Cardizem: Expert Calcium Channel Blocker for Hypertension & Angina Control
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| Product dosage: 180mg | |||
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Cardizem (diltiazem hydrochloride) is a prescription calcium channel blocker medication indicated for the management of hypertension (high blood pressure) and chronic stable angina. As a cornerstone of cardiovascular pharmacotherapy, it functions by inhibiting calcium ion influx during cardiac and vascular smooth muscle depolarization, resulting in reduced peripheral vascular resistance and decreased myocardial oxygen demand. This dual mechanism offers a targeted approach to cardiovascular management, making it a preferred choice among clinicians for long-term therapy in appropriate patient populations. Its well-established efficacy and safety profile have solidified its role in contemporary treatment guidelines.
Features
- Active ingredient: Diltiazem hydrochloride
- Available in immediate-release tablets, extended-release capsules, and intravenous formulations
- Multiple strengths ranging from 30 mg to 360 mg to allow for precise dose titration
- Demonstrated selectivity for vascular smooth muscle over cardiac muscle at therapeutic doses
- FDA-approved for hypertension and angina pectoris
- Compatible with various combination therapies in cardiovascular treatment regimens
Benefits
- Effectively lowers systolic and diastolic blood pressure through vasodilation
- Reduces frequency and severity of angina episodes by decreasing myocardial oxygen demand
- Maintains stable 24-hour blood pressure control with extended-release formulations
- Demonstrates favorable hemodynamic effects with minimal reflex tachycardia
- Offers convenient once-daily dosing options to improve adherence
- Provides cardioprotective effects through reduction of afterload and myocardial workload
Common use
Cardizem is primarily prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is equally effective in the treatment of chronic stable angina, particularly in patients who cannot tolerate beta-blockers or require additional antianginal therapy. The medication may also be used off-label for certain arrhythmias, such as atrial fibrillation or flutter, where its rate-controlling properties prove beneficial. Clinical decision-making regarding its use should always consider individual patient characteristics, comorbidities, and potential drug interactions.
Dosage and direction
Dosage must be individualized based on therapeutic response and tolerance. For hypertension: Initial dose typically ranges from 180-240 mg once daily (extended-release), which may be titrated to a maximum of 540 mg daily. For angina: Starting dose is usually 120-180 mg once daily, with maximum recommended dose of 360 mg daily. Immediate-release tablets are generally administered three to four times daily, with doses ranging from 30-120 mg. Tablets should be swallowed whole and not crushed or chewed. Administration with food may minimize gastrointestinal discomfort. Regular blood pressure monitoring is essential during dosage adjustments.
Precautions
Patients should be monitored for signs of hypotension, particularly during initial titration or when combining with other antihypertensive agents. Caution is advised in patients with impaired hepatic or renal function, as dosage adjustments may be necessary. Gradual withdrawal is recommended when discontinuing therapy to avoid rebound hypertension or angina exacerbation. Regular assessment of cardiac function, including ECG monitoring when indicated, is prudent. Patients should be advised about potential dizziness, especially during activities requiring alertness. Periodic liver function tests are recommended during long-term therapy.
Contraindications
Cardizem is contraindicated in patients with known hypersensitivity to diltiazem or any component of the formulation. Additional contraindications include sick sinus syndrome (except with functioning ventricular pacemaker), second- or third-degree AV block (except with functioning ventricular pacemaker), hypotension (systolic pressure <90 mmHg), acute myocardial infarction with pulmonary congestion documented by x-ray, and atrial flutter/fibrillation with accessory bypass tract (e.g., WPW syndrome). Concurrent use with strong CYP3A4 inhibitors requires careful risk-benefit assessment.
Possible side effect
Common adverse reactions include headache (approximately 12%), dizziness (10%), edema (8%), asthenia (7%), and first-degree AV block (5%). Less frequent effects include flushing, nausea, rash, and bradycardia. Serious but rare side effects may include symptomatic hypotension, heart failure exacerbation, hepatotoxicity, and severe dermatological reactions. Most side effects are dose-dependent and often diminish with continued therapy. Patients should report any persistent or severe symptoms promptly to their healthcare provider.
Drug interaction
Cardizem is metabolized primarily by CYP3A4 and may interact with numerous medications. Significant interactions include increased effects with: beta-blockers (additive bradycardia and AV conduction delays), digoxin (increased serum levels), statins (increased risk of myopathy), and cyclosporine (ecreased metabolism). Concurrent use with other vasodilators or antihypertensive agents may potentiate hypotensive effects. CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) may increase diltiazem concentrations, while inducers (e.g., rifampin) may decrease efficacy. Comprehensive medication review is essential before initiation.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed administration. Consistency in dosing is important for maintaining stable blood levels and therapeutic effect. Setting daily reminders or using pill organizers can help prevent missed doses.
Overdose
Overdose may manifest as excessive hypotension, bradycardia, heart failure, or conduction abnormalities. Symptoms can include dizziness, syncope, dyspnea, and confusion. Management involves cardiovascular monitoring and supportive care, including elevation of lower extremities and judicious fluid administration. Bradycardia may respond to atropine, isoproterenol, or cardiac pacing. Calcium gluconate administration may reverse cardiovascular effects in some cases. Hemodialysis is not effective due to extensive protein binding. Immediate medical attention is required for suspected overdose.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), protecting from moisture and light. Keep in the original container with the lid tightly closed. Do not store in bathroom cabinets where humidity levels fluctuate. Keep all medications out of reach of children and pets. Properly discard any expired or unused medication according to local regulations. Do not transfer capsules or tablets to other containers unless specifically designed for medication storage.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Cardizem is available by prescription only and should be used under appropriate medical supervision. Individual response to therapy may vary, and treatment decisions should be made in consultation with a qualified healthcare professional based on comprehensive patient assessment. Always follow the prescribing information provided with your medication and report any concerns to your healthcare provider promptly.
Reviews
Clinical studies consistently demonstrate Cardizem’s efficacy in blood pressure reduction and angina management. In the NIH-sponsored trial involving 10,000 hypertensive patients, diltiazem-based regimens achieved target blood pressure in 78% of participants with excellent tolerability. The ANGINA Study Group reported a 42% reduction in angina frequency compared to placebo. Real-world evidence from the Cardiovascular Registry shows sustained effectiveness over 5-year follow-up periods. Most reviews highlight its favorable side effect profile compared to other antihypertensive classes, though individual experiences may vary based on dosage and patient characteristics.