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Diltiazem Hydrochloride

Calcium-channel blockers Prescription
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Indications

Hypertension Angina Pectoris Myocardial Infarction Migraine

Cardizem SR film-coated tablet is used to prevent and treat chronic stable (classical) and vasospastic angina pectoris. It has also been used alone or together with other medicines to manage hypertension. Cardizem SR is also effective in myocardial infarction, coronary artery spasm, arrhythmias, Raynaud's phenomenon, oesophageal motility disorder and migraine. Cardizem SR sustained release tablet is indicated for the prevention and treatment of angina pectoris. It is used to manage classical and vasospastic angina pectoris. It has also been used to treat essential hypertension, and it is used to prevent some selected supraventricular tachyarrhythmias.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Diltiazem hydrochloride is a calcium channel antagonist. It works as a peripheral and coronary vasodilator and has some negative inotropic activity. Diltiazem inhibits cardiac conduction, particularly at the sino-atrial and atrioventricular nodes. It has the following actions.

Antianginal: it directly dilates the coronary arteries and arterioles, improving oxygen supply to the heart muscle tissue. Dilatation of the peripheral blood vessels also lowers systemic pressure on the cardiac "after load," which lessens stress on the heart and reduces its oxygen requirements.

Antiarrhythmic: by inhibiting the influx of calcium ions into cardiac tissue, it slows electrophysiological activity through the S-A and A-V nodes, without affecting accessory bypass conduction or altering normal atrial action potential or intraventricular conduction.

Antihypertensive: it reduces peripheral vascular resistance through vasodilatation.

More than 90% of an oral dose is rapidly absorbed, and protein binding is very high. Peak plasma concentration is reached within 30 to 60 minutes. Diltiazem is metabolised in the liver, and 60% of it is excreted through bile.

Pregnancy & Breastfeeding

Diltiazem hasn't been thoroughly studied in pregnant women, so there's no solid evidence on its safety in pregnancy. For this reason, it should only be used during pregnancy if the expected benefit to the mother clearly outweighs any possible risk to the unborn baby.

Diltiazem also passes into breast milk, so breastfeeding is not recommended for mothers taking this medicine. If treatment with diltiazem is needed while a mother is breastfeeding, an alternative way of feeding the infant should be arranged instead.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Film-coated tablets: The usual dose of diltiazem hydrochloride film-coated tablets is 60 mg three times daily. However, response varies and dosage requirements can differ significantly between individual patients. If necessary, the total daily dose, given in divided doses, may be increased to 180 to 300 mg per day. Treatment may be started at 30 mg four times daily, increasing at intervals of 1 to 2 days until the best response is achieved. Higher doses of up to 480 mg per day have been used with benefit in some patients, especially in unstable angina. Elderly patients and patients with impaired liver or kidney function: The recommended starting dose is 60 mg twice daily. Heart rate should be measured regularly, and the dose should not be increased if the heart rate falls below 50 beats per minute. Sustained-release formulation: For mild to moderate hypertension, the initial dose is 90 mg or 120 mg twice daily (once daily in the elderly); up to 360 mg daily may be required (up to 240 mg daily in the elderly). For angina, the initial dose is 90 mg or 120 mg twice daily in divided doses, as may be required (up to 240 mg daily in the elderly).

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.