It works by affecting the movement of calcium into the cells of the heart and blood vessels. In the perinatal/postnatal studies, there was an increased incidence of stillbirths at doses of 20 times the human dose or greater.There are no well-controlled studies in pregnant women; therefore, use diltiazem in pregnant women only if the potential benefit justifies the risk to the fetus.Diltiazem is excreted in human milk. Like all medicines, chloramphenicol can cause side effects, although not everyone gets them. The plasma elimination half-life following single or multiple drug administration is approximately 3.0 to 4.5 hours. In patients with sick sinus syndrome, diltiazem significantly prolongs sinus cycle length (up to 50% in some cases).Chronic oral administration of diltiazem hydrochloride to patients in doses of up to 540 mg/day has resulted in small increases in PR interval, and on occasion produces abnormal prolongation Diltiazem is well absorbed from the gastrointestinal tract and is subject to an extensive first-pass effect, giving an absolute bioavailability (compared to intravenous administration) of about 40%. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency or establish a causal relationship to drug exposure.The following post-marketing reactions have been reported infrequently in patients receiving diltiazem: acute generalized exanthematous pustulosis, allergic reactions, alopecia, angioedema (including facial or periorbital edema), erythema multiforme, extrapyramidal symptoms, gingival hyperplasia, hemolytic anemia, increased bleeding time, leukopenia, photosensitivity (including lichenoid keratosis and hyperpigmentation at sun-exposed skin areas), purpura, retinopathy, myopathy, and thrombocytopenia.In addition, events such as myocardial infarction have been observed which are not readily distinguishable from the natural history of the disease in these patients.A number of well-documented cases of generalized rash, some characterized as leukocytoclastic vasculitis, have been reported.Using other agents known to affect cardiac conduction or contractility with diltiazem may increase the risk of bradycardia, AV block, and heart failure Diltiazem is both a substrate and an inhibitor of the cytochrome P450 3A4 enzyme system.Pregnancy Category C. Reproduction studies have been conducted in mice, rats, and rabbits. Drug information provided by: IBM Micromedex Along with its needed effects, a medicine may cause some unwanted effects. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). Take Diltiazem Hydrochloride Extended-Release Tablets once a day at approximately the same time. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug.Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. There are as yet few data on the interaction of diltiazem and beta-blockers in patients with poor ventricular function. Because of the potential for serious adverse reactions in nursing infants from diltiazem, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.Safety and effectiveness in pediatric patients have not been established.Clinical studies of diltiazem did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Side Effects. Advertising revenue supports our not-for-profit mission.Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Blood levels after a standard dose of diltiazem can vary over tenfold, limiting the usefulness of blood levels in overdose cases.There have been 29 reports of diltiazem overdose in doses ranging from less than 1 g to 18 g. Sixteen of these reports involved multiple drug ingestions.Twenty-two reports indicated patients had recovered from diltiazem overdose ranging from less than 1 g to 10.8 g. There were seven reports with a fatal outcome; although the amount of diltiazem ingested was unknown, multiple drug ingestions were confirmed in six of the seven reports.Events observed following diltiazem overdose included bradycardia, hypotension, heart block, and cardiac failure. Initiate dosing at 180 to 240 mg once daily, although some patients may respond to lower doses. Most reports of overdose described some supportive medical measure and/or drug treatment. Chloramphenicol comes in tablet form, capsules, as a liquid suspension, and also in an injectable form (chloramphenicol sodium succinate). Many patients will require more than one drug to achieve blood pressure goals. In the same study, there was no significant change in 20 mg single dose pravastatin AUC and Cmax during diltiazem coadministration. These reactions tended to occur early after therapy initiation (1 to 8 weeks) and have been reversible upon discontinuation of drug therapy.
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