Diltiazem is a calcium channel blocker.
- Angina: prophylaxis and treatment
- Hypertension (particularly the long-acting form)
- Rate limiting of Atrial fibrillation
- Anal fissure (reportedly causing less headache than glyceryl trinitrate cream)
Oral from 60mg tds to 360mg daily- in divided doses or as a long acting preparation.
Many brands of long acting diltiazem are available.
- Severe bradycardia
- LVF with pulmonary congestion
- Second or third degree heart block without pacemaker
- Sick sinus syndrome
- Breast feeding
- Hepatic impairment
- Renal impairment
- Heart failure or significant LVF
- First degree heart block or prolonged PR interval
- Sino-atrial block
- AV block
- Hot flushes
- GI disturbances
Other rare side effects - rashes, photosensitivity
Reported - Hepatitis, gynaecomastia, gum hyperplasia, extrapyramidal symptoms, depression
Like verapamil, diltiazem is a non-dihydropyridine calcium channel blocker. Due to its plasma half-life of 4 hours, most preparations are modified release.