Diltiazem
Uses of Diltiazem
Diltiazem is commonly used in the treatment of anal fissure, angina, arrhythmias, and hypertension. It is also used to relieve heart-related chest pain.
How Diltiazem Works
Diltiazem inhibits the influx of calcium ions during depolarization of the vascular smooth muscles and myocardium. This will then relax the coronary vascular muscles and cause coronary vasodilation. Diltiazem also blocks cardiac conduction at the AV and SA nodes.
Side Effects of Diltiazem
Dizziness, Headache, Flushing, Hypotension, Ankle edema, Bradycardia, Vomiting, Nausea, Photosensitivity, Diarrhea
Warnings
Kidney Use With Care
Studies have shown that in patients with renal impairment, an increase of plasma concentration of Diltiazem may be noted. At the commencement of the treatment, close monitoring is required and caution must be practiced.
Alcohol Not Advisable
It is not advisable to use Diltiazem with alcohol as the combination may have additive vasodilatory effects. Both lower the blood pressure and this can worsen dizziness, light-headedness and cause tachycardia or loss of consciousness.
Pregnancy Not Safe
Animal studies on rats, mice, and rabbits demonstrated that there is evidence of reproductive toxicity caused by Diltiazem. However, there is limited data from human studies on the usage of Diltiazem in pregnant women. Even though potential benefits may allow the usage despite the risks, it is best to avoid Diltiazem in pregnancy as well as in women of childbearing age.
Driving Not advisable
Do not drive unless you are feeling well. Diltiazem may cause side effects such as dizziness or tiredness, all of which could affect the ability to concentrate and drive.
Liver Limited Data
Studies have shown that in patients with liver insufficiency, an increase of plasma concentration of Diltiazem may be noted. At the beginning of the treatment, close monitoring is required and caution must be practiced.
Lactation Limited Data
It is recommended to avoid breastfeeding while on Diltiazem as it is excreted at low concentration in breast milk. If Diltiazem usage is deemed medically required, other method of infant feeding should be commenced.
Frequently Asked Questions
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
