Diltiazem

Diltiazem Brand Names

Cardizem | Cardizem CD | Cardizem LA | Cardizem SR | Cartia XT | Dilacor XR | Dilt-CD | Diltia XT | Diltzac | Matzim LA | Taztia XT | TIADYLT ER | Tiamate | Tiazac

What is Diltiazem

Diltiazem is a benzothiazepine calcium-channel blocking agent that is most similar to verapamil in its clinical use.

Diltiazem increases exercise capacity and improves multiple markers of myocardial ischemia. Diltiazem reduces heart rate and blood pressure, may increase cardiac output, improves myocardial perfusion, reduces left ventricular workload, and may reduce coronary vasospasm and ischemia following angioplasty.

Diltiazem is used for the management of Prinzmetal’s variant angina, stable angina pectoris, unstable angina in patients with preserved left ventricular function,hypertension, paroxysmal supraventricular tachycardia, control of ventricular rate in atrial fibrillation and flutter.

It also has been found to possibly reduce recurrent cardiac events, although not mortality, following non-ST-segment elevation myocardial infarction in patients without left ventricular dysfunction;however, this is not an FDA-approved indication at this time.

Diltiazem was approved by the FDA for general use in November 1982.

Oral diltiazem is marketed in several different dosage forms including regular-release tablets (Cardizem®), twice-daily extended-release capsules (Cardizem® SR), and once-daily extended-release formulations (e.g., Cardizem® CD, Cardizem® LA, Dilacor XR®, Tiazac®, and generic equivalents).

The dosage, administration, and approved indications vary with each specific product.

Indications

1. angina
2. atrial fibrillation
3. atrial flutter
4. cardiomyopathy
5. diabetic nephropathy
6. hypertension
7. migraine prophylaxis
8. paroxysmal supraventricular tachycardia (PSVT)
9. proteinuria
10. unstable angina
11. variant angina

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. alopecia
4. amblyopia
5. amnesia
6. angina
7. angioedema
8. anorexia
9. arthralgia
10. arthropathy
11. asthenia
12. asystole
13. atrial fibrillation
14. atrial flutter
15. AV block
16. back pain
17. bone pain
18. bradycardia
19. bundle-branch block
20. chest pain (unspecified)
21. colitis
22. confusion
23. conjunctivitis
24. constipation
25. contact dermatitis
26. cough
27. cystitis
28. depression
29. diaphoresis
30. diarrhea
31. dizziness
32. drowsiness
33. dysgeusia
34. dysmenorrhea
35. dyspepsia
36. dyspnea
37. elevated hepatic enzymes
38. epistaxis
39. eructation
40. erythema multiforme
41. exfoliative dermatitis
42. fatigue
43. flatulence
44. flushing
45. GI bleeding
46. gingival hyperplasia
47. gout
48. gynecomastia
49. hallucinations
50. headache
51. heart failure
52. hemolytic anemia
53. hyperglycemia
54. hypertonia
55. hyperuricemia
56. hypotension
57. impotence (erectile dysfunction)
58. infection
59. influenza
60. injection site reaction
61. insomnia
62. leukopenia
63. muscle cramps
64. myalgia
65. myopathy
66. nasal congestion
67. nausea
68. nephrolithiasis
69. nocturia
70. ocular hemorrhage
71. ocular irritation
72. otalgia
73. palpitations
74. paresthesias
75. peptic ulcer
76. peripheral edema
77. peripheral neuropathy
78. peripheral vasodilation
79. petechiae
80. pharyngitis
81. photosensitivity
82. polyuria
83. pruritus
84. purpura
85. rash
86. renal failure (unspecified)
87. retinopathy
88. rhinitis
89. sinus tachycardia
90. sinusitis
91. Stevens-Johnson syndrome
92. syncope
93. thrombocytopenia
94. tinnitus
95. toxic epidermal necrolysis
96. tremor
97. urticaria
98. vaginitis
99. vasculitis
100. ventricular fibrillation
101. ventricular tachycardia
102. vertigo
103. vomiting
104. weight gain
105. xerostomia

Monitoring Parameters

• blood pressure
• ECG
• echocardiogram
• heart rate
• LFTs

Contraindications

• acute myocardial infarction
• aortic stenosis
• AV block
• bradycardia
• breast-feeding
• cardiogenic shock
• gastroesophageal reflux disease (GERD)
• geriatric
• heart failure
• hepatic disease
• hiatal hernia
• hypotension
• Lown-Ganong-Levine syndrome
• pregnancy
• sick sinus syndrome
• ventricular dysfunction
• ventricular tachycardia
• Wolff-Parkinson-White syndrome

Interactions

• Abemaciclib
• Acalabrutinib
• Acebutolol
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pseudoephedrine
• Acrivastine; Pseudoephedrine
• Aldesleukin, IL-2
• Alemtuzumab
• Alfentanil
• Alfuzosin
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alprazolam
• Alprostadil
• Amifostine
• Aminolevulinic Acid
• Amiodarone
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphetamine; Dextroamphetamine Salts
• Amprenavir
• Amyl Nitrite
• Apalutamide
• Apixaban
• Apomorphine
• Apraclonidine
• Aprepitant, Fosaprepitant
• Aripiprazole
• Artemether; Lumefantrine
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol
• Atenolol; Chlorthalidone
• Atorvastatin
• Atorvastatin; Ezetimibe
• Avanafil
• Avapritinib
• Baclofen
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzonatate
• Benzphetamine
• Bepridil
• Betaxolol
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bortezomib
• Bosentan
• Bosutinib
• Brexpiprazole
• Brigatinib
• Brimonidine; Timolol
• Bromocriptine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Budesonide
• Budesonide; Formoterol
• Bupivacaine
• Bupivacaine Liposomal
• Bupivacaine; Lidocaine
• Buprenorphine
• Buprenorphine; Naloxone
• Buspirone
• Cabergoline
• Caffeine; Ergotamine
• Cannabidiol
• Carbamazepine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carteolol
• Carvedilol
• Celecoxib
• Cenobamate
• Ceritinib
• Cetirizine; Pseudoephedrine
• Cevimeline
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroprocaine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorthalidone; Clonidine
• Cilostazol
• Cimetidine
• Cinacalcet
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Clonazepam
• Clonidine
• Clorazepate
• Clozapine
• Co-Enzyme Q10, Ubiquinone
• Cobicistat
• Cobimetinib
• Cocaine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Colchicine
• Colchicine; Probenecid
• Colesevelam
• Conivaptan
• Conjugated Estrogens
• Conjugated Estrogens; Bazedoxifene
• Conjugated Estrogens; Medroxyprogesterone
• Crizotinib
• Cyclosporine
• Danazol
• Dantrolene
• Dapagliflozin; Saxagliptin
• Darifenacin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deflazacort
• Delavirdine
• Desloratadine; Pseudoephedrine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmedetomidine
• Dexmethylphenidate
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Quinidine
• Diazepam
• Diazoxide
• Diclofenac
• Diclofenac; Misoprostol
• Dienogest; Estradiol valerate
• Diethylpropion
• Diflunisal
• Digoxin
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Dihydroergotamine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Dorzolamide; Timolol
• Doxercalciferol
• Doxorubicin
• Dronabinol
• Dronedarone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Duloxetine
• Dutasteride
• Dutasteride; Tamsulosin
• Duvelisib
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Elbasvir; Grazoprevir
• Eletriptan
• Elexacaftor; tezacaftor; ivacaftor
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Encainide
• Encorafenib
• Enflurane
• Entrectinib
• Enzalutamide
• Ephedrine
• Epirubicin
• Eplerenone
• Epoprostenol
• Ergoloid Mesylates
• Ergonovine
• Ergotamine
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esmolol
• Esomeprazole; Naproxen
• Estazolam
• Esterified Estrogens
• Esterified Estrogens; Methyltestosterone
• Estradiol
• Estradiol Cypionate; Medroxyprogesterone
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Estradiol; Progesterone
• Estropipate
• Eszopiclone
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Ethosuximide
• Etodolac
• Etomidate
• Etonogestrel
• Etravirine
• Everolimus
• Ezetimibe; Simvastatin
• Famotidine; Ibuprofen
• Fedratinib
• Fenoprofen
• Fentanyl
• Fesoterodine
• Fexofenadine; Pseudoephedrine
• Fingolimod
• Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
• Flecainide
• Flibanserin
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Flurazepam
• Flurbiprofen
• Fluvoxamine
• food
• Fosamprenavir
• Fosphenytoin
• Fospropofol
• General anesthetics
• Ginger, Zingiber officinale
• Ginkgo, Ginkgo biloba
• Ginseng, Panax ginseng
• grapefruit juice
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guaifenesin; Pseudoephedrine
• Guanfacine
• Halofantrine
• Haloperidol
• Halothane
• Homatropine; Hydrocodone
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydroxyprogesterone
• Ibrutinib
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Idelalisib
• Ifosfamide
• Iloperidone
• Iloprost
• Imatinib
• Imipramine
• Indinavir
• Indomethacin
• Intravenous Lipid Emulsions
• Isavuconazonium
• Isocarboxazid
• Isoflurane
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isoproterenol
• Isosorbide Dinitrate, ISDN
• Isosorbide Mononitrate
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Ixabepilone
• Ketamine
• Ketoconazole
• Ketoprofen
• Ketorolac
• Labetalol
• Lacosamide
• Lanreotide
• Lansoprazole; Naproxen
• Lapatinib
• Lasmiditan
• Lefamulin
• Lemborexant
• Letermovir
• Levodopa
• Lidocaine
• Lidocaine; Prilocaine
• Lisdexamfetamine
• Lithium
• Lofexidine
• Lomitapide
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Lorlatinib
• Lovastatin
• Lovastatin; Niacin
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Lumateperone
• Lurasidone
• Lurbinectedin
• Maraviroc
• Meclofenamate Sodium
• Mefenamic Acid
• Mefloquine
• Melatonin
• Meloxicam
• Mestranol; Norethindrone
• Metformin; Repaglinide
• Metformin; Saxagliptin
• Methadone
• Methamphetamine
• Methoxsalen
• Methylergonovine
• Methylphenidate
• Methylprednisolone
• Methysergide
• Metoprolol
• Midazolam
• Midostaurin
• Mifepristone
• Milrinone
• Mitotane
• Moricizine
• Nabumetone
• Nadolol
• Naldemedine
• Naloxegol
• Nanoparticle Albumin-Bound Paclitaxel
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nebivolol
• Nebivolol; Valsartan
• Nefazodone
• Nelfinavir
• Neratinib
• Nesiritide, BNP
• Neuromuscular blockers
• Nevirapine
• Niacin, Niacinamide
• Niacin; Simvastatin
• Nifedipine
• Nilotinib
• Nitrates
• Nitroglycerin
• Nitroprusside
• Nonsteroidal antiinflammatory drugs
• Octreotide
• Olanzapine
• Olaparib
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Oritavancin
• Oxaprozin
• Oxybutynin
• Oxycodone
• Oxymetazoline
• Paclitaxel
• Palbociclib
• Paliperidone
• Paricalcitol
• Pasireotide
• Pemigatinib
• Penbutolol
• Pentoxifylline
• Perindopril; Amlodipine
• Phenelzine
• Phentermine; Topiramate
• Phenylephrine
• Phenylephrine; Promethazine
• Phenytoin
• Photosensitizing agents (topical)
• Pimozide
• Pindolol
• Piroxicam
• Posaconazole
• Prazosin
• Prednisolone
• Prednisone
• Procainamide
• Procaine
• Progesterone
• Propafenone
• Propofol
• Propranolol
• Pseudoephedrine
• Quazepam
• Quetiapine
• Quinidine
• Quinine
• Ramelteon
• Ranolazine
• Rasagiline
• Red Yeast Rice
• Remifentanil
• Repaglinide
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifapentine
• Rilpivirine
• Rimegepant
• Risperidone
• Ritonavir
• Rofecoxib
• Rucaparib
• Ruxolitinib
• Saquinavir
• Saxagliptin
• Segesterone Acetate; Ethinyl Estradiol
• Selegiline
• Selpercatinib
• Selumetinib
• Sevoflurane
• Sildenafil
• Silodosin
• Simvastatin
• Simvastatin; Sitagliptin
• Sincalide
• Siponimod
• Sirolimus
• Solifenacin
• Sonidegib
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sufentanil
• Sulindac
• Suvorexant
• Tacrolimus
• Tadalafil
• Talazoparib
• Tamsulosin
• Tasimelteon
• Tazemetostat
• Telithromycin
• Temsirolimus
• Terbinafine
• Tetrabenazine
• Tetracaine
• Tezacaftor; Ivacaftor
• Thalidomide
• Theophylline, Aminophylline
• Thiothixene
• Timolol
• Tipranavir
• Tolmetin
• Tolterodine
• Tolvaptan
• Topiramate
• Tranylcypromine
• Trazodone
• Treprostinil
• Tretinoin, ATRA
• Triazolam
• Tucatinib
• Ubrogepant
• Ulipristal
• Valdecoxib
• Vardenafil
• Venetoclax
• Verteporfin
• Vinblastine
• Vinorelbine
• Vorapaxar
• Voriconazole
• Yohimbine
• Zafirlukast
• Zanubrutinib
• Zileuton
• Ziprasidone
• Zolpidem