Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. This medication must be taken regularly to prevent angina. It should not be used to treat angina when it occurs. Use other medications such as sublingual nitroglycerin to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details. Consult your healthcare professional before taking or discontinuing any drug, changing your diet or commencing any course of treatment. CARDIZEM tablets and CARDIZEM SR capsules is observed. IV diltiazem contraindicated in patients with cardiogenic shock.
Wright JT, Bakris G, Greene T et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. Some products that may interact with this drug include: amiodarone, digoxin, fingolimod. Hansten PD. Diltiazem and digoxin. Drug Interact Newsl.
If there is no response to vagal blockage, administer isoproterenol cautiously. Frishman WH, Charlap S, Goldberger J et al. Comparison of diltiazem and nifedipine for both angina pectoris and systemic hypertension. Am J Cardiol. Höglund P, Nilsson LG. Pharmacokinetics of diltiazem and its metabolites after single and multiple dosing in healthy adults. Ther Drug Monit. Exertional Angina: Cardizem has been shown to produce increases in exercise tolerance, probably due to its ability to reduce myocardial oxygen demand. This is accomplished via reductions in heart rate and systemic blood pressure at submaximal and maximal exercise workloads.
Three-character codes are assigned only in situations when more than one reference listed drug of the same strength has been designated under the same heading. Two or more reference listed drugs are generally selected only when there are at least two potential reference drug products which are not bioequivalent to each other. If a study is submitted that demonstrates bioequivalence to a specific listed drug product, the generic product will be given the same three-character code as the reference listed drug it was compared against. Carbamazepine Tegretol drug interaction: Diltiazem Cardizem. In: Hansten PD, Horn JR. Drug interactions analysis and management.
Henry M, Kay MM, Viccellio P. Cardiogenic shock associated with calcium-channel and beta blockers: reversal with intravenous calcium chloride. Am J Emerg Med. Cardizem will be handled and stored by a health care provider. You will not store it at home. Keep all medicines out of the reach of children and away from pets. Schulte KL, Meyer-Sabellek WA, Haertenberger A et al. Antihypertensive and metabolic effects of diltiazem and nifedipine. Hypertension. Josefson D. Infarction risk found with calcium channel blocker. BMJ. Ask your pharmacist about using those products safely. Hoechst Marion Roussel. Cardizem diltiazem hydrochloride for injection product monograph. Kansas City, MO; undated.
Desacetyl diltiazem is also present in the plasma at levels of 10% to 20% of the parent drug and is 25% to 50% as potent as a coronary vasodilator as diltiazem. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Use Cardizem with caution in the ELDERLY; they may be more sensitive to its effects. Take this medication by mouth with or without food, usually once daily at the same time or as directed by your doctor. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Depending on your specific brand, take this medication either in the morning or at bedtime as directed. Consult your pharmacist if you have any questions about when to take the medication. Inhibitors, inducers, and substrates of CYP3A4: potential pharmacokinetic interaction altered plasma diltiazem concentrations. Alderman M, Madhavan S, Cohen H. Calcium antagonists and cardiovascular events in patients with hypertension and diabetes. Lancet. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ. Chellingsworth MC, Kendall MJ, Wright AD et al. The effects of verapamil, diltiazem, nifedipine and propranolol on metabolic control in hypertensives with non-insulin dependent diabetes mellitus. J Hum Hypertens.
Rifampin: Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered. Okada M, Inoue H, Nakamura Y et al. Excretion of diltiazem in human milk. N Engl J Med. Calcium-channel blockers considered the drugs of choice in management of Prinzmetal variant angina. Pratt Pharmacueticals. Procardia nifedipine capsules prescribing information dated 1993 Feb. Kansas City, MO; 1996 Jul. American Heart Association. Public advisory statement on calcium channel blocker drugs. If there is no response to vagal blockade, administer isoproterenol cautiously.
Important: The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, blogs, or WebMD Answers are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Marion Merrell Dow. Cardizem CD diltiazem hydrochloride once-a-day capsules for hypertension: clinical monograph. Kansas City, MO; 1992 Jan. Scher DL, Arsura EL. Multifocal atrial tachycardia: mechanisms, clinical correlates, and treatment. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee JNC 8 hypertension guidelines. J Clin Hypertens Greenwich. Hg may still be considered. Store at room temperature away from light and moisture. not store in the bathroom. Keep all away from children and pets. Cooper DS. Antithyroid drugs. N Engl J Med. American Heart Association Task Force on Practice Guidelines Committee on Management of Acute Myocardial Infarction. From ACC website.
Packer M, Kessler PD, Lee WH. Calcium-channel blockade in the management of severe chronic congestive heart failure: a bridge too far. Circulation. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Management of hypertension alone or in combination with other classes of antihypertensive agents. American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. May be used for relief of ongoing ischemia or to control rapid ventricular response with atrial fibrillation after an acute MI when β-adrenergic blocking agents are ineffective or contraindicated, but only in patients in whom there is no evidence of heart failure, left-ventricular dysfunction, or AV block and only after weighing carefully the potential benefits versus risks, particularly negative inotropic effects and concerns about short-acting formulations of the drugs. Inc. Steinbach, MB R5G 1Z7 Canada. Diltiazem is used to prevent chest pain angina. It may help to increase your ability to exercise and decrease how often you may get angina attacks. Diltiazem is called a calcium channel blocker. It works by relaxing blood vessels in the body and heart and lowers the heart rate. Blood can flow more easily and your heart works less hard to pump blood. You may need to have an electrocardiogram ECG checked before starting Cardizem and while taking it. Discuss any questions or concerns with your doctor. Biovail Pharmaceuticals, Inc. Cardizem CD diltiazem hydrochloride capsules prescribing information. Morrisville, NC; 2001 Aug.
ACE inhibitors, angiotensin II receptor antagonists. 500 501 504 However, diminished response to these other drug classes is largely eliminated when administered concomitantly with a calcium-channel blocker or thiazide diuretic. Cyclosporine: A pharmacokinetic interaction between diltiazem and cyclosporine has been observed during studies involving renal and cardiac transplant patients. In renal and cardiac transplant recipients, a reduction of cyclosporine trough dose ranging from 15% to 48% was necessary to maintain concentrations similar to those seen prior to the addition of diltiazem. If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted, or discontinued. The effect of cyclosporine on diltiazem plasma concentrations has not been evaluated. McGraw BF, Walker SD, Hemberger JA et al. Clinical experience with diltiazem in Japan. With IV therapy, hypotension, injection site reactions, vasodilation, arrhythmia. Wolfson P, Abernethy D, DiPette DJ et al. Diltiazem and captopril alone or in combination for the treatment of mild to moderate systemic hypertension. Am J Cardiol. There are no well-controlled studies in pregnant women; therefore, use Cardizem in pregnant women only if the potential benefit justifies the potential risk to the fetus. While you are taking this medicine, you should avoid eating grapefruit or or drinking grapefruit juice. You may choose an alternative citrus beverage such as orange juice. National Heart, Lung, and Blood Institute. NHLBI panel reviews safety of calcium channel blockers. Rockville, MD; 1995 Aug 31. Press release. PVC bags: Store at room temperature or under refrigeration and use within 24 hours. LA and other formulations of diltiazem HCl. Cardizem CD and Cartia XT extended-release capsules: Maximum 480 mg daily. Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician. Cardizem Dosage and Administration Exertional Angina Pectoris Due to Atherosclerotic Coronary Artery Disease or Angina Pectoris at Rest Due to Coronary Artery Spasm: Dosage must be adjusted to each patient's needs. Starting with 30 mg four times daily, before meals and at bedtime, dosage should be increased gradually given in divided doses three or four times daily at 1- to 2-day intervals until optimum response is obtained. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. Peitz TJ. Intravenous diltiazem hydrochloride rather than verapamil for resistant paroxysmal supraventricular tachycardia. West J Med. Patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission Warnings 1. Cardiac Conduction: Cardizem prolongs AV node refractory periods without significantly prolonging sinus node recovery time, except in patients with sick sinus syndrome. ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension ESH and of the European Society of Cardiology ESC. J Hypertens.
If your symptoms do not improve or if they become worse, check with your doctor. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC 7. Bethesda, MD: National Institutes of Health; 2004 Aug. NIH publication No. 04-5230. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. Tell your doctor if your condition worsens for example, your chest pain worsens or your routine blood pressure readings increase. Roti E, Montermini M, Roti S et al. The effect of diltiazem, a calcium channel-blocking drug, on cardiac rate and rhythm in hyperthyroid patients. Arch Intern Med.
Brodie MJ, Macphee GJA. Carbamazepine neurotoxicity precipitated by diltiazem. BMJ. Black HR. Choosing initial therapy for hypertension: a personal view. In: The National Heart, Lung, and Blood Institute workshop on antihypertensive drug treatment. Events observed following diltiazem overdose included bradycardia, hypotension, heart block, and cardiac failure. The therapeutic benefits achieved with Cardizem are believed to be related to its ability to inhibit the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle. CMT Charcot Marie Tooth. I take 100mg daily. Been taking it about 20 years. Before taking it I wrote down every little thing that seemed to bother me and after about 2 mo. I had several improvements. Don't remember what they were lost the paper. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Administer by direct IV injection, continuous IV infusion, or orally. Kaplan NM. The meaning of ALLHAT. J Hypertens. Woie L, Storstein L. Successful treatment of suicidal verapamil poisoning with calcium gluconate. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Select dosage cautiously; geriatric patients may respond to lower dosages. Arsura EL, Scher DL. Verapamil and multifocal atrial tachycardia. Ann Intern Med. Mantzoros CS, Prabhu AS, Sowers JR. Paralytic ileus as a result of diltiazem treatment. J Int Med. Cardizem 120 mg scored tablets are supplied in bottles of 100 NDC 0187-0792-47. Each light yellow, capsule-shaped tablet is engraved with Cardizem on one side and 120 mg on the other.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. For the treatment of high blood pressure, it may take 2 weeks before you get the full benefit of this drug. Long-acting forms of diltiazem may be used to treat high blood pressure. If your doctor prescribes diltiazem to treat high blood pressure, check with your pharmacist to make sure you are getting the correct form of diltiazem. CD and 240 mg on one end. Concomitant use of diltiazem with beta-blockers or digitalis may result in additive effects on cardiac conduction. A patient with Prinzmetal's angina developed periods of asystole 2 to 5 seconds after a single dose of 60 mg of diltiazem see ADVERSE REACTIONS. For solution and drug compatibility information, see Compatibility under Stability. Szlachcic J, Hirsch AT, Tubau JF et al. Diltiazem versus propranolol in essential hypertension: responses of rest and exercise blood pressure and effects on exercise capacity. Am J Cardiol. Winship LC, McKenney JM, Wright JT et al. The effect of ranitidine and cimetidine on single-dose diltiazem pharmacokinetics. Pharmacotherapy. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?
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Tell your doctor if your condition worsens for example, your worsens or your routine increase. Do not chew or crush the tablet. Ivabradine: Concurrent use of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Avoid concomitant use of ivabradine and diltiazem.
Diltiazem Cardizem drug interaction: Pravastatin Pravachol. In: Hansten PD, Horn JR. Drug interactions analysis and management. Anesthetics: The depression of cardiac contractility, conductivity, and automaticity, as well as the vascular dilation associated with anesthetics, may be potentiated by calcium channel blockers. When used concomitantly, anesthetics and calcium blockers should be titrated carefully. Oyama Y, Fujii S, Kanda K et al. Digoxin-diltiazem interaction. Am J Cardiol.
Szlachcic J, Tubau JF, Vollmer C et al. Effect of diltiazem on left ventricular mass and diastolic filling in mild to moderate hypertension. Am J Cardiol. Distinguishing hype from reality. Chest. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. The following represent occurrences observed in clinical studies of angina patients. In many cases, the relationship to Cardizem has not been established.
IV injection over 2 minutes. Monitor ECG and BP continuously during IV administration. Weiss RJ, Bent B. Diltiazem-induced left ventricular mass regression in hypertensive patients. J Clin Hypertens. For information on systemic interactions resulting from concomitant use, see Interactions.