Diltiazem Hydrochloride(dil tye’ a zem)
Apo-Diltiaz (CAN), Apo-Diltiaz CD (CAN)DNC, Apo-Diltiaz SR (CAN)DNC, Cardizem, Cardizem CDDNC, Cardizem, LADNC, Cartia XTDNC, Dilt-CDDNC, Dilt-XRDNC, Diltia XTDNC, DiltzacDNC, Gen-Diltiazem (CAN), Gen-Diltiazem CD (CAN)DNC, Novo-Diltiazem (CAN), Novo-Diltiazem CD (CAN)DNC, Nu-Diltiaz (CAN), Nu-Diltiaz-CD (CAN)DNC, ratio-Diltiazem (CAN), Taztia XTDNC, TiazacDNC
PREGNANCY CATEGORY C
Drug Classes
Antianginal
Antihypertensive
Calcium channel blocker
Therapeutic Actions
Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells, resulting in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of myocardial contractility, and dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac energy consumption, and in patients with vasospastic (Prinzmetal) angina, increased delivery of oxygen to myocardial cells.
Indications
Angina pectoris due to coronary artery spasm (Prinzmetal variant angina)
Effort-associated angina; chronic stable angina in patients not controlled by beta-adrenergic blockers, nitrates
ER and SR forms only: Essential hypertension
Parenteral: Paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter
Contraindications and Cautions
Contraindicated with allergy to diltiazem, impaired hepatic or renal function, sick sinus syndrome, heart block (second or third degree), severe hypertension, cardiogenic shock, acute MI with cardiogenic shock (oral), lactation.
Available Forms
Tablets—30, 60, 90, 120 mg; ER capsulesDNC—60, 90, 120, 180, 240, 300, 360, 420 mg; ER tabletsDNC—120, 180, 240, 300, 360, 420 mg; injection—5 mg/mL; powder for injection—25 mg
Indications
Evaluate patient carefully to determine the appropriate dose of this drug.
Dosages
Adults
Initially, 30 mg PO qid before meals and at bedtime; gradually increase dose at 1- to 2-day intervals to 180–360 mg PO in three to four divided doses.
ER
Cardizem CD and Cartia XT 180–240 mg daily PO for hypertension; 120–180 mg daily PO for angina.
Cardizem LA: 120–540 mg daily PO for hypertension; 180–360 mg/day PO for chronic, stable angina. May be given with nitroglycerin or nitrate therapy.
Diltia XT, Dilt-CD, and Dilt-XR: 180–240 mg daily PO as needed; up to 480 mg has been used.
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