Composition
Tab 30 mg/60 mg: Diltiazem HCI 30 mg/60 mg. Retard Tab/Cap 90 mg: Diltiazem HCI 90 mg. SR Tab 60 mg/90 mg/120 mg/180 mg: Diltiazem HCI 60 mg/90 mg/120 mg/180 mg; sustained release tab. Cap 12
Indications & Dosage
Prophylaxis and treatment of angina: Adult: Initially 60 mg 3 times a day, adjusted according to response; max. 360 mg per day. Alternately, 90 mg SR Tab/Cap twice daily; increased if necessary to 180 mg twice daily Elderly: Initially 60 mg twice daily, adjusted according to response; max. 360 mg per day. Alternately, 90 mg SR Tab/Cap twice daily. Mild to moderate hypertension: Adult: 120 mg SR Tab/Cap twice daily, dose form not appropriate for initial dose titration.
Contraindications
Acute porphyria, left ventricular failure with pulmonary congestion, severe bradycardia, sick sinus syndrome, 2nd or 3rd degree AV block, uncontrolled cardiac failure
Precautions
Observe patients with mild bradycardia, 1st degree AV block or a prolonged PR interval, significantly impaired left ventricular function. Impaired renal or hepatic function; reduced dose. In overdose, diltiazem has a profound cardiac depressant effect causing hypotension and arrhythmias, including complete heart block and asystole.
Interactions
Other anti hypertensives, cardiac depressants, beta-blockers, digitalis, carbamazepine, cyclosporin, theophylline, H2 antagonists, dantrolene infusion.
Pregnancy
Contraindicated in pregnancy.
Lactation
Not recommended.
Side Effects
Asthenia, AV block, bradycardia, dizziness, GI disturbances, headache, hot flushes, hypotension, malaise, oedema (notably of ankles), palpitation, sino-atrial block, fatigue, gum hyperplasia, changes in liver function, depression, extrapyramidal symptoms, gum hyperplasia, gynaecomastia, hepatitis. Rare: Erythema multiforme, exfoliative dermatitis, photosensitivity, rashes