ratio-Diltiazem CD

Brand Name:Apo-Diltiaz, Apo-Diltiaz SR, Apo-Diltiaz CD, Apo-Diltiaz Injectible, Cardizem, Cardizem CD, Diltiazem Hydrochloride Injection, Gen-Diltiazem, Gen-Diltiazem CD, Novo-Diltazem, Novo-Diltazem CD, Nu-Diltiaz-CD, Nu-Diltiaz, Sandoz Diltiazem CD, Tiazac, Tiazac XC

Prescription needed: Yes

What is this drug used for?

Diltiazem is most commonly used (alone or in combination with other medications) to lower blood pressure in people with high blood pressure (hypertension) and to prevent and decrease the frequency of angina (chest pain) attacks. It can also be used to decrease the heart rate in people who have atrial fibrillation.

Is there any reason not to take this drug?

You should not use this drug if you are allergic to it, if you have heart rhythm conditions such as second or third degree heart block or sick sinus syndrome. Before taking this medication, tell your doctor specifically if you have or have ever had:
  • congestive heart failure
  • problems with your kidney or liver
  • swelling (edema) in the ankles or feet
  • low blood pressure (hypotension)

What about possible side effects?

The most common side effects are:

  • headache
  • leg and ankle swelling
  • feeling dizzy
  • feeling tired and weak
  • a slow heartbeat

Other side effects:

  • flushing
  • constipation and nausea
  • rash
  • swelling of the gums
This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact and change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes or monitor you more closely:
  • other medications to treat high blood pressure or angina - may increase your chances for experiencing low blood pressure or having other similar side effects
  • if you are taking this drug to treat high blood pressure, be careful of certain over-the-counter medicines that may increase your blood pressure - these include some cough and cold medicines; ask your doctor or pharmacist for more information
  • beta-blockers (e.g metoprolol, atenolol, propranolol) - this combination should be used with caution and with close monitoring; when used together, you may have an increase chance for side effects, especially a slow heartbeat
  • ketoconazole, itraconazole, fluconazole, erythromycin, clarithromycin, amiodarone, HIV protease inhibitors (e.g. ritonavir) - may increase the amount of diltiazem in your blood
  • quinidine, procainamide, amiodarone, disopyramide, digoxin, cyclosporine, theophylline, simvastatin, carbamazepine, atorvastatin, lovastatin - diltiazem can increase the amount of these drugs in the blood and increase the chance for side effects
  • rifampin, St. John’s Wort - may see a decrease in the amount of diltiazem in the blood

Other information:

Special Instructions and Follow-up

If you are taking this drug for high blood pressure or angina, your blood pressure should be checked regularly to see how well diltiazem is working. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse and ask what “number” your heart rate should be. If your pulse is faster or slower than it should be, call your doctor.

This drug (in the long-acting forms) will not work to decrease angina attacks at the time that they happen. You should also have a medication, called nitroglycerin, to use when you have episodes of chest pain.

As you see an improvement in your chest pain because of taking diltiazem, you may be tempted to exercise vigorously - check with your doctor first to determine whether you can safely exercise and/or how intensely you should be exercising.

If you are undergoing medical or dental surgery, tell your doctor or dentist you are taking diltiazem as some anesthetics may cause your blood pressure to drop.

Do not crush or chew the capsules. The CD and Tiazac capsules can be opened and sprinkled. Talk to your pharmacist.

Children: Can be used. Lower doses are required. Talk to your doctor.

Seniors: Are more sensitive to side effects and lower doses are usually necessary, especially at the start of therapy.

Pregnancy: Generally not prescribed. Safer drugs are available. Talk to your doctor.

Women who are nursing: Drug passes into the breast milk. Generally considered to be okay. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know how this drug affects them personally. May cause drowsiness and dizziness.

Overdose: A large overdose of this medicine could cause severe drowsiness, dizziness or a very low heart rate. If you experience any unusual reactions, or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: Talk to your doctor before you stop taking this drug. Stopping the drug will likely cause your blood pressure to increase or your other symptoms of chest pain (angina) to return.

If you miss a dose: Talk to your pharmacist as it may differ depending on whether you are taking the short or long acting form of the medication. Do not take a double dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always away from children.

Alcohol: You should drink in moderation as too much alcohol may cause a decrease in blood pressure and dizziness.

Dietary precautions: Avoid drinking grapefruit juice or eating grapefruit as it may decrease the breakdown of diltiazem in the body, cause higher levels in the blood and increase the chance for side effects. No other precautions, unless prescribed by your doctor.