100 Pieces
Oral
60mg
Cardiza® Diltiazem
This medicine has been prescribed for your current illness, so do not use it in similar cases or recommend its use to others.
General instructions:
Before using this medicine, consult your doctor in the following cases:
If you are allergic to this medicine or any other substance such as food preservatives, dyes, etc.
If you have a history of any disease, especially heart disease such as heart failure, bradycardia (heart rate less than 40 beats per minute) or arrhythmia.
If you are pregnant or breastfeeding.
If you are taking any medication.
Use during pregnancy and breastfeeding:
Diltiazem should not be used during pregnancy and breastfeeding except under the advice of a specialist.
Warnings:
Diltiazem should be used with caution in people with a history of any heart disease, depression, digestive problems, liver disease, kidney disease, asthma.
Diltiazem is contraindicated with drugs such as ivabradine, pimozide, domperidone, aprepitant, and fusidic acid.
Diltiazem interacts with many drugs such as herbal remedies, tamsulosin, atenolol, propranolol, amiodarone, digoxin, isosorbide trinitrate, simvastatin, atorvastatin, cyclosporine, phenytoin, aspirin, clopidogrel, carbamazepine, theophylline, lithium, midazolam, methylprednisolone, rifampin, cimetidine, and ranitidine.
Dosage:
The dosage of the drug is determined by the attending physician for each patient. However, the usual dosage of the drug is as follows.
Prevention and treatment of angina:
Adults: Start with 60 mg three times a day and increase to 360 mg per day based on response.
Elderly: Start with 60 mg twice daily and increase to 360 mg daily based on response.
Note: Diltiazem is not recommended for children.
Note: Dosage adjustment is required in patients with liver failure.
How to take the medicine:
The medicine can be taken with food or on an empty stomach.
If you take more than the prescribed amount, consult your doctor.
If you miss a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and do not double the dose.
Avoid stopping the medicine suddenly.
Diltiazem may cause dizziness and fatigue, so avoid driving or doing things that require great care.
Side effects:
In addition to the desired therapeutic effects, any drug may also have some unwanted side effects. If any of the following
side effects occur, inform your doctor.
Common or very common side effects: cardiac conduction disorders, constipation, gastrointestinal upset, fatigue
Uncommon side effects: arrhythmia, diarrhea, insomnia, nervousness, postural hypotension
Rare or very rare side effects: dry mouth, cardiac arrest, heart failure, extrapyramidal symptoms, fever, gynecomastia, hepatitis, hyperglycemia, excessive sweating, mood changes, increased sensitivity to photosensitivity, severe skin reactions, thrombocytopenia, vasculitis.
Storage conditions:
Store the drug at a temperature below 30 degrees Celsius, away from light and moisture.
Avoid using expired medication.
Keep the medicine out of the reach of children.
Dosage forms and packaging:
This medicine is produced and supplied in the form of coated tablets containing 60 mg of diltiazem in boxes of 100 under the brand name Cardiza by Afashimi Pharmaceutical Company.
Diltiazem is used in the treatment of angina, high blood pressure, and arrhythmias. It is used to control vasospastic angina or unstable angina in patients who are unable to tolerate beta-adrenergic receptor blocking drugs or nitrates or whose symptoms are not relieved by these drugs. Diltiazem injection is also used to treat supraventricular tachycardia and temporarily control rapid ventricular rate in atrial flutter or atrial fibrillation.
A non-dihydropyridine calcium channel blocker. It causes relaxation of cardiac and vascular smooth muscle by inhibiting the entry of extracellular calcium across the myocardial membrane into myocardial cells and vascular smooth muscle without affecting blood calcium concentration.
This drug is well absorbed from the gastrointestinal tract and, due to first-pass metabolism in the liver, its bioavailability is approximately 40%. Bioavailability increases with prolonged use and increased dosage. The drug is highly bound to plasma proteins. The half-life of this drug is 20-30 minutes after a single oral dose and approximately 5-8 hours for repeated and high doses. Its half-life by injection is approximately 3.4 hours. The effect of diltiazem by injection begins within 3 minutes (to slow the heart rate or convert paroxysmal supraventricular tachycardia to sinus rhythm) and after 30-60 minutes with regular tablets. The time required to reach the peak effect with repeated oral administration is about 2 weeks and with rapid intravenous injection is 2-7 minutes. The duration of the drug’s effect is 4-8 hours by oral administration, 1-3 hours by rapid intravenous injection, and 0.5-1 hours by continuous intravenous infusion.
General Interaction Profile:
– CYP3A4 Substrate
– P-gp Substrate
– CYP2D6 Inhibitor (Weak)
– CYP3A4 Inhibitor (Moderate)
– P-gp Inhibitor (Weak)
– Antihypertensive Agent
– Bradycardia Intensification
– PR Interval Prolongation
Class X Interactions (Avoidance):
Aprepitant, Asunaprevir, Bosutinib, Bromperidol, Budesonide (Systemic), Canivaptan, Dantrolene, Domperidone, Fexofenadine, Flibanserin, Fos-Eprepitant, Fusidic Acid (Systemic), Idelalisib, Ivabradine, Lasmiditan, Lamburexant, Lomitapide, Lomateprone, Pimozide, Rifampin, Simeprevir, Ulipristal
Drugs Reduced by Diltiazem:
Clopidogrel, Ifosfamide, Sincalid
Diltiazem Reduced by Drugs:
Amphetamines, barbiturates, bromperidol, calcium salts, carbamazepine, colestipol, moderate and strong CYP3A4 inducers, dabrafenib, deferasirox, dexmethylphenidate, efavirenz, enzalutamide, erdaftib, herbs (with blood pressure-increasing properties), methylphenidate, mitotane, P-gp/ABCB1 inducers, phenytoin, rifampin, rifamycin derivatives, sarilumab, siltuximab, tocilizumab, yohimbine
Drug effects enhanced by diltiazem:
Abmaciclib, acalabrutinib, alfentanil, amifostine, amiodarone, amlodipine, antipsychotics (atypical [second-generation]), apixaban, aprepitant, aripiprazole, aspirin, asunaprevir, atorvastatin, atosiban, Avanafil, avapritinib, axitinib, benzhydrocodone, beta-blockers, blonanserin, bosutinib, bradycardia-inducing drugs, brexpiprazole, brigatinib, bromocriptine, bromperidol, budesonide (topical and systemic), buspirone, calcium channel blockers (dihydropyridine), cannabidiol, marijuana (controlled), carbamazepine, cardiac glycosides, ceritinib, cilostazol, cobimtinib, codeine, colchicine, copanlisib, corticosteroids (systemic), crizotinib, cyclosporine (systemic), CYP3A4 substrates (high risk with inhibitors), dapoxetine, darifenacin, deflazacort, disopyramide, dofetilide, domperidone, doxorubicin (common), dronabinol, drondarone, duloxetine, eletriptan, Alexacaftor/Tezacaftor/Ivacaftor, Oligoglustat, Encorafenib, Enterotinib, Eplerenone, Esmolol, Estrogen Derivatives, Everolimus, Fentanyl, Fexofenadine, Fingolimod, Flibanserin, Fos-Eprepitant, Fosphenytoin, Giltritinib, Guanfacine, Halofantrine, Hydrocodone, Antihypertensives, Ibrutinib, Imatinib, Ivabradine, Ivacaftor, Ivocidinib, Lacosamide, Lefamolin, Lamburexant, Lercanidipine, Loamlodipine, Levodopa-Containing Products, Lithium, Lomitapide, Lorlatinib, Lovastatin, Lomateprone, Lurasidone, Lerbinectidine, Macitentan, Magnesium Salts, Manidipine, Meperidine, Midostaurin, Mirodafil, Naldemidine, Nalfurafine, naloxegol, neratinib, neuromuscular blocking agents (non-depolarizing), nimodipine, nitroprusside, olaparib, oxycodone, pemigatinib, pexidartinib, phenytoin, pholcodine, pimecrolimus, pimozide, propafenone, quinidine, ranolazine, red yeast rice, rimejpant, rupatadine, ruxolitinib, salmeterol, saxagliptin, selpercatinib, selumetinib, sildenafil, silodosin, simeprovir, simvastatin, siponimod, sirolimus, sonegib, suvorexant, tacrolimus (topical and systemic), tadalafil, talazoparib, tamsulosin, tazmetostat, tetrahydrocannabinol, tezacaftor and ivacaftor, ticagrelor, tofacitinib, toluaptan, trabectedin, triazolam, Abrogept, udenafil, ulipristal, vardenafil, ventocalx, vilazodone, vindesine, zanobrutinib, zopiclone
Increased effects of diltiazem by drugs:
Alfuzosin, alpha-1 blockers, antifungals (azole derivatives; systemic), atorvastatin, barbiturates, benperidol, brimonidine (topical), calcium channel blockers (dihydropyridines), cimetidine, clofazimine, clonidine, canivaptan, cyclosporine (systemic), moderate and strong CYP3A4 inhibitors, dantrolene, diazoxide, drondharone, dolizib, erdaftib, fluconazole, fosnotipitant, fusidic acid (systemic), grapefruit juice, herbs (with blood pressure-lowering properties), idelalisib, ivabradine, larotrectinib, Lasmiditan, lormetazepam, macrolide antibiotics, magnesium salts, midodrine, mifepristone, molcidomine, naftopidil, netopitant, nicergoline, nicorandil, obinutuzumab, palbociclib, pentoxifylline, P-gp/ABCB1 inhibitors, prostacyclin analogs, protease inhibitors, quinagolide, regorafenib, ruxolitinib, simvastatin, stiripentol, trilipressin, tofacitinib
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