Drug Index


Mechanism :

Diltiazem is a calcium ion cellular influx inhibitor, slow channel blocker or calcium antagonist. The therapeutic effects of diltiazem are related to its ability to inhibit the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle.

Indication :

  • Raynaud’s phenomenon
  • Hypertension

Contraindications :

Diltiazem is contraindicated in patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker; in patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker; in patients with hypotension; in patients who have hypersensitivity to the drug and in patients with acute myocardial infarction and pulmonary congestion.

Dosing :

1.5-2 mg/kg/day orally, divided tid-qid.
Max: 6 mg/kg/day 360 mg/day.

Adverse Effect :

Angina, arrhythmia, AV block (second- or third-degree), bundle branch block, congestive heart failure, ECG abnormalities, hypotension, palpitations, syncope, tachycardia, ventricular extrasystoles, abnormal dreams, amnesia, depression, gait abnormality, hallucinations, insomnia, nervousness, paresthesia, personality change, somnolence, tinnitus, tremor.Gastrointestinal: Anorexia, constipation, diarrhea, dry mouth, mild elevations of SGOT, SGPT, LDH, and alkaline phosphatase, nausea, thirst, vomiting, weight increase, petechiae, photosensitivity, pruritus.

Interaction :

Carbamazepine, Cyclosporin and Theophylline: Diltiazem may cause increase levels.
Cimetidine and Ranitidine: May cause an increase in diltiazem levels.
Amiodarone: There is an increased risk of AV block, bradycardia and myocardial depression.
Rifampicin, Phenobarbital and Phenytoin: Diltiazem levels are reduced.
Beta-blockers: An increased risk of AV block and bradycardia.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

Decrease the dose and adjust the dose based on clinical response.
02/14/2024 21:01:02 Diltiazem
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