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Diltiazem is a calcium channel blocker. It works by relaxing the muscles of your heart and blood vessels.
Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.
Diltiazem may also be used for purposes not listed in this medication guide.
You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs.
Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure.
Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse.
Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.
If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking diltiazem.
You should not use diltiazem if you are allergic to it, or if you have:
a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker);
very low blood pressure; or
if you have recently had a heart attack and you have a build-up of fluid in your lungs.
To make sure diltiazem is safe for you, tell your doctor if you have:
kidney disease;
liver disease;
congestive heart failure; or
if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others).
It is not known whether diltiazem will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Diltiazem can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.
Take diltiazem exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Swallow it whole.
To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use.
Use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
You should not stop using diltiazem suddenly. Stopping suddenly may make your condition worse.
If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Your blood pressure will need to be checked often. You may also need frequent blood tests.
Store diltiazem at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diltiazem can be fatal.
Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting.
Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.
Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Avoid drinking alcohol while taking diltiazem.
Avoid taking herbal supplements containing St. John's wort at the same time you are taking diltiazem.
Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
slow heartbeats;
pounding heartbeats or fluttering in your chest;
a light-headed feeling, like you might pass out;
shortness of breath (even with mild activity), swelling, rapid weight gain;
nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common diltiazem side effects may include:
swelling;
dizziness, weakness;
headache;
nausea; or
rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many drugs can interact with diltiazem, and your doctor may need to change your treatment plan if you use certain other medicines. The following are common drugs that interact with diltiazem;
Not all possible interactions are listed in this medication guide.
Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. Tell your doctor about all medicines you use, and those you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use diltiazem only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Diltiazem Hydrochloride (www.drugs.com/diltiazem.html).
More frequently reported side effects include: dizziness, edema, asthenia, headache, and vasodilation. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to diltiazem: oral capsule extended release, oral capsule extended release 12 hr, oral capsule extended release 24 hr, oral tablet, oral tablet extended release, oral tablet extended release 24 hr
Other dosage forms:
Along with its needed effects, diltiazem may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking diltiazem:
More common
Less common
Incidence not known
Some side effects of diltiazem may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Incidence not known
For Healthcare Professionals
Applies to diltiazem: compounding powder, intravenous powder for injection, intravenous solution, oral capsule extended release, oral tablet, oral tablet extended release
GeneralThe most commonly reported side effects include edema, headache, and dizziness.
CardiovascularVery common (10% or more): Peripheral edema (up to 15%)
Common (1% to 10%): Arrhythmia (junctional rhythm/isorhythmic dissociation), asymptomatic/symptomatic hypotension, atrioventricular (AV) block (first/second/third degree), bradycardia, bundle branch block, ECG abnormality, edema, extrasystole/ventricular extrasystole, flushing, lower limb edema, palpitations, vasodilation
Uncommon (0.1% to 1%): Orthostatic hypotension
Frequency not reported: Angina, asystole/cardiac arrest, atrial flutter, chest pain, development/aggravation of congestive heart failure, hypotension, sinoatrial block, sinus node dysfunction, sinus pause/arrest, vasculitis, ventricular arrhythmia, ventricular fibrillation, ventricular tachycardia/tachycardia
Postmarketing reports: Myocardial infarction, vasodilation symptoms (flushing, lower limb edema, sweating)
A patient with Prinzmetal's angina developed asystole after a single, 60 mg dose.
Myocardial infarction was not readily distinguishable from the natural history of the disease.
Vasodilatory events (e.g., peripheral edema, headache, flushing) are dose-related and may be more common in elderly patients.
First degree AV block and sinus bradycardia occurred more frequently with higher doses.
OtherCommon (1% to 10%): Asthenia, fatigue, flu syndrome, infection, malaise, pain
Frequency not reported: Thirst, tinnitus
GastrointestinalCommon (1% to 10%): Abdominal enlargement, constipation, dyspepsia, gastric pain, nausea
Uncommon (0.1% to 1%): Diarrhea, vomiting
Rare (0.01% to 0.1%): Dry mouth
Frequency not reported: Gastrointestinal disorder, gingivitis, gingival hyperplasia
DermatologicWell-documented cases of rashes (as leukocytoclastic vasculitis) have been reported, but a definitive between these events and this drug have not been established.
Lichenoid keratosis and hyperpigmentation occurred in skin exposed to the sun.
Common (1% to 10%): Erythema, hot flushes, rash, urticaria
Frequency not reported: Acute generalized exanthematous pustular dermatitis, desquamative erythema with/without fever exfoliative dermatitis, facial edema, hyperhidrosis/sweating, hyperpigmentation, leukocytoclastic vasculitis, petechiae, photosensitivity (lichenoid keratosis), pruritus, Steven-Johnson's syndrome
Postmarketing reports: Allergic dermatitis, alopecia, angioneurotic edema, erythema multiforme, generalized dermatitis, musculocutaneous reactions, simple erythema, toxic epidermal necrolysis
RespiratoryCommon (1% to 10%): Bronchitis, cough, increased cough, pharyngitis, sinus/nasal congestion
Frequency not reported: Dyspnea, epistaxis
Postmarketing reports: Asthma aggravation, bronchospasm
Nervous systemCommon (1% to 10%): Dizziness, headache, lightheadedness
Frequency not reported: Amnesia, dysgeusia, extrapyramidal syndrome/symptoms, gait abnormality, paresthesia, somnolence, syncope, tremor
Dizziness occurred more frequently with higher doses.
MusculoskeletalCommon (1% to 10%): Myalgia
Frequency not reported: Creatine phosphokinase (CPK) increase, muscle cramp, muscle pain, muscle weakness, myopathy, neck rigidity, osteoarticular pain
MetabolicCommon (1% to 10%): Gout
Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, mild elevation of alkaline phosphatase, mild elevation of lactate dehydrogenase, thirst, weight increase
GenitourinaryCommon (1% to 10%): Impotence
Frequency not reported: Albuminuria, crystalluria, nocturia, polyuria, sexual difficulties
OcularCommon (1% to 10%): Conjunctivitis
Frequency not reported: Amblyopia, eye irritation, periorbital edema, retinopathy
LocalCommon (1% to 10%): Injection site reactions (e.g., itching, burning)
PsychiatricUncommon (0.1% to 1%): Insomnia, nervousness
Frequency not reported: Abnormal dreams, depression, hallucinations, mood changes (including depression), personality change
HepaticThere were rare cases of clinical hepatitis that were reversible with discontinuation of this drug.
Uncommon (0.1% to 1%): Increased hepatic enzymes (ALT, AST)
Frequency not reported: Clinical hepatitis/hepatitis
HematologicFrequency not reported: Eosinophilia, hemolytic anemia, increased bleeding time, leukopenia, lymphadenopathy, thrombocytopenia
Postmarketing reports: Purpura
HypersensitivityFrequency not reported: Allergic reactions, angioedema (including facial/periorbital edema)
EndocrineFrequency not reported: Gynecomastia
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Diltiazem Hydrochloride (www.drugs.com/diltiazem.html).
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