Diltiazem
- Atc Codes:C08DB01
- CAS Codes:33286-22-5#42399-41-7
- PHARMGKB ID:33286-22-5#42399-41-7
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Diltiastad, Diltiazem; Belgium: Diltiazem, Progor, Tildiem; Bulgaria: Aldizem, Altiazem, Diltiazem; Cyprus: Adizem, Dazil, Denazox; Czech Republic: Blocalcin, Diacordin; Denmark: Cardil, Cardizem, Dilcor, Myonil, Tilker; Estonia: Altiazem, Diltiazem; Finland: Cardizem, Dilmin, Dilpral, Dilzem; France: Deltazen, Diacor, Dilrene, Diltiazem, Tildiem; Germany: Cardelene, Corazet Diltiazem, Dil-Sanorania, Dilsal, Diltabeta, Diltahexal, Diltapect, Diltapham, Diltaretard, Dilti-CT, Diltiagamma, Diltiazem, Diltiuc, Diltivis, Dilzanton, Dilzem; Greece: Diltiazem; Hungary: Blocalcin, Dilrene, Dilzem; Ireland: Adizem, Diacardyne, Diltam, Diltiazem, Dilzem, DTZ, Entrydil, Tildiem; Italy: Altiazem, Angizem, Diladel, Dilem, Diltiazem, Dilzene, Tildiem; Latvia: Altiazem, Diltiazem, Dilzem; Lithuania: Altiazem, Cardil, Dilzem, Diltiazem; Luxembourg: Adizem, Diltahexal, Diltiazem, Tildiem; Malta: Dacil, Denazox; Netherlands: Diltiazem, Tildiem; Poland: Blocalcin, Diacordin, Dilocard, Dilrene, Diltiazem, Dilzem, Oxycardil, Zilden; Portugal: Dilfar, Diltiangina, Diltiazem, Diltiem, Etizem, Herbesser, Tilker; Romania: Corzem, Diltiazem, Dilzem; Slovakia: Altiazem, Blocalcin, Diacordin; Slovenia: Aldizem; Spain: Angiodrox, Cardiser, Carreldon, Clobendian, Cronodine, Dilaclan, Diltiazem, Diltiwas, Dinisor, Doclis, Lacerol, Masdil, Tilker, Trumsal; Sweden: Cardizem; UK: Adizem, Angitil, Diltiazem, Dilzem, Slozem, Tildiem, Viazem.
North America
Canada: Cardizem, Diltiaz, Diltiazem, Tiazac; USA: Cardizem, Cartia XT, Dilacor XR, Dilt-CD, Diltiazem, Diltzac, Taztia XT, Tiazac.
Latin America
Argentina: Acalix, Angular, Corodrox, Diltenk, Dilzen-G, Hart, Incoril, Kaltiazem, Tilazem; Brazil: Angiolong, Balcor, Cardizem, Cordil, Diltiacor, Diltiazem, Diltipress, Diltizem, Diltor, Incoril; Mexico: Angiotrofin, Anremed, Diltiazem, Sertidel, Tilazem.
Asia
Japan: Calnurs, Clarute, Cohlen, Coroherser, Diltiazem, Frotty, Hemarekeat, Herbesser, Hirosutas R, Lutianon R, Marumunen, Miocardie, Nackless, Paretnamin, Pazeadin, Seresnatt, Youtiazem, Ziruvate.
Drug combinations
Diltiazem and Enalapril
Chemistry
Diltiazem Hydrochloride: C~22~H~26~N~2~O~4~S HCl. Mw: 450.98. (1) 1,5-Benzothiazepin-4(5H)-one, 3-(acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(4-methoxyphenyl)-, monohydrochloride, (+)-cis-; (2)(+)-5-[2-(Dimethylamino)ethyl]-cis-2,3-dihydro-3-hydroxy-2-(p-methoxyphenyl)-1,5-benzothiazepin-4(5H)-one acetate (ester) monohydrochloride. CAS-33286-22-5; CAS-42399-41-7 (diltiazem)(1977).
Pharmacologic Category
Antiarrhythmic Agents; Class IV Antiarrhythmics. Vasodilating Agents; Vasodilating Agents, Miscellaneous. Calcium-Channel Blocking Agents, Miscellaneous. (ATC-Code: C08DB01).
Mechanism of action
Inhibits calcium ions from entering the «slow channels» or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation. Increases myocardial oxygen delivery in vasospastic angina.
Therapeutic use
Essential hypertension, chronic stable angina or angina from coronary artery spasm. Temporary control of rapid ventricular rate in atrial fibrillation or flutter. Management of supraventricular tachyarrhythmias, including rapid conversion to sinus rhythm of paroxysmal supraventricular tachycardias (e.g. those associated with Wolff-Parkinson-White or Lown-Ganong-Levine syndrome).
Pregnancy and lactiation implications
Teratogenic and embryotoxic effects demonstrated in small animals. There are no adequate, well-controlled studies in pregnant women. Available evidence suggests safe use during breast-feeding.
Unlabeled use
Treatment of ectopic or multifocal (chaotic) atrial tachycardia or of symptomatic junctional tachycardia if the rhythm is unresponsive to (i.e. not controlled or converted by) vagal maneuvers or adenosine. Investigational: Therapy of Duchenne muscular dystrophy.
Contraindications
Hypersensitivity to diltiazem or any component of the formulation. Sick sinus syndrome. Second- or third-degree AV block (except with a functioning artificial pacemaker). Hypotension. Acute MI and pulmonary congestion.
Warnings and precautions
May cause first-, second-, and third-degree AV block or sinus bradycardia. Symptomatic hypotension with or without syncope can rarely occur. Peripheral edema is common (within 2-3 weeks of starting therapy). Use with caution in hepatic or renal impairment. Use with caution in hypertrophic obstructive cardiomyopathy. Use with caution in left ventricular dysfunction (due to negative inotropic effects, may exacerbate condition). Concomitant use with β-blockers can result in conduction disturbances, hypotension, and worsened LV function. Avoid I.V. administration concomitantly or within a few hours of I.V. β-blockers. Concomitant use with digoxin can result in conduction disturbances.