Class: Calcium Channel Blocker
Dosage Forms. Tablet: 30 mg, 60 mg, 90 mg, 120 mg; Capsule (Extended Release, 12 h): 60 mg, 90 mg, 120 mg; Capsule (Extended Release, 24 h): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg
Common FDA Label Indication, Dosing, and Titration.
1. Hypertension: Extended release, 12 h, 60-120 mg po bid, may titrate to 360 mg/d po; Extended release, 24 h, 120-240 mg po daily, may titrate to 540 mg po daily
2. Stable, chronic angina: Immediate release, 30 mg po qid, may titrate to 360 mg/d po; Extended release, 24 h, 120 mg po daily, may titrate to 540 mg/d po
1. Atrial arrhythmia: 180-360 mg daily po
2. Hypertension: Children, 1.5-2 mg/kg/d po in 3-4 divided doses, may titrate to 3.5 mg/kg/d po
MOA. Diltiazem is a calcium-channel-blocking drug that decreases heart rate, prolongs AV nodal conduction, and decreases arteriolar and coronary vascular tone. It also has negative inotropic properties.
Drug Characteristics: Diltiazem
Medication Safety Issues: Diltiazem
Drug Interactions: Diltiazem
Adverse Reactions: Diltiazem
Efficacy Monitoring Parameters. Decreased BP, reduction of chest pain, decreased number of angina attacks, reduction in use of nitroglycerin for chest pain.
Toxicity Monitoring Parameters. Signs/symptoms of CHF, decreased heart rate, signs/symptoms of liver toxicity; exacerbations of angina pectoris or acute coronary insufficiency while tapering chronic therapy, especially in patients with CAD.
Key Patient Counseling Points. Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope. This drug is available in multiple brand names with varying properties by brand. Instruct patient to follow administration instructions specific to the prescribed brand with regards to meals and timing. Do not drink alcohol while taking this drug.
Clinical Pearls. Patient should avoid concomitant use of beta-blockers during drug therapy, unless otherwise directed by healthcare professional.