Cardizem: Expert Calcium Channel Blocker for Hypertension & Angina Control
Cardizem
| Product dosage: 120mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | 1.68 $ | 50.31 $ (0%) | 🛒 Add to cart |
| 60 | 1.25 $ | 100.62 $ 74.88 $ (26%) | 🛒 Add to cart |
| 90 | 1.12 $ | 150.93 $ 100.62 $ (33%) | 🛒 Add to cart |
| 120 | 1.04 $ | 201.24 $ 125.19 $ (38%) | 🛒 Add to cart |
| 180 | 0.97 $ | 301.86 $ 175.50 $ (42%) | 🛒 Add to cart |
| 270 | 0.93 $ | 452.79 $ 250.38 $ (45%) | 🛒 Add to cart |
| 360 | 0.90 $
Best per pill | 603.72 $ 325.26 $ (46%) | 🛒 Add to cart |
| Product dosage: 180mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | 2.61 $ | 78.39 $ (0%) | 🛒 Add to cart |
| 60 | 1.68 $ | 156.78 $ 100.62 $ (36%) | 🛒 Add to cart |
| 90 | 1.36 $ | 235.17 $ 122.85 $ (48%) | 🛒 Add to cart |
| 120 | 1.21 $ | 313.56 $ 145.08 $ (54%) | 🛒 Add to cart |
| 180 | 1.05 $ | 470.34 $ 189.54 $ (60%) | 🛒 Add to cart |
| 270 | 0.94 $ | 705.51 $ 253.89 $ (64%) | 🛒 Add to cart |
| 360 | 0.89 $
Best per pill | 940.68 $ 320.58 $ (66%) | 🛒 Add to cart |
Cardizem (diltiazem hydrochloride) is a prescription calcium channel blocker medication indicated for the management of chronic stable angina, hypertension, and certain cardiac arrhythmias. It functions by inhibiting calcium ion influx during cardiac and vascular smooth muscle depolarization, resulting in reduced peripheral vascular resistance and decreased myocardial oxygen demand. This comprehensive product card provides detailed, expert-level information for healthcare professionals and informed patients regarding its appropriate use, mechanism, and clinical considerations.
Features
- Active pharmaceutical ingredient: Diltiazem hydrochloride
- Available in multiple formulations: immediate-release tablets, extended-release capsules (Cardizem CD, Cardizem LA), and intravenous solution
- Standardized, bioavailable formulation ensuring consistent pharmacokinetics
- Specific chemical designation: (2S,3S)-5-[2-(Dimethylamino)ethyl]-2-(4-methoxyphenyl)-4-oxo-2,3,4,5-tetrahydro-1,5-benzothiazepin-3-yl acetate hydrochloride
- Manufactured under strict cGMP (current Good Manufacturing Practices) protocols
Benefits
- Effectively lowers elevated blood pressure, reducing long-term cardiovascular risk.
- Decreases the frequency and severity of angina pectoris episodes, improving exercise tolerance.
- Offers a favorable side effect profile compared to some other antianginal and antihypertensive agents.
- Provides 24-hour blood pressure control with once-daily dosing in its extended-release formulations, enhancing patient adherence.
- Can be used as part of a combination therapy regimen for synergistic cardiovascular effects.
Common use
Cardizem is primarily prescribed for the treatment of hypertension (high blood pressure). It is also widely used for the management of chronic stable angina (chest pain associated with coronary artery disease) and for the control of certain supraventricular tachyarrhythmias, such as atrial fibrillation or atrial flutter, particularly in its intravenous form. Its use is determined by a physician based on the patient’s specific cardiovascular profile.
Dosage and direction
Dosage is highly individualized and must be prescribed by a healthcare professional based on the patient’s condition, formulation, and response to therapy.
- Hypertension (Extended-Release): Initial dose typically ranges from 180 to 240 mg orally once daily, with titration up to 480 mg once daily based on blood pressure response.
- Angina (Extended-Release): Initial dose is often 120 or 180 mg orally once daily. Dosage may be adjusted at 1- to 2-week intervals up to 480 mg once daily.
- Immediate-Release Tablets: For angina, doses range from 30 mg three or four times daily before meals and at bedtime, up to 360 mg daily divided into 3-4 doses.
- Administration: Extended-release capsules (CD, LA) must be swallowed whole and must not be crushed, chewed, or divided. They may be taken with or without food but consistency is key. The immediate-release tablets can be taken with or without food.
Precautions
- Use with caution in patients with impaired hepatic or renal function, as diltiazem is extensively metabolized by the liver and excreted by the kidneys; dosage adjustments are likely necessary.
- Monitor for signs of worsening heart failure, as calcium channel blockers can have a negative inotropic effect.
- Abrupt withdrawal may cause an increase in the frequency and duration of angina attacks; dosage should be tapered under medical supervision.
- May prolong AV nodal conduction times; use caution in patients with sick sinus syndrome or AV block (unless a pacemaker is present).
- Can cause hypotension; monitor blood pressure closely, especially upon initiation and after dosage increases.
- Peripheral edema is a common side effect that is not generally associated with fluid retention; it results from vasodilation.
Contraindications
- Patients with sick sinus syndrome or second- or third-degree AV block, except in the presence of a functioning ventricular pacemaker.
- Patients with hypotension (systolic pressure < 90 mm Hg).
- Patients with demonstrated hypersensitivity to diltiazem or any component of the formulation.
- Patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission.
- The intravenous formulation is contraindicated in patients with atrial fibrillation/flutter associated with an accessory bypass tract (e.g., Wolff-Parkinson-White syndrome).
Possible side effect
Common side effects (may affect up to 1 in 10 people) include headache, dizziness, fatigue, nausea, flushing, and peripheral edema (swelling of the lower limbs). Bradycardia (slow heart rate), first-degree AV block, and rash occur less commonly. Rare but serious side effects requiring immediate medical attention include symptomatic hypotension, severe bradycardia, heart failure, hepatitis, and skin reactions like Stevens-Johnson syndrome.
Drug interaction
Cardizem is metabolized by the CYP3A4 enzyme system and has the potential for numerous interactions.
- CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, clarithromycin): Can significantly increase diltiazem plasma levels, increasing the risk of toxicity.
- Beta-Blockers: Concomitant use can result in additive effects on cardiac conduction (e.g., bradycardia, AV block) and contractility. Monitor closely.
- Digoxin: Diltiazem can increase serum digoxin levels by 20-50%; monitor digoxin levels and observe for signs of toxicity.
- Statins (e.g., simvastatin, lovastatin, atorvastatin): Diltiazem can increase the plasma concentration of these HMG-CoA reductase inhibitors, increasing the risk of myopathy and rhabdomyolysis.
- Anesthetics: Can potentiate the cardiovascular effects of anesthetics.
- Cyclosporine: Diltiazem can inhibit the metabolism of cyclosporine, leading to increased plasma levels.
Missed dose
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should never take a double dose to make up for a missed one. Maintaining a consistent dosing schedule is crucial for the effectiveness of the medication, especially for the extended-release formulations.
Overdose
Overdose can lead to severe hypotension, bradycardia, heart failure, and cardiac arrest. Other symptoms may include confusion, drowsiness, slurred speech, and shortness of breath. Treatment is primarily supportive and focused on restoring stable cardiovascular function. This may include IV fluids, vasopressors, atropine for bradycardia, inotropic agents, and cardiac pacing. As diltiazem is highly protein-bound, hemodialysis is not likely to be effective. Gastric lavage may be considered if presented soon after ingestion.
Storage
Store at controlled room temperature, 20°-25°C (68°-77°F). Protect from light and moisture. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Do not store in bathrooms or other damp places. Do not use after the expiration date printed on the label. Properly discard any unused medication.
Disclaimer
This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the drug’s prescribing information but may not be exhaustive.
Reviews
- “As a cardiologist, Cardizem has been a cornerstone in my armamentarium for managing hypertension and stable angina for decades. Its predictable pharmacokinetics and generally well-tolerated profile make it an excellent choice, particularly in its extended-release forms for adherence.” – Dr. A. Reynolds, MD, Cardiology
- “Switching my patient to Cardizem LA provided much more consistent 24-hour BP control compared to his previous regimen. The once-daily dosing has significantly improved his compliance.” – Clinical Pharmacist
- “I’ve been on Cardizem CD for my hypertension for three years. It effectively controls my blood pressure with minimal side effects. The only notable issue is some mild ankle swelling.” – Patient, long-term user
- “In the ER, IV diltiazem is our go-to for rapid rate control in stable AFib with RVR. Its rapid onset of action and titratability are invaluable.” – Emergency Medicine Physician