Diltiazem lowers blood
pressure
and has some effect on cardiac conduction. Diltiazem interferes with the influx
of calcium ions through the channels
of active cell membranes.
Indication
Diltiazem
is used for the prophylaxis and treatment of chronic stable (classical) and
vasopastic angina pectoris and has also been used alone or in combination in
the management of hypertension, also, Diltiazem is effective in myocardial infarction,
coronary artery spasm, arrhythmias, Raynaud's phenomenon, oesophageal motility
disorder and migraine.
Dosage
& Administration
Adult:
The usual dose is 60 mg thrice daily. However patient's response may
vary and dosage requirements can
differ
significantly between individual patients. If necessary, the divided dose may
be increased to 180-00mg/day. Dosage may be started as 30 mg four times daily
and increasing at 1 to 2 days intervals until the optimum response is achieved.
Higher doses upto 480mg/day have been used with benefit in some patients
especially in unstable angina. Elderly and patients with impaired hepatic or
renal function : The recommended starting dose is 60 mg twice daily. The heart
rate should be measurecfregularly and the dose should not be increased if the
heart rate falls bejew 50 beats per minute.
Children:
Not recommended.
Side-effect
With
Diltiazem headache, ankle oedema, hypertension, dizziness, flushing, rashes (toxic
erythema), nausea and Gl disturbances may occur. Transient elevation in liver
enzyme values and occasionally hepatitis have been reported. Diltiazem may
depress cardiac conduction and has occasionally led to AV block, bradycardia
and rarely asystole or sinus
arrest.
Contraindication Diltiazem is contraindicated to the patients of severe
bradycardia, sick sinus syndrome, pregnancy, second or third degree AV block.
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