
Diltiazem is excreted in breast milk; M/P ratio not established. Limited data suggest low levels; however, monitor infant for bradycardia, hypotension, and feeding difficulties. Use with caution.
Excreted in human milk: Amlodipine: present in low levels (M/P ratio approximately 1.0); atorvastatin: unknown. Due to potential for serious adverse reactions in nursing infants (e.g., skeletal muscle toxicity from statins), breastfeeding is contraindicated during therapy. Alternative agents preferred.
No standard dose adjustment; pharmacokinetic changes (increased volume of distribution, altered protein binding) may necessitate titration based on clinical response. Avoid in first trimester if possible.
Contraindicated during pregnancy; therefore, no dosing adjustments recommended. Discontinue therapy immediately if pregnancy is suspected or confirmed. Pharmacokinetic changes during pregnancy may alter drug metabolism, but no dose adjustments are justified due to teratogenic risk.
CARDIZEM LA is a once-daily extended-release formulation of diltiazem, a non-dihydropyridine calcium channel blocker. It is useful for hypertension and chronic stable angina. Avoid use in patients with second- or third-degree AV block, sick sinus syndrome without pacemaker, hypotension (SBP <90 mm Hg), or acute MI with pulmonary congestion. Monitor heart rate and PR interval, as it can cause bradycardia and AV block. Contraindicated with IV beta-blockers; caution with oral beta-blockers due to additive negative chronotropic effects. CYP3A4 substrate; avoid strong inhibitors/inducers. Do not crush or chew capsules; can sprinkle contents on applesauce for patients with swallowing difficulties. Max antihypertensive effect may take 2 weeks. Withdrawal may cause angina exacerbation; taper if discontinuing. Use with caution in heart failure with reduced ejection fraction (HFr EF) due to negative inotropic effects.
CADUET is a fixed-dose combination of amlodipine (a calcium channel blocker) and atorvastatin (a statin) used for hypertension and dyslipidemia. Avoid concomitant use with strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) due to increased statin exposure and risk of myopathy. Monitor liver enzymes before and during therapy, and for muscle symptoms. Use with caution in patients with severe renal impairment. Avoid grapefruit juice as it increases atorvastatin levels.
Take exactly as prescribed, usually once daily. Swallow capsule whole; do not crush or chew. If you have trouble swallowing, you may open the capsule and sprinkle the beads on a spoonful of applesauce; swallow immediately without chewing.,This medication helps lower blood pressure and reduce chest pain (angina). It may take up to 2 weeks to see the full effect on blood pressure. Keep taking it even if you feel well.,Avoid drinking grapefruit juice or eating grapefruit while taking this medication as it can increase side effects.,Common side effects include swelling in legs/ankles, headache, dizziness, or flushing. Report slow heartbeat, severe dizziness, fainting, or shortness of breath to your doctor.,Do not stop taking this medication suddenly, as it may worsen chest pain or cause a heart attack. Your doctor will tell you how to taper the dose if needed.,Limit alcohol consumption, as it may increase dizziness or lower blood pressure further.,Inform all healthcare providers you are taking CARDIZEM LA, especially before surgery or dental procedures.
Take this medication once daily at the same time, with or without food.,Avoid grapefruit and grapefruit juice while taking this medication.,Report unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.,Notify your doctor if you become pregnant, plan to become pregnant, or are breastfeeding.,Do not stop taking this medication without consulting your doctor, even if you feel well.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about CARDIZEM LA vs CADUET, answered by our medical review team.
CARDIZEM LA is a Calcium Channel Blocker that works by Cardizem LA (diltiazem) is a calcium channel blocker that inhibits calcium ion influx across cardiac and smooth muscle cells during depolarization, leading to negative inotropic, chronotropic, and dromotropic effects. It dilates coronary and peripheral arteries, reducing systemic vascular resistance and myocardial oxygen demand.. CADUET is a Calcium Channel Blocker + HMG-CoA Reductase Inhibitor that works by Amlodipine: Dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral vascular resistance. Atorvastatin: HMG-Co A reductase inhibitor that competitively inhibits the conversion of HMG-Co A to mevalonate, reducing cholesterol synthesis in the liver.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between CARDIZEM LA and CADUET depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of CARDIZEM LA is: Oral, 180-360 mg once daily; initiate at 180 mg once daily, titrate to 240 mg, then 300 mg, then 360 mg once daily as needed.. The standard adult dose of CADUET is: CADUET (amlodipine/atorvastatin) is available as tablets of 2.5/10, 2.5/20, 2.5/40, 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40, and 10/80 mg amlodipine/atorvastatin. Initial dose depends on current antihypertensive and lipid-lowering therapy. Usual starting dose is 5/10 mg orally once daily; titrate at intervals of 2-4 weeks based on blood pressure and LDL-C goals. Maximum daily dose: amlodipine 10 mg; atorvastatin 80 mg.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between CARDIZEM LA and CADUET in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. CARDIZEM LA is classified as Category C. Category C. First trimester: No adequate studies in humans; animal studies show embryotoxicity and fetotoxicity at high doses. Second and third trimesters: Risk of fetal bradycardi. CADUET is classified as Category C. FDA Pregnancy Category X. Amlodipine: No evidence of teratogenicity in animal studies, but limited human data; atorvastatin: contraindicated in pregnancy as HMG-CoA reductase inhib. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.