Diltiazem

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rINN: Diltiazem
Other Names
Diltiazem Hydrochchloride 1,5- Benzothiazepin-4(5H)- one,3-( acetyloxy)-5[2-( dimethylamino)ethyl]-2,-3- dihydro-2(4- methoxyphenyl), Tildiem®, Adizem-SR®, Angitil SR®, Cardicard CR®,Dilcardia SR®,Diltzem SR®,Slozem®, Viazem XL®,Zemtard® etc
Pharmacological Information
Pharmacology Images
Diltiazem Molecule
Diltiazem.png
Web information on Diltiazem
Mechanism of Action
Calcium Channel Blocker
Other Issues for Diltiazem
Care in heart failure or AV block, prolonged PR interval
Relevant Clinical Literature
UK Guidance
Regulatory Literature
Other Literature
Other Wikis
Wikipedia on Diltiazem (Less technical, ? quality control)

Contents

Introduction

Diltiazem is a calcium channel blocker.

Clinical Use

Indications

  1. Angina: prophylaxis and treatment
  2. Hypertension (particularly the long-acting form)
  3. Rate limiting of Atrial fibrillation
  4. Anal fissure[1] (reportedly causing less headache than glyceryl trinitrate cream)

Administration

Oral from 60mg tds to 360mg daily- in divided doses or as a long acting preparation.

Many brands of long acting diltiazem are available.

Clinical Issues

Toxicity

Contra-indications

  1. Severe bradycardia
  2. LVF with pulmonary congestion
  3. Second or third degree heart block without pacemaker
  4. Sick sinus syndrome
  5. Pregnancy
  6. Breast feeding

Cautions

  1. Hepatic impairment
  2. Renal impairment
  3. Heart failure or significant LVF
  4. Bradycardia
  5. First degree heart block or prolonged PR interval

Interactions

See calcium channel blockers

Side effects

  1. Bradycardia
  2. Sino-atrial block
  3. AV block
  4. Palpitations
  5. Dizziness
  6. Hypotension
  7. Malaise
  8. Asthenia
  9. Headache
  10. Hot flushes
  11. GI disturbances
  12. Oedema

Other rare side effects - rashes, photosensitivity

Reported - Hepatitis, gynaecomastia, gum hyperplasia, extrapyramidal symptoms, depression

Pharmacology

See calcium channel blockers.

Like verapamil, diltiazem is a non-dihydropyridine calcium channel blocker. Due to its plasma half-life of 4 hours, most preparations are modified release.

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