Diltiazem

Diltiazem is a prescription medication used to treat high blood pressure and control chest pain. It can also be used to control an irregular heartbeat.

Diltiazem belongs to a group of drugs called calcium channel blockers. These work by relaxing the blood vessels so the heart does not need to work as hard. Calcium channel blockers also increase the supply of blood and oxygen to the heart.

This medication comes in tablet, extended release tablet, and extended release capsule forms. The tablet is usually taken 3 to 4 times a day. The extended release tablet and capsule are usually taken 1 to 2 times a day. Each diltiazem product has different instructions for whether or not it should be taken with or without food, so ask your pharmacist for more information.

Do not chew, divide, or break diltiazem extended release tablets or capsules. Swallow the tablets and capsules whole.

This medication is also available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Common side effects of diltiazem include headache, flushing, slow heartbeat, and nausea.

Diltiazem can also cause dizziness. Do not drive or operate heavy machinery until you know how diltiazem affects you.

Oral:

Diltiazem tablets and capsules are prescription medications used to treat high blood pressure and control chest pain.

Injectable:

Diltiazem injection is a prescription medication used to treat arrhythmias, which are problems with the rate or rhythm of the heartbeat.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Diltiazem may be found in some form under the following brand names:

• Cardizem

• Cartia

• Dilacor

• Dilt

• Diltia

• Diltzac

• Matzim

• Taztia

• Teczem

• Tiazac

Oral:

Serious side effects have been reported with oral forms of diltiazem. See the “Diltiazem Precautions” section.

Common side effects of diltiazem include the following:

• Dizziness or lightheadedness
• Edema
• Flushing
• Headache
• Weakness
• Slow heartbeat
• Vomiting
• Diarrhea
• Constipation
• Nasal congestion
• Cough
• Rash

Injectable:

Serious side effects have been reported with the injectable form of diltiazem. See the “Diltiazem Precautions” section.

Common side effects of diltiazem injection include the following:

• Low blood pressure
• Itching and burning at the site of injection
• Flushing

This is not a complete list of diltiazem side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Atazanavir (Reyataz)
• Benzodiazepines such as
  • Midazolam (Versed)
  • Triazolam (Halcion)
• Beta blockers such as
  • Atenolol (Tenormin)
  • Metoprolol (Toprol XL, Lopressor)
  • Carvedilol (Coreg)
  • Bisoprolol (Zebeta)
  • Betaxolol (Kerlone)
  • Nebivolol (Bystolic)
  • Propranolol (Inderal)
  • Labetalol (Trandate)
  • Nadolol (Corgard)
• Buspirone (Buspar)
• Carbamazepine (Tegretol)
• Cimetidine (Tagamet)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Digoxin (Lanoxin)
• Statins such as
  • Lovastatin (Altoprev, Mevacor)
  • Simvastatin (Zocor)
• Quinidine
• Rifampin 
• Clonidine

This is not a complete list of diltiazem drug interactions. Ask your doctor or pharmacist for more information.

Oral:

• Serious side effects have been reported with oral forms of diltiazem including the following:
• Swelling of the face, eyes, lips, or tongue
• Swelling of the hands, arms, feet, ankles or lower legs
• Difficulty breathing or swallowing
• Fainting
• Yellowing of the skin or eyes
• Extreme tiredness
• Unusual bleeding or bruising
• Loss of appetite
• Pain in the upper right part of the abdomen
• Flu-like symptoms
• Increased frequency or severity of chest pain

Injectable:

Serious side effects have been reported with injectable forms of diltiazem including the following:

• Low blood pressure
• Flushing
• Unusual changes to the heart rate or rhythm

Diltiazem can cause dizziness. Do not drive or operate heavy machinery until you know how diltiazem affects you.

Do not take diltiazem if you:

• are allergic to diltiazem or to any of its ingredients
• have sick sinus syndrome, except if you have a functioning  ventricular pacemaker
• have second- or third-degree Av block, except if you have a functioning ventricular pacemaker
• have low systolic blood pressure (less than 90 mmHg)
• have acute myocardial infarction (also called a heart attack) and pulmonary congestion 

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of diltiazem, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking diltiazem, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to diltiazem or to any of its ingredients
• have or have had a myocardial infarction (heart attack)
• have or have had a blockage or condition of your digestive system that causes food to move through your digestive system slowly
• have or have had low blood pressure
• have or have had liver disease
• have or have had kidney disease
• have or have had heart disease
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Diltiazem falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Diltiazem has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from diltiazem, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Oral:

Take diltiazem exactly as prescribed.

Diltiazem comes in tablet, extended release tablet, and extended release capsule forms. The tablet is usually taken 3 to 4 times a day. The extended release tablet and capsule are usually taken 1 to 2 times a day. Each diltiazem product has different instructions for whether or not it should be taken with or without food, so ask your pharmacist for more information.

Do not chew, divide, or break diltiazem extended release tablets or capsules. Swallow the tablets and capsules whole.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of diltiazem at the same time.

Injectable:

This medication is also available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

Oral:

The usual dose range of oral diltiazem for the treatment of hypertension is 180 to 360 mg daily.

The usual dose range of oral diltiazem for controlling chest pain is 120 to 480 mg daily.

Your doctor will adjust the dose and frequency of diltiazem to your needs. The dose may be increased slowly over time until treatment goals are achieved.

Injectable:

The usual dose range of injectable diltiazem is 20 to 25 mg as a single injection, followed by 10 to 15 mg/hour for up to 24 hours.

If you take too much diltiazem, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If diltiazem is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store diltiazem at room temperature.
• Avoid excessive humidity.
• Keep this and all medicines out of the reach of children.