Diltiazem

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 :

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 :

Hepatic Dose :