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Cardizem (diltiazem) 

Indications

Cardizem is indicated for: 

• Management of chronic stable angina. 
• Management of angina due to coronary artery spasm. 

Dosage and Administration

• Take Cardizem exactly as prescribed by your healthcare provider. 
• Swallow Cardizem tablets whole with a full glass of water. 
• Take Cardizem at the same time each day to maintain an even level in your blood. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. 
• Do not crush or chew Cardizem tablets. 
• Do not take more than the prescribed dose. 
• Do not stop taking Cardizem suddenly without consulting your healthcare provider. 

Mechanism of Action

Cardizem works by relaxing the muscles of your heart and blood vessels. It is a calcium channel blocker that inhibits the influx of calcium ions during the depolarization of cardiac and vascular smooth muscle. This action helps to decrease heart rate, lower blood pressure, and reduce the workload on the heart, improving oxygen delivery to the heart muscle. 

Contraindications

Cardizem is contraindicated in: 

• Patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker. 
• Patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker. 
• Patients with hypotension (less than 90 mm Hg systolic). 
• Patients who have demonstrated hypersensitivity to the drug. 
• Patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission. 

Side Effects

Common Side Effects: 

• Headache 
• Dizziness 
• Fatigue 
• Nausea 
• Edema (swelling of the legs and ankles) 

Serious Side Effects: 

• Severe hypotension (low blood pressure) 
• Bradycardia (slow heart rate) 
• Heart block 
• Congestive heart failure 
• Hepatotoxicity (liver damage) 
• Severe allergic reactions (e.g., rash, itching/swelling, severe dizziness, trouble breathing) 

Precautions

• Liver and Kidney Monitoring: Since Cardizem is extensively metabolized by the liver and excreted by the kidneys and in bile, monitor your liver and kidney function regularly, especially for long-term use.
• Use with Caution: Used the medication with caution if you have impaired renal or hepatic function. High doses in animal studies have been associated with reversible liver damage.
• Drug Interactions: Inform your healthcare provider about all other medications you are taking, as Cardizem can interact with other drugs.
• Elderly Patients: Use with caution in elderly patients, who may be more sensitive to the effects of the drug.
• Alcohol: Avoid alcohol while taking Cardizem, as it can increase the risk of side effects.

Storage Instructions

Store Cardizem at 25°C (77°F); temporary variations are permitted between 15°C and 30°C (59°F to 86°F). 

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/018602s065lbl.pdf