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- What is diltiazem, and how does it work (mechanism of action)?
- What brand names are available for diltiazem?
- Is diltiazem available as a generic drug?
- Do I need a prescription for diltiazem?
- What are the side effects of diltiazem?
- What is the dosage for diltiazem?
- Which drugs or supplements interact with diltiazem?
- Is diltiazem safe to take if I'm pregnant or breastfeeding?
- What else should I know about diltiazem?
What is diltiazem, and how does it work (mechanism of action)?
Diltiazem is a drug that is used for treating heart pain (angina), high blood pressure, and abnormal heart rhythms. It belongs to a class of drugs called calcium channel blockers (CCBs), which includes amlodipine (Norvasc), verapamil (Calan, Isoptin), nifedipine (Adalat, Procardia) as well as others. 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
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.
Quick GuideHow to Lower Blood Pressure: Exercise Tips
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.
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?
Diltiazem is excreted in breast milk. To avoid adverse effects in the infant, diltiazem should not be taken while nursing.
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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Medications & Supplements
- High Blood Pressure Drugs (Hypertension)
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- Calcium Channel Blockers (CCBs)
- amlodipine, Norvasc
- nifedipine, Adalat (discontinued brand), Procardia, Afeditab, Nifediac
- amiodarone, Cordarone, Nextrone, Pacerone
- verapamil (Calan, Verelan, Verelan PM [Discontinued: Isoptin, Isoptin SR, Covera-HS])
- nicardipine, Cardene, Cardene SR
- bepridil (Vascor, Bepadin - Discontinued)
Prevention & Wellness
Heart Health Resources
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top diltiazem Related Articles
Angina SymptomsAngina 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.
FaintingFainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Heart Disease (Coronary Artery Disease)
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:
- High blood pressure
- High cholesterol
- Family history
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.
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High Blood Pressure Hypertension
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.
Take the HBP QuizTake this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and heart attacks. How are dizziness, snoring, and gout related to HBP? Find the answer and learn how medical treatments and lifestyle adjustments fight this common problem.
High Blood Pressure TreatmentHigh 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.
Hypertension PictureHigh blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90. See a picture of Hypertension and learn more about the health topic.
MigraineMigraine 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.
Mitral Valve Prolapse
Mitral valve prolapse (MVP), also called "click murmur syndrome" and "Barlow's syndrome," is the most common type of heart valve abnormality. Usually, people with mitral valve prolapse have no signs and symptoms; however, if the prolapsed valve is severe, symptoms may appear. When symptoms of severe mitral valve prolapse do appear, they may include, fatigue, palpitations, chest pain, anxiety, migraine headaches, and pulmonary edema. Echocardiography is the most useful test for mitral valve prolapse. Most people with mitral valve need no treatment. However, if the valve prolapse is severe, treatment medications or surgery may be necessary to repair the heart valve.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Raynaud's PhenomenonRaynaud'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.
SclerodermaScleroderma 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.