Diltiazem
Generic Name: diltiazem (dil TYE a zem)
Brand names: Cardizem, Cardizem CD, Cardizem LA, Cartia XT, Dilacor XR, Dilt-CD, Dilt-XR, Diltia XT, Diltiazem Hydrochloride CD, Diltiazem Hydrochloride SR, Diltiazem Hydrochloride XR, Diltiazem Hydrochloride XT, Diltzac, Taztia XT, Tiazac, Cardizem SR, Cardizem Monovial
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 not listed in this medication guide.
Important information about diltiazem
Do not use diltiazem 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 have kidney disease, liver disease, or congestive heart failure.
Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be 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 diltiazem even if you feel well. High blood pressure often has no symptoms.
Before taking diltiazem
You should 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.
To make sure you can safely take diltiazem, tell your doctor if you have any of these other conditions:
kidney disease;
liver disease; or
congestive heart failure.
FDA pregnancy category C. It is not known whether diltiazem will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. 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.
See also: Diltiazem pregnancy and breastfeeding warnings (in more detail)
How should I take diltiazem?
Take diltiazem exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results.
Take diltiazem with a full glass of water. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may 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.
Use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Do not stop taking diltiazem 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 well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.
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 diltiazem is helping your condition and is not causing harmful effects, your blood pressure will need to be checked often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.
Store diltiazem at room temperature away from moisture and heat.
See also: Diltiazem dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diltiazem can be fatal.
Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, feeling light-headed, or fainting.
What should I avoid while taking diltiazem?
Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be 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 to diltiazem: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
slow heartbeats;
dizziness, fainting, fast or pounding heartbeat;
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, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious diltiazem side effects may include:
stuffy nose;
skin rash or itching;
dizziness, headache, tired feeling;
nausea; or
warmth, itching, redness, or tingly feeling under your skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Diltiazem side effects (in more detail)
Diltiazem Dosing Information
Usual Adult Diltiazem Dose for Hypertension:
Initial dose: 30 to 60 mg orally 3 to 4 times a day.
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day.
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
XR maintenance dose: 240 to 480 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 420 mg orally once a day.
IV Dosing:
Initial bolus doses: 0.25 mg/kg as a bolus administered over 2 minutes. A second bolus of 0.35 mg/kg may be used if necessary.
Initial infusion dose: 5 mg/hr.
Maintenance infusion dose: The infusion rate may be increased in 5 mg/hr increments up to 15 mg/hr.
Usual Adult Diltiazem Dose for Atrial Fibrillation:
Initial dose (oral): 30 to 60 mg orally 3 to 4 times a day
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 420 mg orally once a day.
Initial dose (IV): 0.25 mg/kg actual body weight bolus over 2 minutes. If necessary, a second bolus of 0.35 mg/kg ABW may be given. In some cases, an infusion of diltiazem 5 mg/hour may be started, and advanced in 5 mg/hour increments to 15 mg/hour for up to 24 hours.
Usual Adult Diltiazem Dose for Atrial Flutter:
Initial dose (oral): 30 to 60 mg orally 3 to 4 times a day
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 420 mg orally once a day.
Initial dose (IV): 0.25 mg/kg actual body weight bolus over 2 minutes. If necessary, a second bolus of 0.35 mg/kg ABW may be given. In some cases, an infusion of diltiazem 5 mg/hour may be started, and advanced in 5 mg/hour increments to 15 mg/hour for up to 24 hours.
Usual Adult Diltiazem Dose for Supraventricular Tachycardia:
Initial dose (oral): 30 to 60 mg orally 3 to 4 times a day
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 420 mg orally once a day.
Initial dose (IV): 0.25 mg/kg actual body weight bolus over 2 minutes. If necessary, a second bolus of 0.35 mg/kg ABW may be given. In some cases, an infusion of diltiazem 5 mg/hour may be started, and advanced in 5 mg/hour increments to 15 mg/hour for up to 24 hours.
Usual Adult Diltiazem Dose for Angina Pectoris Prophylaxis:
Initial dose: 30 to 60 mg orally 3 to 4 times a day
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 360 mg orally once a day.
Usual Adult Diltiazem Dose for Congestive Heart Failure:
Initial dose: 30 to 60 mg orally 3 to 4 times a day
Maintenance dose: 180 to 360 mg orally/day in divided doses.
SR initial dose: 60 to 120 mg orally twice a day
SR maintenance dose: 240 to 360 mg orally/day.
CD or XR initial dose: 120 to 240 mg orally once a day.
CD maintenance dose: 240 to 360 mg orally once a day.
LA initial dose: 120 to 240 mg orally once a day.
LA maintenance dose: 240 to 360 mg orally once a day.
What other drugs will affect diltiazem?
Tell your doctor about all other medicines you use, especially:
amiodarone (Cordarone, Pacerone);
buspirone (BuSpar);
carbamazepine (Carbatrol, Tegretol);
cimetidine (Tagamet, Tagamet HB);
clonidine (Catapres);
cyclosporine (Gengraf, Neoral, Sandimmune);
digoxin (digitalis, Lanoxin, Lanoxicaps);
lovastatin (Mevacor);
rifampin (Rifadin, Rimactane, Rifater);
quinidine (Quinaglute, Quinidex, Quin-Release);
a sedative such as midazolam (Versed) or triazolam (Halcion);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), or telithromycin (Ketek);
an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), or voriconazole (Vfend);
a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others; or
HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), or ritonavir (Norvir, Kaletra).
This list is not complete and other drugs may interact with diltiazem. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More Diltiazem resources
Diltiazem Side Effects (in More Detail)
Diltiazem Dosage
Diltiazem Use in Pregnancy & Breastfeeding
Drug Images
Diltiazem Drug Interactions
Diltiazem Support Group
28 Reviews for Diltiazem - Add your own review/rating
Diltiazem MedFacts Consumer Leaflet (Wolters Kluwer)
Diltiazem Prescribing Information (FDA)
diltiazem Advanced Consumer (Micromedex) - Includes Dosage Information
Cardizem Prescribing Information (FDA)
Cardizem CD 24-Hour Sustained-Release Beads Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
Cardizem CD Prescribing Information (FDA)
Cardizem LA Prescribing Information (FDA)
Cardizem LA 24-Hour Extended-Release Beads Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
Cartia XT Prescribing Information (FDA)
DILT-CD Prescribing Information (FDA)
Dilacor XR Prescribing Information (FDA)
Dilacor XR 24-Hour Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
Dilt-XR Prescribing Information (FDA)
Diltia XT Prescribing Information (FDA)
Diltiazem Hydrochloride Monograph (AHFS DI)
Taztia XT Prescribing Information (FDA)
Taztia XT 24-Hour Extended-Release Beads Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
Tiazac Prescribing Information (FDA)
Compare Diltiazem with other medications
Angina Pectoris Prophylaxis
Atrial Fibrillation
Atrial Flutter
Heart Failure
High Blood Pressure
Raynaud's Syndrome
Supraventricular Tachycardia
Where can I get more information?
Your pharmacist can provide more information about diltiazem.
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