Uses for diltiazem

Diltiazem is used alone or together with other medicines to treat angina (severe chest pain) or hypertension (high blood pressure). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Diltiazem is a calcium channel blocker. It works by affecting the movement of calcium into the cells of the heart and blood vessels. This relaxes the blood vessels, lowers blood pressure, and increases the supply of blood and oxygen to the heart while reducing its workload.

This medicine is available only with your doctor's prescription.

Before using diltiazem

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of diltiazem in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of diltiazem in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving diltiazem.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Cisapride
• Colchicine
• Eliglustat
• Flibanserin
• Lomitapide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abametapir
• Acalabrutinib
• Acebutolol
• Alfentanil
• Alprazolam
• Alprenolol
• Amiodarone
• Apixaban
• Aprepitant
• Atazanavir
• Atenolol
• Atorvastatin
• Avapritinib
• Benzhydrocodone
• Betaxolol
• Bevantolol
• Bisoprolol
• Bosutinib
• Brexpiprazole
• Brigatinib
• Bucindolol
• Buprenorphine
• Carbamazepine
• Carteolol
• Carvedilol
• Celiprolol
• Ceritinib
• Cilostazol
• Clarithromycin
• Clonidine
• Clopidogrel
• Clozapine
• Cobimetinib
• Codeine
• Conivaptan
• Crizotinib
• Cyclosporine
• Dantrolene
• Daridorexant
• Deflazacort
• Digoxin
• Dihydrocodeine
• Dilevalol
• Domperidone
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Droperidol
• Elacestrant
• Elexacaftor
• Encorafenib
• Entrectinib
• Epirubicin
• Eplerenone
• Erythromycin
• Esmolol
• Fedratinib
• Fentanyl
• Fexinidazole
• Finerenone
• Fingolimod
• Fosaprepitant
• Fosnetupitant
• Hydrocodone
• Ibrutinib
• Ifosfamide
• Infigratinib
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Labetalol
• Lacosamide
• Larotrectinib
• Lemborexant
• Levobunolol
• Lovastatin
• Lumateperone
• Lurasidone
• Lurbinectedin
• Mavacamten
• Meperidine
• Mepindolol
• Methadone
• Metipranolol
• Metoprolol
• Mitapivat
• Mobocertinib
• Morphine
• Morphine Sulfate Liposome
• Nadolol
• Naloxegol
• Nebivolol
• Netupitant
• Nilotinib
• Olaparib
• Omaveloxolone
• Oxprenolol
• Oxycodone
• Pacritinib
• Pemigatinib
• Penbutolol
• Pentazocine
• Pexidartinib
• Phenobarbital
• Pindolol
• Piperaquine
• Pixantrone
• Ponesimod
• Primidone
• Propranolol
• Ranolazine
• Rimegepant
• Rivaroxaban
• Selpercatinib
• Selumetinib
• Simeprevir
• Simvastatin
• Siponimod
• Sirolimus Protein-Bound
• Sonidegib
• Sotalol
• Sparsentan
• St John's Wort
• Sufentanil
• Tacrolimus
• Talinolol
• Tazemetostat
• Tertatolol
• Tezacaftor
• Timolol
• Tolvaptan
• Tramadol
• Ubrogepant
• Venetoclax
• Venlafaxine
• Voclosporin
• Zanubrutinib
• Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfuzosin
• Amlodipine
• Buspirone
• Cimetidine
• Colestipol
• Dalfopristin
• Digitoxin
• Dutasteride
• Efavirenz
• Enflurane
• Fosphenytoin
• Guggul
• Indinavir
• Lithium
• Methylprednisolone
• Midazolam
• Moricizine
• Nevirapine
• Phenytoin
• Quinupristin
• Rifampin
• Rifapentine
• Sirolimus
• Suvorexant
• Triazolam

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bowel blockage, severe or
• Congestive heart failure—Use with caution. May make these conditions worse.

• Heart attack or
• Heart block (type of abnormal heart rhythm, can use if have a pacemaker that works properly) or
• Hypotension (low blood pressure), severe or
• Lung problem (eg, pulmonary congestion) or
• Sick sinus syndrome (type of abnormal heart rhythm, can use if have a pacemaker that works properly)—Should not be used in patients with these conditions.

• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of diltiazem

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

You may swallow whole, crush, or chew the 30 milligrams (mg), 60 mg, 90 mg, or 120 mg tablet. Do not split the 30 mg tablet.

Swallow the extended-release tablet or extended-release capsule whole. Do not open, crush, or chew it. It is best to take the extended-release capsule on an empty stomach.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For chest pain:
  • For oral dosage form (extended-release capsules):
    • Adults—At first, 120 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • Adults—At first, 180 milligrams (mg) once a day, either in the morning or evening. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults—At first, 30 milligrams (mg) 4 times a day before meals and at bedtime. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.

• For high blood pressure:
  • For oral dosage form (extended-release capsules):
    • Adults—At first, 180 to 240 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • Adults—At first, 180 to 240 milligrams (mg) once a day, either in the morning or at bedtime. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using diltiazem

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning. If you faint, call your doctor right away. .

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, skin rash, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of diltiazem

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Body aches or pain
• congestion
• cough
• dryness or soreness of the throat
• fever
• hoarseness
• runny nose
• tender or swollen glands in the neck
• trouble swallowing
• voice changes

Less common

• Chest pain, discomfort, or tightness
• chills
• diarrhea
• difficult or labored breathing
• feeling faint, dizzy, or lightheaded
• feeling of warmth or heat
• flushing or redness of the skin, especially on the face and neck
• general feeling of discomfort or illness
• headache
• joint pain
• loss of appetite
• muscle aches and pains
• nausea
• shivering
• slow or irregular heartbeat
• sweating
• swelling of the hands, ankles, feet, or lower legs
• trouble sleeping
• unusual tiredness or weakness
• vomiting

Incidence not known

• Blistering, peeling, or loosening of the skin
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• no heartbeat
• red skin lesions, often with a purple center
• red, irritated eyes
• sores, ulcers, or white spots in the mouth or on the lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Sneezing
• stuffy nose

Less common

• Acid or sour stomach
• belching
• constipation
• continuing ringing or buzzing or other unexplained noise in the ears
• degenerative disease of the joint
• difficulty with moving
• hearing loss
• heartburn
• indigestion
• lack or loss of strength
• muscle aching or cramping
• muscle pains or stiffness
• pain or tenderness around the eyes and cheekbones
• rash
• stomach discomfort, upset, or pain
• swollen joints

Incidence not known

• Loss or thinning of the hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.