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GENERIC NAME: DILTIAZEM - INJECTION (dill-TIE-uh-zem)

BRAND NAME(S): Cardizem

USES: Diltiazem is a calcium channel blocker. Calcium is involved in blood vessel contraction and in controlling the electrical impulses within the heart. By blocking calcium, diltiazem relaxes and widens blood vessels and can normalize heart rates. Diltiazem injection is used to treat irregular heartbeats.

OTHER USES: This medication may also be used for chest pain (angina) or high blood pressure.

HOW TO USE: This medication is given by vein (slow IV injection or continuous infusion) as directed by the doctor. The patient's blood pressure and heart rhythm (ECG) should be monitored during the administration period. It is generally administered for up to 24 hours or as directed, then therapy is changed to an oral heart drug (antiarrhythmic). The dosage is based on the patient's medical condition and response to the medication. Learn all mixing, dilution and administration/usage instructions in the product package and ask the doctor or pharmacist if you are unclear about any of the information. The liquid should be checked for particles or discoloration. If present, discard the liquid. Make sure needles and medical supplies are stored safely and disposed of properly.

SIDE EFFECTS: Itching or burning at the injection site, drowsiness, flushing, dizziness, nausea, vomiting, loss of appetite, diarrhea, mental/mood changes, trouble sleeping and headache may occur. If these effects persist or worsen, notify the doctor promptly. Unlikely but report promptly: swelling, black stool, ringing in the ears, tremor, slow/irregular heartbeat, rash. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell the doctor the patient's medical history, including: any allergies, heart disease, very low blood pressure, liver problems, kidney disorders. Avoid alcohol intake, as it may intensify drug side effects. Some diltiazem products contain benzyl alcohol and should not be administered to newborn infants. If you have questions about which products contain benzyl alcohol contact the pharmacist. Caution is advised when using this drug in the elderly, as they may be more sensitive to drug effects (e.g., low blood pressure). This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk. Breast-feeding is not recommended while you are receiving this medication.

DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription medication you may use, especially of: digoxin and other heart (antiarrhythmic), blood pressure drugs such as beta- blockers (e.g., propranolol, timolol ), other calcium channel blockers (e.g., nifedipine, verapamil), intravenous (IV) calcium, nitrates (e.g., sublingual nitroglycerin), disopyramide, flecainide, quinidine, cimetidine, cyclosporine, carbamazepine, theophylline, lithium, benzodiazepines (e.g., midazolam, triazolam), buspirone, lovastatin, rifampin, St John's wort. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include dizziness, weakness, slowed or irregular heartbeat, nausea, drowsiness, confusion, and slurred speech.

NOTES: Do not share this medication with others. Laboratory and/or medical tests will be performed to monitor your progress (e.g., blood pressure and EKG).

MISSED DOSE: If your dose is interrupted, contact the doctor or pharmacist immediately to re-establish dosing.

STORAGE: Store the vials in the refrigerator between 36 and 46 degrees F (2-8 degrees C) away from light and moisture. Do not freeze. The vials may be stored at room temperature for 1 month. The single dose syringes (Lyo-ject) should be stored at room temperature between 59 and 86 degrees F (15-30 degrees C). Once the powder has been mixed with the solution, the syringe can be stored at room temperature for 24 hours. Discard any unused solution after 24 hours. If the drug is added to a larger volume of solution, it can be stored at room temperature or under refrigeration (36-46 degrees F or 2-8 degrees C) and should be used within 24 hours.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).

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