Product Description

Indications:

Cardizem (Diltiazem) is used for the prevention and treatment of chronic stable (classical) and vasospastic angina. It is also used in the management of hypertension, either alone or with other drugs, and may be effective in myocardial infarction, coronary artery spasm and arrhythmias. Additionally, it can be helpful in Raynaud’s phenomenon, oesophageal motility disorders and migraine. Sustained-release formulations are indicated for long-term management of angina pectoris, essential hypertension and prevention of selected supraventricular tachyarrhythmias.

Pharmacology:

Diltiazem hydrochloride is a calcium channel blocker that acts as a peripheral and coronary vasodilator. It reduces cardiac workload and oxygen demand while improving oxygen supply to the heart. It slows conduction through the SA and AV nodes, helping to control heart rhythm. It also lowers blood pressure by reducing peripheral vascular resistance. More than 90% of the oral dose is absorbed, it is highly protein-bound, reaches peak plasma levels within 30–60 minutes, is metabolized in the liver and about 60% is excreted via bile.

Dosage and Administration:

Film-coated tablets are usually given at 60 mg three times daily, which may be increased to 180–300 mg/day depending on response. Treatment may begin at 30 mg four times daily, with gradual adjustment. In some cases, doses up to 480 mg/day may be used. In elderly patients or those with hepatic or renal impairment, the starting dose is 60 mg twice daily, and dose escalation should be avoided if heart rate falls below 50 beats per minute. Sustained-release tablets for hypertension are usually started at 90–120 mg twice daily (once daily in elderly), with a maximum of 360 mg/day (240 mg/day in elderly). For angina, the initial dose is 90–120 mg twice daily, with up to 240 mg/day in elderly patients.

Drug Interactions:

Diltiazem can be safely used with short- or long-acting nitrates. However, caution is required when it is administered with other drugs that affect cardiac contractility or conduction, and dose adjustments may be necessary.

Contraindications:

This medication should not be used in patients with hypersensitivity to Diltiazem, sick sinus syndrome, second- or third-degree AV block, severe hypertension or acute myocardial infarction accompanied by pulmonary congestion.

Side Effects:

Reported side effects include bradycardia, sinoatrial or atrioventricular block, headache, flushing, gastrointestinal disturbances, edema, hepatitis and depression.

Pregnancy and Lactation:

Diltiazem should be used during pregnancy only if the potential benefits outweigh the risks to the fetus. As the drug is excreted into breast milk, breastfeeding should be avoided during treatment.

Therapeutic Class:

Calcium Channel Blocker

Storage Conditions:

Store below 30°C, protect from light and moisture, and keep out of reach of children.

⚠️ Always use this medication under the advice of a registered healthcare professional.