Indications
Diltiazem SR film-coated tablets serve to prevent and treat chronic stable (classic) and vasospastic angina pectoris. Additionally, they’ve shown efficacy alone or combined in managing hypertension. Diltiazem SR also proves effective in addressing myocardial infarction, coronary artery spasm, arrhythmias, Raynaud’s phenomenon, esophageal motility disorders, and migraines.
Pharmacology
Diltiazem hydrochloride functions as a calcium channel antagonist, acting as a peripheral and coronary vasodilator while also exhibiting negative inotropic activity. By inhibiting cardiac conduction, particularly at the sinoatrial and atrioventricular nodes, Diltiazem offers antianginal, antiarrhythmic, and antihypertensive effects. It undergoes rapid absorption, high protein binding, hepatic metabolism, and primarily bile excretion.
Dosage & Administration
For the film-coated formulation, the typical dose of Diltiazem Hydrochloride tablets is 60 mg thrice daily, with adjustments based on individual response. The dosage may start at 30 mg four times daily, gradually increasing until optimal response, up to 480 mg/day. Elderly or hepatically/renally impaired patients commence at 60 mg twice daily, with heart rate monitoring.
For the sustained-release formulation:
- Mild to moderate hypertension: Initially 90 mg or 120 mg twice daily (or elderly once daily), up to 360 mg daily.
- Angina: Initially 90 mg or 120 mg twice daily, up to 240 mg daily for elderly.
Interaction
Diltiazem SR necessitates cautious dosing when administered alongside drugs affecting cardiac contractility or conduction.
Contraindications
Diltiazem SR is contraindicated in hypersensitive patients, those with sick sinus syndrome, second or third degree AV block, severe hypertension, acute myocardial infarction, or radiographically documented pulmonary congestion.
Side Effects
Reported side effects include bradycardia, sinoatrial and atrioventricular block, hypertension, malaise, headache, hot flushes, gastrointestinal disturbances, edema, hepatitis, and depression.
Pregnancy & Lactation
Diltiazem usage during pregnancy warrants careful consideration due to limited data. Breastfeeding while on diltiazem therapy is not advised.
Therapeutic Class
Calcium-channel blockers.
Storage Conditions
Keep out of children’s reach, store in a cool, dry place.
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