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What is diltiazem, and how does it work (mechanism of action)?
CCBs block the entry of calcium into muscle cells that make up the heart and that surround the arteries. It is the entry of calcium into these cells that causes the cells to contract, allowing the heart to pump blood, and the arteries to narrow. By blocking the entry of calcium, diltiazem decreases the force of contraction of the heart and its rate of contraction. It also relaxes the muscles surrounding the arteries, allowing the arteries to widen (dilate). In order to pump blood, the heart needs oxygen. The harder the heart works, the more oxygen it requires. Angina occurs when the supply of oxygen to the heart is inadequate for the amount of work the heart must do.
By dilating arteries, diltiazem reduces the pressure in the arteries into which the heart must pump blood, and, as a result, the heart needs to work less and requires less oxygen. By reducing the heart's need for oxygen, diltiazem relieves or prevents angina. Dilation of the arteries also reduces blood pressure.
The FDA approved diltiazem in 1982.
What brand names are available for diltiazem?
Cardizem, Cardizem CD, Cardizem LA, Tiazac, Cartia XT, Diltzac, Dilt-CD, and several others
Is diltiazem available as a generic drug?
Do I need a prescription for diltiazem?
What are the side effects of diltiazem?
Side effects include:
- edema (swelling of the legs and feet with fluid),
- low blood pressure (hypotension),
- drowsiness, and
Liver dysfunction and overgrowth of the gums also may occur. Diltiazem can cause mildly abnormal liver tests that usually return to normal with discontinuation of the medication. When diltiazem is given to individuals with heart failure, symptoms of heart failure may worsen because these drugs reduce the ability of the heart to pump blood. Like other drugs for high blood pressure, diltiazem is associated with sexual dysfunction.
What is the dosage for diltiazem?
- Adult oral doses for chest pain or high blood pressure (hypertension) range between 120 and 540 mg daily. Dosing varies depending on formulation and use.
- Immediate release tablets are administered up to 4 times a day.
- Extended release formulations are administered once daily at approximately the same time each day and should not be crushed or chewed.
- Injectable forms are used for treating atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardia.
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Which drugs or supplements interact with diltiazem?
Administration of diltiazem with digoxin (Lanoxin) can increase digoxin blood levels. Therefore, blood levels of digoxin usually are monitored to avoid toxicity from digoxin. Similarly, concurrent administration of diltiazem with an anti-seizure medication, carbamazepine (Tegretol), can increase blood levels of the seizure medication, and occasionally lead to toxicity. Diltiazem increases blood levels of lovastatin (Mevacor), atorvastatin (Lipitor) and simvastatin (Zocor), possibly increasing the risk of adverse effects. Diltiazem may increase blood levels of buspirone (Buspar), midazolam (Versed), triazolam (Halcion) and diazepam (Valium) by reducing their breakdown and elimination from the body by the liver. This can lead to toxicity from these drugs. Rifampin (Rifamate, Rifadin, Rimactane) reduces the effect of diltiazem by reducing its levels in blood to undetectable levels.
Is diltiazem safe to take if I'm pregnant or breastfeeding?
What else should I know about diltiazem?
What preparations of diltiazem are available?
- Tablets (immediate release): 30, 60, 90, and 120 mg.
- Tablets (extended release): 120, 180, 240, 300, 360, 420 mg.
- Capsules (extended release): 120, 180, 240, 300, 360, 420 mg.
- Powder for injection: 100 mg.
- Injectable Solution: 5 mg/ml.
How should I keep diltiazem stored?
Tablets, capsules and powder for injection should be stored at room temperature, 15 C and 30 C (59 F and 86 F). Solution for injection should be stored at 2 C and 8 C (36 F and 46 F).
Diltiazem (Cardizem, Cardizem CD, Cardizem LA, Dilacor XR, Tiazac, Cartia XT and several others) is a medication prescribed to treat angina, high blood pressure, and abnormal heart rhythms. Diltiazem is in a class of drugs called calcium channel blockers (CCBs). Side effects, drug interactions, dosage, and precautions should be reviewed prior to taking this medication.
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Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Atrial Fibrillation (AFib, AF)
Atrial fibrillation (AF or AFib) is an abnormality in the heart rhythm, which involves irregular and often rapid beating of the heart. Symptoms may include heart palpitations, dizziness, fainting, fatigue, shortness of breath, and chest pain. Atrial fibrillation treatment may include medication or procedures like cardioversion or ablation to normalize the heart rate.
High Blood Pressure (Hypertension) Signs, Causes, Diet, and Treatment
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
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Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
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High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Abnormal Heart Rhythms (Heart Rhythm Disorders)
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
Paroxysmal Supraventricular Tachycardia (PSVT)
Paroxysmal supraventricular tachycardia (PSVT) is an abnormal conduction of electricity in particular areas of the heart. PSVT was referred to at one time as paroxysmal atrial tachycardia or PAT, however, the term PAT is reserved for as specific heart condition. Symptoms of PSVT include weakness, shortness of breath, chest pressure, lightheadedness, and palpitations. PSVT is treated with medications or procedures that return the heart to its normal electrical pattern.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Febrile seizures, or convulsions caused by fever, can be frightening in small children or infants. However, in general, febrile seizures are harmless. Febrile seizure is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure. Some of the features of a febrile seizure include: losing consciousness, shaking, moving limbs on both sides of the body, lasts 1-2 minutes. Less commonly, a febrile seizure may only affect one side of the body.
Atrial Flutter (Symptoms, Causes, ECG, and Treatments)
Atrial flutter is a problem with the atria of the heart. In atrial flutter the atria of the heart rapidly and repeatedly beat due to an anomaly in the electrical system of the heart. It is a type of arrhythmia and can be dangerous because complications can develop easily. Signs and symptoms of atrial flutter include near fainting, palpitations, mild shortness of breath, and fatigue. While the exact cause of atrial flutter is not clearly understood, it's most likely related to your health, what medical conditions you certainly have, poor diet, lack of exercise, and drinking too much alcohol. Atrial flutter is diagnosed by physical examination, medical history, and a sawtooth ECG wave pattern.
Atrial Fibrillation (AFib) Treatment Drugs
Atrial fibrillation (AFib) is a heart rhythm disorder that causes irregular and often rapid heartbeat. The medications to treat AFib include beta-blockers, blood thinners, and heart rhythm drugs. Atrial fibrillation drugs can cause serious side effects like seizures, vision changes, shortness of breath, fainting, other abnormal heart rhythms, excessive bleeding while coughing or vomiting, blood in the stool, and bleeding into the brain.
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