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Diltiazem Medication: Uses, Dosage, Side Effects & Interactions
Summary of Key Points
Diltiazem is a prescription medication used to manage several heart and blood vessel conditions, including high blood pressure (hypertension), chest pain (angina), and certain types of irregular heartbeats. It works by relaxing blood vessels and slowing the heart rate, which improves blood flow and reduces the heart’s workload. Always consult your healthcare provider before starting or adjusting your dose of Diltiazem. You can also schedule a telemedicine visit with one of our providers for personalized care.
Names of Diltiazem Medication
Generic Name: Diltiazem
US Brand Names: Cardizem, Cartia XT, Tiazac, Dilt-XR
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.
Diltiazem Drug Class
Pharmacologic Category: Calcium Channel Blocker (Non-Dihydropyridine)
Other medications in this category include Verapamil and Amlodipine.
Diltiazem Dosage
Diltiazem is prescribed for various conditions, with dosing tailored to the specific condition being treated. Always follow your doctor’s instructions and never adjust your dose without consulting a healthcare provider. If you have concerns about your dosage, schedule a telemedicine appointment with one of our providers.
Diltiazem for High Blood Pressure (Hypertension)
Initial dose: 180 to 240 mg once daily (extended-release). The dose may be gradually increased based on your response. Maintenance dose: 240 to 360 mg once daily. Treatment is typically long-term to manage blood pressure.
Diltiazem for Angina (Chest Pain)
Immediate-release: 30 mg four times daily. Extended-release: 120 to 180 mg once daily. The dose may be adjusted based on symptoms and response. Treatment duration depends on the severity of angina.
Diltiazem for Atrial Fibrillation (Irregular Heartbeat)
Initial dose: 120 to 360 mg once daily (extended-release). The dose may be adjusted based on heart rate and symptoms. Treatment is typically long-term to control heart rhythm.
Diltiazem for Supraventricular Tachycardia (SVT)
Initial dose: 120 to 360 mg once daily (extended-release). The dose may be adjusted based on heart rate and symptoms. Treatment duration varies depending on the severity of the condition.
Diltiazem for Coronary Artery Disease
Initial dose: 120 to 180 mg once daily (extended-release). The dose may be adjusted based on symptoms and response. Long-term treatment is often necessary to manage symptoms.
Diltiazem for Heart Failure
Initial dose: 120 to 180 mg once daily (extended-release). The dose may be adjusted based on symptoms and response. Treatment is usually long-term.
Diltiazem for Raynaud’s Phenomenon
Initial dose: 120 mg once daily (extended-release). The dose may be increased based on response. Treatment duration varies depending on symptom control.
Diltiazem for Migraine and Cluster Headaches
Initial dose: 120 mg once daily (extended-release). The dose may be increased based on response. Treatment is typically long-term for prevention.
Diltiazem for Tachyarrhythmias
Initial dose: 120 to 360 mg once daily (extended-release). The dose may be adjusted based on heart rate and symptoms. Long-term treatment is often necessary to control heart rhythm.
Dosage Forms and Strengths of Diltiazem
Immediate-release tablets: 30 mg, 60 mg, 90 mg, 120 mg
Extended-release capsules (once daily): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg
Extended-release tablets (twice daily): 60 mg, 90 mg, 120 mg
Injectable form: 5 mg/mL
Administration Instructions for Diltiazem
Diltiazem should be taken exactly as prescribed by your healthcare provider. Extended-release forms must be swallowed whole and should not be crushed or chewed. It can be taken with or without food, but try to take it at the same time each day. If you miss a dose, take it as soon as you remember, but skip it if it’s almost time for your next dose. Do not take two doses at once. If you have questions about how to take your medication, reach out to one of our telemedicine providers for guidance.
Diltiazem Side Effects and Adverse Reactions
Like all medications, Diltiazem can cause side effects. Most people tolerate it well, but some may experience unwanted effects. If you experience severe or concerning symptoms, contact your healthcare provider immediately or schedule a telemedicine visit for further evaluation.
Common side effects: These occur in more than 1 in 10 people.
- Headache: Mild to moderate pain in the head.
- Dizziness: Feeling lightheaded or unsteady.
- Fatigue: Unusual tiredness or weakness.
Less common side effects: These occur in 1 in 100 to 1 in 1,000 people.
- Swelling of the legs or ankles: Fluid retention in the lower limbs.
- Bradycardia: Slower than normal heart rate.
- Constipation: Difficulty passing stools.
Rare but serious side effects: These occur in less than 1 in 1,000 people.
- Severe allergic reaction: Swelling of the face, lips, or throat, difficulty breathing.
- Severe hypotension: Dangerously low blood pressure.
- Liver problems: Yellowing of the skin or eyes (jaundice), dark urine.
Contraindications for Diltiazem
A contraindication is a specific situation where a medication should not be used because it may be harmful. For Diltiazem, there are several conditions where it is not safe to take this medication.
Severe low blood pressure (hypotension): Diltiazem can further lower blood pressure, leading to dizziness, fainting, or even shock.
Recent heart attack with complications: If your heart is not pumping effectively after a heart attack, Diltiazem can worsen heart function.
Advanced heart block (without a pacemaker): Diltiazem slows the heart rate, which can lead to dangerously slow rhythms in people with heart block.
Severe heart failure: Diltiazem can reduce the heart’s ability to pump blood, worsening heart failure symptoms.
Allergy to Diltiazem: If you have had an allergic reaction to Diltiazem, taking it again could cause a serious reaction, such as rash, swelling, or difficulty breathing.
Drug to Drug Interactions with Diltiazem
Diltiazem can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of your treatment. It’s essential to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some medications known to interact with Diltiazem include:
- Beta-blockers (e.g., Metoprolol, Atenolol): Both Diltiazem and beta-blockers lower heart rate and blood pressure. When taken together, they may cause an excessive drop in heart rate or blood pressure.
- Digoxin (Lanoxin): Diltiazem can increase the levels of Digoxin in your body, raising the risk of toxicity.
- Statins (e.g., Simvastatin, Lovastatin): Taking Diltiazem with these cholesterol-lowering medications can increase the risk of muscle damage (myopathy).
- Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Diltiazem by speeding up its breakdown in the liver.
- Carbamazepine (Tegretol): Diltiazem can raise Carbamazepine levels, which may lead to side effects such as dizziness or drowsiness.
Diltiazem in Pregnancy: Is It Safe?
Diltiazem is classified as a Category C drug for pregnancy, meaning that while no well-controlled studies have been conducted in humans, animal studies suggest potential risks. It should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, consult your healthcare provider to determine whether Diltiazem is appropriate for you. You can also schedule a telemedicine appointment with one of our providers to discuss your options.
Can You Take Diltiazem While Breastfeeding?
Diltiazem does pass into breast milk, but its effects on a nursing infant are not well understood. If you are breastfeeding, it’s important to discuss the risks and benefits with your healthcare provider. In some cases, your provider may suggest an alternative medication or recommend monitoring your baby for side effects such as unusual sleepiness or difficulty feeding.
Estimated Cost of Diltiazem Medication
The cost of a 30-day supply of Diltiazem can vary depending on the dosage and the pharmacy. Without insurance, the estimated cost using a GoodRX coupon ranges from $10 to $30 for the generic version. Brand-name versions, such as Cardizem, may be more expensive. Be sure to check with your pharmacy for the most accurate pricing.
Possible Alternatives to Diltiazem
If Diltiazem is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine visit with one of our providers to explore these options.
Alternatives for Hypertension (High Blood Pressure)
Other options include ACE inhibitors (e.g., Lisinopril), ARBs (e.g., Losartan), or lifestyle changes such as reducing salt intake, exercising regularly, and managing stress.
Alternatives for Angina (Chest Pain)
Medications like beta-blockers (e.g., Metoprolol) or nitrates (e.g., Nitroglycerin) may be used. Lifestyle changes, such as quitting smoking and following a heart-healthy diet, can also be beneficial.
Alternatives for Atrial Fibrillation
Other rate-controlling medications, such as beta-blockers or anti-arrhythmic drugs (e.g., Amiodarone), may be considered. In some cases, procedures like electrical cardioversion may be recommended.
Alternatives for Supraventricular Tachycardia (SVT)
Medications such as Adenosine or beta-blockers may be used. In some cases, catheter ablation may be considered as a long-term solution.
Alternatives for Coronary Artery Disease
Statins, aspirin, and lifestyle changes like regular exercise and a heart-healthy diet are common alternatives.
Alternatives for Heart Failure
Medications such as ACE inhibitors, ARBs, or beta-blockers are often prescribed. Lifestyle changes, including reducing salt intake and monitoring fluid levels, can also be helpful.
Alternatives for Raynaud’s Phenomenon
Calcium channel blockers like Nifedipine may be used as an alternative. Keeping warm and avoiding stress can also help manage symptoms.
Alternatives for Migraine
Other preventive medications include beta-blockers (e.g., Propranolol) or anti-seizure medications (e.g., Topiramate). Identifying and avoiding migraine triggers can also be effective in managing symptoms.
Alternatives for Cluster Headaches
Alternatives include oxygen therapy, triptans (e.g., Sumatriptan), or corticosteroids. Avoiding alcohol and smoking can help reduce the frequency of attacks.
Alternatives for Tachyarrhythmias
Other medications, such as beta-blockers or anti-arrhythmic drugs, may be used. In some cases, catheter ablation may be considered.
Recent Updates on Diltiazem Research
Recent studies have explored Diltiazem’s long-term effects in managing chronic conditions like hypertension and atrial fibrillation. A 2022 study published in the Journal of Cardiovascular Pharmacology found that Diltiazem may offer additional benefits by reducing arterial stiffness, potentially improving outcomes for patients with hypertension. Ongoing research is also investigating Diltiazem’s potential in treating conditions like Raynaud’s Phenomenon and certain types of migraines, though more clinical trials are needed to confirm its effectiveness in these areas.
As research continues, it’s important to stay informed about new findings that may impact your treatment plan. If you have any concerns or questions, discuss them with your healthcare provider, or schedule a telemedicine appointment with one of our providers to review the latest information.
