Diltiazem tablets (60 and 90 mg): instructions for use

Diltiazem - benzodiazepine calcium channel blocker, which has a number of features of use.

Thus, when using the form of the drug prolonged action, their combination with beta-blockers is undesirable. Also, do not use the drug to stabilize the heart rhythm with disturbed hemodynamic parameters.

On this page you will find all information about Diltiazem: the full instructions for use for this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Diltiazem. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Selective blocker of calcium channels of III class, benzothiazepine derivative.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Diltiazem cost? The average price in pharmacies is at the level of100 rubles.

Form of issue and composition

Diltiazem is produced in the form of round white tablets, on one side of which there is a risk, in contour cell packs of 10 pcs.

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The composition of one tablet includes 60 or 90 mg of diltiazem chloride and such auxiliary substances as:

Corn starch;
Povidone;
Microcrystalline cellulose;
Talc;
Gelatin;
Colloidal silicon dioxide;
Lactose;
Calcium phosphate is dibasic;
Magnesium stearate;
Hydroxypropylmethylcellulose;
Sodium benzoate.

Also produced dry substance Diltiazem, intended for the preparation of solution for injection, in clear bottles. One bottle contains 10 or 25 mg of diltiazem chloride.

Pharmacological effect

Diltiazem is classified as a group of drugs that can block L-type calcium channels. These specific channels are located in a large enough number in the heart and in the blood vessels (arteries and arterioles).

Calcium ions participate in the formation of the action potential at the level of the conduction system of the heart (a special complex of cells that regulates the contractile function of the heart). As a result, this leads to a lowering of the heart rate, but practically does not affect the force of contractions of the heart muscle (pumping function). Also, diltiazem reduces the oxygen and energy requirement of the myocardium (cardiac muscle).

At the level of the blood vessels of the heart (coronary arteries) and in the arteries of the large, medium and small caliber, the blocking of the calcium channels leads to their reflex dilatation (dilatation). Diltiazem cures spasm of the coronary vessels (contraction of the smooth muscles of the vessels of the heart, which is accompanied by painful sensations) and other arteries, and also reduces the overall peripheral pressure in the vessels (antihypertensive effect). Along with the above effects, diltiazem improves renal and cerebral blood flow to some extent.

Indications for use

According to the instructions to Diltiazem, the use of the drug is indicated for:

Prevention of attacks of angina pectoris, including stenocardia Prinzmetal;
Treatment of various forms of arterial hypertension and ischemic heart disease;
Prevention of supraventricular arrhythmias: paroxysmal supraventricular tachycardia, atrial flutter, extrasystole, atrial fibrillation.

Contraindications

Diltiazem has a number of contraindications, so it can appoint only a doctor. The doctor recommends the patient to undergo the examination, on the basis of which the best treatment is selected.

Tablets are forbidden to take a certain group of patients:

Laun-Ganoga-Levin syndrome;
low blood pressure;
dysfunction of the liver and kidneys;
bradycardia in neglected form;
cardiogenic shock;
weak sinus node;
heart attack, which was accompanied by stasis in the lungs;
heart failure (2 and 3 degrees);
aortic stenosis;
period of pregnancy and breastfeeding;
individual intolerance to one of the components;
Wolff-Parkinsome-White syndrome.

With caution apply for AV-blockade I degree, violations of intraventricular conduction, in patients prone to arterial hypotension, chronic heart failure, myocardial infarction with left ventricular failure, ventricular tachycardia with QRS complex expansion, hepatic insufficiency, renal failure, in elderly patients, in children (efficacy and safety of use not investigated).

Application in pregnancy and lactation

Contraindicated in pregnancy and lactation (breastfeeding). In experimental studies, the teratogenic effect of diltiazem was established.

Instructions for use

In the instructions for use, it is indicated that Diltiazem should be taken orally, swallowing tablets whole and with liquid.

The drug is taken 3 times a day for 60 mg or 2 times a day for 90 mg. The optimal dose of Diltiazem is 180-360 mg per day.

Under the supervision of a doctor in an inpatient setting, an increase in the daily dose to 480 mg is possible.

Side effects

In the responses to Diltiazem, the following side effects of this drug are indicated:

On the part of the gastrointestinal tract: vomiting, dry mouth, nausea, improved appetite, diarrhea or constipation, bleeding, swelling of the gums.
Rarely can there be problems with the formation of blood cells, which is accompanied by agranulocytosis or thrombocytopenia.
Severe headaches, fainting and dizziness, disturbed sleep, constant fatigue and drowsiness, poor mobility of hands and feet, slow or shuffling gait, poor facial expressions, trembling of hands, problems with swallowing. Taking the drug in large quantities, you can cause tremors, problems with vision.
Depending on the particular organism (as the reviews to Diltiazem show), itching, arthritis, rash, reddening of the facial skin, and also Stephen-Johnson syndrome may occur.
With regard to the cardiovascular system, there is often a decrease in blood pressure, arrhythmia, bradycardia, angina, asystole, heart failure, tachycardia.

If you take Diltiazem in very large doses, then this can cause difficulty in breathing, a strong cough, swollen legs. Sometimes there is a galactorrhea and an increase in the total body weight.

Overdose

When using the drug in large doses, peripheral edema, pulmonary edema, increased content serum creatinine, weight gain, galactorrhea, hyperglycemia, potency disorders.

special instructions

Sudden abolition of diltiazem can lead to the development of an anginal attack.
It is not recommended simultaneous use of beta-adrenoblockers and diltiazem for parenteral administration.
Patients with impaired hepatic and / or renal function and elderly persons require a correction of the dosing regimen.
In / in apply only for emergency therapy, but if necessary, the introduction is possible within a few days. When diltiazem is introduced, careful monitoring of cardiovascular function is necessary. Against the background of a regular intake of beta-blockers should be strictly specified indications for iv administration of diltiazem and apply it only after ECG monitoring in the intensive care unit, while the possible need to use a pacemaker should be considered.

Drug Interactions

Diltiazem can not be used alone with other medicines without first consulting a doctor. Its administration with concomitant medications can lead to the consequences given in the table.

Diltiazem and	The result of taking
Cimetidine	Reduces the impact of the drug in question, slows recovery
Disopyramide	Induces a decrease in blood concentrations of potassium ions
Carbamazepine Cyclosporine Quinidine	In this case, Diltiazem increases the toxicity of medicines. If their joint intake is vital, then the dosage of medications decreases
Buspirone	Raises its concentration in the blood, and this leads to side effects
Insulin	Diltiazem reduces the effect of the drug
Midazolam Triazolam	Increases the concentration of drugs
Theophylline	Reduces the metabolism of this drug in liver cells

This is only a small part of the drugs that interact negatively with the drug.

Reviews

The main dissatisfaction of patients about taking the drug, which includes hydrochloride in the diltiazem, is side effects. Most often they suffer from weakness, headaches, nausea.

Experts assure that all these manifestations can be stopped with the help of symptomatic therapy with other medications.