Has anyone that’s taken Diltiazem for a long time and developed glaucoma? I’m attaching a link to an article. I read yesterday claiming that Diltiazem may cause Glaucoma. I’m concerned because I’ve been on Diltiazem for years and I’m being treated for glaucoma now. I’ve noticed an increase in blurred vision lately and I’m not sure if it’s my cataracts or my glaucoma getting worse.
Also, what medication do you think works best to help with severe arrhythmias and Afib? I’m unable to take Flecainide due to making my arrhythmia worse.
The risk is modest. The study says that on average the risk of glaucoma is 39% more (a factor of 1.39) than someone not on CCBs, so it's not like the risk is vast, and bearing in mind glaucoma is not a huge risk itself (a little below 1% in the US).
The paper proper can be found on Pub Med if you search PMID 37676684
The abstract says "CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care". Also note that this is an association, not necessarily a cause. It may be that CCBs are given for high blood pressure and high blood pressure itself is already known to increase the risk of glaucoma.
Don't go too much by journalistic articles pulling out a headline from a medical paper. You need to read the paper itself. Things I'd question are 1. did they determine whether BP was under control? (note, CCB users had 8 mm higher BP than non-users, table 1), 2. did they stratify according to the various types of CCB (yes they did, see table 4, also between CCB and other BP meds)? etc etc.
The paper is a free one and can be accessed at the above PubMed reference. Always read the Discussion and Strengths and Limitations.
A small update. Diltiazem is a benzothiazepine-type calcium channel blocker. The risk ratio for these is 1.8 (table 4), so 80% higher, still modest in my view, so not definite that the med is causing this. However, as you already have glaucoma it may be worth seeing about withdrawal. You'd need to talk to both your optician and cardiologist. The obvious alternative to Diltiazem is a beta blocker such as Bisoprolol. Good luck and I hope you get some answers.
BBs over 2 years 3 months DO NOT CONTROL my Heart Rate Day. Metoprolol 186 changed to Bisoprolol 156 Day. Metoprolol showed pauses at night. All 3 x 24hr heart monitors reported 47avg bpm.
So Diltiazem dramatically brought down my H.Rate BELOW 100bpm. Taken in the morning early.
I kept taking 2.5 Bisoprolol at night. In December was advised to stop as Low BP.
Regarding your first question. I've been on diltiazem for almost three years for AFl/AF and have annual appts with my opthamologist and do not have glaucoma. Also my mother was a high daily dose of diltiazem for over 13 years and did not develop it. But I did ask at my last ophthalmology appt this past fall about glaucoma because I also read about calcium channel blockers and potential for increasing it. He mentioned it was more an association and the studies are still ongoing and did mention it can be multifactorial -- more than one thing going on. It will be interesting to see if others posts here about their experience with diltiazem and glaucoma. And then separately, maybe there could be a possible link between AF/AFl (blood flow) and an increased risk of glaucoma? Though this also is still not medically verified with only a single study.
Asked this of ChatGPT. It gave a pretty good answer, including this latest paper and the figures I quoted above, though it hss a higher incidence of non-CCB Glaucoma, at 2%-3%. ChatGPT has definitely come on a long way in the past year or two
I am 73. I do have cataracts and maybe you are correct in that this is what is causing my blurred vision. The blurred vision seems to have gotten worse since I’ve been on the Diltiazem though. Maybe it’s just my imagination. I did leave a message with my ophthalmologist and he is supposed to get back with me. I’ve also left a message with my cardiologist and I’m waiting to hear back from him also. I’m in desperate need for a medication that’s going to help me with my arrhythmias. Increasing the mg of Diltiazem doesn’t seem to be working so now I’m wondering what’s next as these arrhythmias are taking a toll on me.
I've taken Diltiazem for 8.5 years and do have ocular hypertension (not escalated to glaucoma).Mine is due to some abnormality in the trabecular framework, worse in one eye than the other.
I've had laser surgery on one eye, which was successful so may have it in the other eye too.
I take Amiodarone as Flecanide does not agree with me.
The Amiodarone has caused corneal deposits but hopefully, they will go when the Amiodarone is stopped.
Hi! Thank you for sharing. I believe I may be the same as you as my doctor is treating me with drops for the high pressures in both eyes. He says I am more or less a glaucoma suspect. I do worry that maybe the Diltiazem is what’s causing it as I never had problems before I started taking the Diltiazem.. It may be just a coincidence, I don’t know. I am going to look into it though and check with both my ophthalmologist and my cardiologist..
I did have pressure issues prior to the Diltiazem so I know it's not the cause from me. I'm seen in the stable glaucoma clinic but definitely don't have glaucoma. I'm on 2 different drops, 1 once per day and the other twice per day. Perhaps check if you're a candidate for SLT laser treatment. It bought my pressure down.
I couldn't function at all on Bisoprolol so I definitely wouldn't go back onto that.
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