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All about: Diltiazem hydrochloride

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Generic name: Diltiazem hydrochloride
Brand names: Tiazac, Dilacor XR, Cardizem SR, Cardizem LA, Cardizem CD, Cardizem

Why is Diltiazem hydrochloride prescribed?

Cardizem and Cardizem CD (a controlled release form of diltiazem) are used in the treatment of angina pectoris (chest pain usually caused by lack of oxygen to the heart due to clogged arteries). Cardizem, Cardizem CD, and Cardizem LA (an extended-release, once-a-day tablet form of diltiazem) are used to control chronic stable angina (caused by exertion). Cardizem CD and Cardizem LA are also used to treat high blood pressure. Another controlled release form, Cardizem SR, is used only in the treatment of high blood pressure. Cardizem, a calcium channel blocker, dilates blood vessels and slows the heart to reduce blood pressure and the pain of angina.

Doctors sometimes prescribe Cardizem for loss of circulation in the fingers and toes (Raynaud's phenomenon), for involuntary movements (tardive dyskinesia), and to prevent heart attack.

Tiazac and Dilacor XR are used in the treatment of high blood pressure and chronic stable angina. They may be taken alone or combined with other blood pressure medications.

Most important fact about Diltiazem hydrochloride

If you are taking Cardizem for high blood pressure, remember that it does not cure the problem; it merely controls it. You may need to take a blood pressure medication for the rest of your life.

If you are taking Cardizem for angina, do not stop suddenly. This can lead to an increase in your attacks.

How should you take Diltiazem hydrochloride?

Cardizem should be taken before meals and at bedtime. Cardizem CD, Cardizem LA, Cardizem SR, and Dilacor XR should be swallowed whole; do not chew, crush, or divide. Tiazac capsules may be swallowed whole or opened and sprinkled on a spoonful of applesauce. Swallow the applesauce immediately, without chewing, and wash it down with a glass of cool water.

Take Diltiazem hydrochloride exactly as prescribed by your doctor, even if your symptoms have disappeared.

--If you miss a dose...

If you forget to take a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Cardizem should be stored at room temperature; protect from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cardizem.

  • More common side effects may include:
    Abnormally slow heartbeat (more common with Cardizem SR, Cardizem LA, and Cardizem CD), dizziness, fatigue, fluid retention, flushing (more common with Cardizem SR, Cardizem LA, and Cardizem CD), headache, nausea, rash, weakness

Why should Diltiazem hydrochloride not be prescribed?

If you suffer from "sick sinus" syndrome or second- or third-degree heart block (various types of irregular heartbeat), you should not take diltiazem unless you have a ventricular pacemaker. Also avoid diltiazem if you've just suffered a heart attack or have lung congestion.

Do not take diltiazem if you have low blood pressure or an allergy to the drug.

Special warnings about Diltiazem hydrochloride

If you have congestive heart failure or suffer from kidney or liver disease, use Cardizem with caution.

This medication may cause your heart rate to become too slow. You should check your pulse regularly.

Possible food and drug interactions when taking Diltiazem hydrochloride

If Cardizem is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cardizem with the following:

Beta-blockers (heart and blood pressure drugs such as Tenormin and Inderal)
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Cyclosporine (Sandimmune, Neoral)
Digoxin (Lanoxin)
Lovastatin (Mevacor)
Midazolam (Versed)
Rifampin (Rifadin)
Triazolam (Halcion)

Special information if you are pregnant or breastfeeding

The effects of Cardizem during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Cardizem appears in breast milk and could affect a nursing infant. If Diltiazem hydrochloride is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Diltiazem hydrochloride is finished.

Recommended dosage

ADULTS

Dosage levels are determined by each individual's needs.

Cardizem

The average daily dosage is between 180 milligrams and 360 milligrams, divided into 3 or 4 smaller doses.

Cardizem SR

The recommended starting dosage is 60 to 120 milligrams 2 times a day, to be increased to 240 to 360 milligrams a day.

Cardizem CD

This is a once-a-day form of Diltiazem hydrochloride. For high blood pressure, starting doses range from 180 to 240 milligrams; for angina, 120 to 180 milligrams.

Cardizem LA

This is also a once-a-day drug. For high blood pressure, when used alone, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams once daily. For angina, the starting dose is 180 milligrams once daily with increases every 7 to 14 days if necessary.

Dilacor XR

This is another once-a-day drug. For high blood pressure, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams. For angina, doses start at 120 milligrams and may be increased to 480 milligrams.

Tiazac

The usual starting dose for high blood pressure is 120 to 240 milligrams once a day. After the drug has taken effect--in about 2 weeks--the dose can range from 120 to 540 milligrams. For angina, once-daily doses start at 120 to 180 milligrams and may be increased to 540 milligrams if necessary.

CHILDREN

Safety and effectiveness in children have not been established.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Cardizem, seek medical attention immediately.

  • The symptoms of Cardizem overdose may include:
    Fainting, dizziness, and irregular pulse, heart failure, low blood pressure, very slow heartbeat

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