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All about: diltiazem

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Generic Name: diltiazem (dil TYE a zem)
Brand Names: Cardizem, Cardizem CD, Cardizem LA, Cardizem SR, Cartia XT, Dilacor XR, Diltia XT, Tiazac

What is diltiazem?

Diltiazem is in a group of drugs called calcium channel blockers. It works by relaxing the muscles of your heart and blood vessels.

Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.

Diltiazem may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about diltiazem?

Do not use this medication if you have certain heart conditions such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), low blood pressure, or if you have recently had a heart attack.

Before taking diltiazem, tell your doctor if you are allergic to any drugs, or if you have kidney disease, liver disease, or congestive heart failure.

Diltiazem can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse.

Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

What should I discuss with my healthcare provider before taking diltiazem?

Do not use this medication if you are allergic to diltiazem, or if you have:
  • certain heart conditions, especially "sick sinus syndrome" or "AV block" (unless you have a pacemaker);

  • low blood pressure; or

  • if you have recently had a heart attack.

Before taking diltiazem, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;
  • liver disease; or
  • congestive heart failure.

If you have any of these conditions, you may not be able to use diltiazem, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Diltiazem can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take diltiazem?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take diltiazem with a full glass of water. Do not crush, chew, break, or open a controlled-delivery or extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

If you have trouble swallowing a diltiazem capsule whole, ask your doctor or pharmacist if it is safe for you to open the capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

It is important to use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.

To be sure this medication is helping your condition, your blood pressure will need to be tested on a regular basis. Your kidney and liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Store diltiazem at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a diltiazem overdose may include slow heartbeat, weakness, chest pain, shortness of breath, feeling light-headed, or fainting.

What should I avoid while taking diltiazem?

Diltiazem can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while taking diltiazem.

Grapefruit and grapefruit juice may interact with diltiazem and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Diltiazem side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • fast or slow heartbeats;

  • feeling light-headed, fainting;

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • feeling short of breath, even with mild exertion;

  • swelling, rapid weight gain; or

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may be more likely to occur, such as:

  • stuffy nose;

  • skin rash or itching;

  • dizziness, headache, tired feeling;

  • nausea; or

  • warmth, itching, redness, or tingly feeling under your skin.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diltiazem?

Before taking diltiazem, tell your doctor if you are using any of the following drugs:

  • amiodarone (Cordarone, Pacerone);

  • cimetidine (Tagamet, Tagamet HB);

  • cyclosporine (Gengraf, Neoral, Sandimmune);

  • dexamethasone (Decadron, Hexadrol);

  • digoxin (digitalis, Lanoxin, Lanoxicaps);

  • lovastatin (Mevacor);

  • midazolam (Versed) or triazolam (Halcion);

  • rifampin (Rifadin, Rimactane, Rifater) or rifabutin (Mycobutin);

  • St. John's wort;

  • antibiotics such as ciprofloxacin (Cipro), griseofulvin (Fulvicin, Grifulvin, Grisactin), metronidazole (Flagyl, Protostat), azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), itraconazole (Sporanox), or ketoconazole (Nizoral);

  • antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft);

  • HIV /AIDS medicine such as amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase, Fortovase);

  • seizure medication such as carbamazepine (Carbatrol, Tegretol), or phenobarbital (Luminal, Solfoton); or

  • a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others.

If you are using any of these drugs, you may not be able to use diltiazem, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect diltiazem. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about diltiazem written for health professionals that you may read.

What does my medication look like?

Diltiazem is available with a prescription generically and under the brand names Cardizem, Cardizem SR, Cardizem CD, Cardizem LA, Cartia XT, Diltia XT, and Dilacor XR. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children. Never share your medicines with others and only use this medication for the condition prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 8.03. Revision Date: 04/25/2007 10:19:17 AM.

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