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DESCRIPTION:
It is a Calcium Channel Blocker. It inhibits the influx of calcium into smooth muscle hence cause vasodilatation. The total peripheral vascular resistance is reduced.
MECHANISM OF ACTION:
It has direct negative inotropic and chronotropic effect. It is a coronary vasodilator and total peripheral vascular resistance is reduced.
PHARMACOKINETICS:
After oral administration, it is highly bound to plasma proteins. Diltiazem is metabolized to active metabolite.
Onset of Action: 2-4 hours.
Duration of Action: 8-12 hours
ADVERSE EFFECTS:
Nausea, headache, flushing, oedema, bradycardia, skin rash.
CONTRAINDICATION: Heart block: (2 nd & 3 rd degree), children, heart disease, not recommended in children, severe CHF.
SPECIAL PRECAUTIONS: Abrupt withdrawal, renal or hepatic impairment, long term use, diabetes, CHF.
PREGNANCY :CONTRAINDICATED
LACTATION:Use with caution
ELDERLY: Use with caution
INTERACTION: Cimetidine and Ranitidine : Enhances the efficacy of diltiazem.
ß-Blockers: Though advantageous in some concomitant use may result in increased adverse effects like bradycardia and conduction disturbance.
Carbamazepine: Increased carbamazepine serum levels with possible toxicity.
Cyclosporine: Increased cyclosporine serum levels leading to toxicity.
Digitails Glycosides: Increased serum digoxin levels with possible toxicity.
Theophylline: Increased efficiency of theophylline.
INDICATIONS:
Angina pectoris due to coronary artery spasm, chronic stable angina.
DOSAGE AND ADMINISTRATION:
Adults: Initially 30 mg, 2-5 times daily before meals & at bedtime. Increase gradually to max. 240 mg in 3-4 divided doses daily.
Children: Not applicable
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