Meds and you

Updated 11 February 2013

Diltiazem

Diltiazem is a medication that widens and relaxes blood vessels, and decrease the rate at which the heart beats.

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Diltiazem is the active ingredient of Dilatam, Sandoz Diltiazem, Tilazem and Zildem.

General Information

Diltiazem is a medication that widens and relaxes blood vessels, and decrease the rate at which the heart beats.

It is used to treat and prevent angina pectoris, which is chest pain as a result of a lack of oxygen available to the heart muscle. It is of particular use in those patients with asthma who cannot make use of other medications such as beta blockers that are often prescribed for angina prevention and treatment.

It is furthermore used for the treatment of high blood pressure and to treat abnormal rhythms of the heart.

Diltiazem does not cure any of these conditions, but merely keeps it under control. For diltiazem to be effective, it has to be taken regularly, even if you do not notice any immediate effect. It may take several weeks no notice the full benefit of this medication.

Be aware that, at the start of treatment with this medication, you may feel dizzy, especially when getting up suddenly. Caution is advised.

How does diltiazem work?

Calcium plays an important role in the contraction of heart muscle, as well as smooth muscle in the walls of arteries. By blocking the channels though which calcium enters cells in these muscles, relaxation of these muscles is obtained. The result is a reduced workload of the heart (and a decrease in occurrence of angina), as well as widening of blood vessels causing high blood pressure to return to normal and safe levels.

Fast facts

Drug schedule: Schedule 3

Available as: Diltiazem is available as tablets and capsules.

What does it do? Diltiazem reduce high levels of blood pressure, and treats and prevents chest pains.

Overdose risk: Medium

Dependence risk: Low

Is diltiazem available as a generic? Yes

Is diltiazem available on prescription only? Yes

User information

Onset of effect: Depending on formulation; within 60 minutes to three hours.

Duration of action: Up to eight hours.

Dietary advice: To minimise stomach irritation and adverse effects this medication should be taken with or immediately after food; a low-salt and low-fat diet is advised.

Stopping this medicine: Do not withdraw treatment abruptly as this may cause a return of symptoms; consult you prescriber before discontinuing treatment.

Prolonged use: Although no problems are expected with long-term use, your doctor may occasionally request kidney and liver function tests.

Special precautions

Consult your doctor before using this drug if:

  • you have a liver or kidney disease,
  • you have or had congestive heart failure,
  • you have any disease affecting your blood vessels, or
  • you are taking other medication.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Diltiazem is not usually prescribed.

Elderly: Caution is advised in the elderly as side effects may be more likely; dosage adjustment may be needed.

Driving and hazardous work : Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: Avoid concomitant use of alcohol with this medication as it is possible that this combination may cause a further drop in blood pressure adding to dizziness. Caution is advised.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Headache

x

x

Heartburn

x

X

Gastric upset

x

X

Dizziness/ light-headedness

x

X

Flushing in face

X

x

Dry mouth

x

x

Swelling/ weight gain

x

X

Fatigue

x

x

Drowsiness

x

x

Nausea/ abdominal pain

x

x

Slow pulse

x

x

Rash

x

x

Jaundice

x

x

Shortness of breath

x

x

Slow heartbeat

x

x

Interactions

Drug interactions

ACE inhibitor drugs

Possible decrease in blood pressure

Beta blocking drugs

Increased risk of heart failure

Amiodarone

Severe low blood pressure

Benzodiazepines

Benzodiazepine effects markedly increased

Anticonvulsants

Possible anticonvulsant toxicity; reduced blood pressure lowering effect

Ciclosporin

Increased risk of ciclosporin toxicity

Digoxin

Increased risk of digoxin toxicity

Theophylline

Increased risk of theophylline toxicity

Food interactions

A low-salt and low-fat diet is advised. Alcohol may cause a drop in blood pressure.

Disease interactions

Consult your doctor before using this drug if you have a liver or kidney disease, congestive heart failure or if you have a disease affecting your blood vessels.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage

Adults, oral:

Hypertension: 60-120 mg twice daily

Angina: 30-90 mg 3-4 times daily (maximum 360 mg/day)

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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