Dilzem (diltiazem hci): Uses, Dosage & Side Effects

What it's for (Indications)

Management of angina (chest pain) and hypertension (high blood pressure).
Also used for heart rate reduction in conditions like atrial fibrillation/flutter or PSVT.

Dosage Information

Type	Guideline
Standard	For direct intravenous single injections (Bolus): The initial dose is 0.25 mg/kg actual body weight (e.g., 20 mg for an average patient) administered over 2 minutes. If the response is inadequate, a second dose of 0.35 mg/kg actual body weight (e.g., 25 mg for an average patient) may be administered after 15 minutes over 2 minutes. Subsequent intravenous bolus doses should be individualized. Patients with low body weights should be dosed on a mg/kg basis. Some patients may respond to an initial dose of 0.15 mg/kg, although experience with this dose is limited and duration of action may be shorter. Continuous intravenous infusion is also used for continued reduction of heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter.

Type

Guideline

Standard

For direct intravenous single injections (Bolus): The initial dose is 0.25 mg/kg actual body weight (e.g., 20 mg for an average patient) administered over 2 minutes. If the response is inadequate, a second dose of 0.35 mg/kg actual body weight (e.g., 25 mg for an average patient) may be administered after 15 minutes over 2 minutes. Subsequent intravenous bolus doses should be individualized. Patients with low body weights should be dosed on a mg/kg basis. Some patients may respond to an initial dose of 0.15 mg/kg, although experience with this dose is limited and duration of action may be shorter. Continuous intravenous infusion is also used for continued reduction of heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter.

Safety & Warnings

Common Side Effects

Common adverse events reported during clinical trials include hypotension (asymptomatic 4.
3%, symptomatic 3.
2%), injection site reactions (e.
g.
, itching, burning, 3.
9%), vasodilation/flushing (1.
7%), and arrhythmia (junctional rhythm or isorhythmic dissociation, 1%).
Other reported side effects include bradycardia, 1st degree AV block, ankle edema, nausea, headache, rash, GI upset, fatigue, gingival hyperplasia, and changes in liver function.

Serious Warnings

Black Box Warning: None
Diltiazem is not recommended for pregnant or nursing females.
It might cause dizziness or tiredness; patients should avoid driving or operating heavy machinery until they know how this medicine affects them.
Use with caution in patients with liver disease or kidney disease.
Avoid alcohol consumption while using this medicine.
Before using, inform your doctor about your complete medical history, especially if you have heart, liver, or kidney diseases, depression, or gut problems.
Inform your doctor about all your current medicines and if you are about to undergo surgery.
Do not quit this medicine without informing your doctor.
Do not share this medicine with anyone.
Caution is advised in patients with sick sinus syndrome or AV block without a functioning ventricular pacemaker.

How it Works (Mechanism of Action)

Diltiazem is a non-dihydropyridine calcium channel blocker. It inhibits the influx of extracellular calcium ions across the myocardial and vascular smooth muscle cell membranes, leading to coronary and peripheral vasodilation, reduction in myocardial contractility, and slowing of AV nodal conduction.