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Diltiazem

Systems	Cardiovascular System and Peripheral Vascular System
Category	Calcium Channel Blocker

Pharmacokinetics

Given orally, it has high hepatic metabolism. Hence a higher dose by mouth should be used than by I.V route. It is highly protein bound.

Indications

Diltiazem blocks the Calcium Channels that are present in the heart and the blood vessels. Diltiazem is also useful to dialte the coronary arteries and so can be used in angina pectoris.. Diltiazem is also useful in reducing the blood pressure and in controlling supra ventricular arrythmias.

Routes of Administration and Dosage

For diltiazem: For long-acting oral dosage form (extended-release capsules): For hypertension: Adults : 180 to 240 milligrams (mg) once a day. For regular (short-acting) oral dosage form (tablets): For angina : Adults : 30 mg three or four times a day.

Contra Indications

It is contraindicated in Hypersensitivity reaction, Acute MI, Hypotension, Lactation and Cardiogenic shock.

Precautions

Allergies : Allergic reaction to diltiazem may occur. Pregnancy: Calcium channel blockers have not been extensively studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blockers cause birth defects, prolonged pregnancy, poor bone development, and stillbirth. Elderly people may be especially sensitive to the effects of calcium channel blockers. This may increase the chance of side effects during treatment.

Interactions

Interaction with the following drugs have been reported : Acetazolamide, Amphotericin B, Corticosteroids, Dichlorphenamide, Diuretics, Methazolamide, Beta-blockers like acebutolol, atenolol, betaxolol, carteolol, labetalol, metoprolol, nadolol, oxprenolol, penbutolol, pindolol, propranolol, sotalol, timolol (Effects of both may be increased. In addition, adverse effects may occur if a calcium channel blocker or a beta-blocker is stopped suddenly after concurrent use.). Carbamazepine, Cyclosporine, Procainamide,Quinidine (Effects of these drugs may be increased if they are used with some calcium channel blockers). Digitalis glycosides : Effects of these drugs may be increased if they are used with calcium channel blockers. Disopyramide: Effects of calcium channel blockers on the heart may be potentiated.

Brand Names

Altiazem (Menarini Raunaq), Angizem (Sun Pharma), Angizem CD (Aztec), Cardem ( Anglo French) Channel (Micro Labs), Coriem XL(Stancare ), Dicard (Intas), Dilcal (Boehringer Mannheim), Cardia(Unique), Dilcontin (Modi Mundipharma), Dilgard (Cipla), Dilotol ( Pace), Dilter Cd ( Natco), Diltiaz (Plethico), Diltime (Cadila Healthcare), Diltysin (Themis Pharma), Dilzem (Torrent), DTM ( Biochem), Emdil (Malladi Drugs), Ionozem 9Parke Davis), ISKI (Stadmed), Kiazem (Wockhardt), Kiazem CD ( Wockhardt), Masdil (Lupin ), Sefgard (Hindustan Antibiotics).