Cardizem

Cardizem (diltiazem hydrochloride) is a prescription calcium channel blocker medication clinically proven to manage hypertension (high blood pressure) and chronic stable angina. Developed through rigorous pharmaceutical research, it operates by relaxing blood vessels and reducing cardiac workload, facilitating improved blood flow and oxygen delivery to the heart. Trusted by cardiologists worldwide, Cardizem offers a balanced mechanism of action suitable for long-term cardiovascular management.

Features

• Active ingredient: Diltiazem hydrochloride
• Available in extended-release capsules and immediate-release tablets
• Multiple strengths: 30 mg, 60 mg, 90 mg, 120 mg, 180 mg, 240 mg, 300 mg, 360 mg
• FDA-approved for hypertension and angina pectoris
• Once-daily or twice-daily dosing options depending on formulation

Benefits

• Effectively lowers systolic and diastolic blood pressure, reducing strain on the cardiovascular system
• Decreases frequency and severity of angina episodes, improving exercise tolerance
• Minimizes myocardial oxygen demand through coronary and peripheral vasodilation
• Provides 24-hour blood pressure control with extended-release formulations
• Suitable for monotherapy or combination therapy with other antihypertensives
• Well-established safety profile with decades of clinical use and research

Common use

Cardizem is primarily prescribed for the management of essential hypertension and chronic stable angina. In hypertension, it reduces elevated blood pressure by inhibiting calcium influx into vascular smooth muscle and cardiac cells. For angina management, Cardizem improves myocardial oxygen supply by dilating coronary arteries and arterioles while simultaneously reducing oxygen demand through afterload reduction. Off-label uses may include atrial fibrillation/flutter rate control, Raynaud’s phenomenon, and migraine prophylaxis, though these applications require specialist cardiovascular consultation.

Dosage and direction

Dosage must be individualized based on therapeutic response and tolerance. For hypertension: Extended-release capsules typically start at 180-240 mg once daily, maximum 540 mg daily. For angina: Immediate-release tablets usually begin at 30 mg four times daily, titrated to 180-360 mg daily in divided doses. Extended-release formulations for angina start at 120-180 mg once daily, maximum 480 mg daily. Tablets should be swallowed whole with water, with or without food consistently. Extended-release capsules must not be crushed, chewed, or divided. Regular blood pressure monitoring is essential during dosage titration.

Precautions

Cardizem requires careful monitoring in patients with impaired hepatic or renal function, as diltiazem is extensively metabolized by the liver and excreted renally. Use with caution in patients with heart failure, sick sinus syndrome, or left ventricular dysfunction. Elderly patients may require lower doses due to decreased hepatic and renal function. Abrupt discontinuation may cause rebound hypertension or angina exacerbation. Regular liver function tests and ECG monitoring are recommended during long-term therapy. Patients should avoid grapefruit juice, which may increase diltiazem bioavailability.

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 pacemaker), hypotension (systolic pressure <90 mmHg), acute myocardial infarction with pulmonary congestion confirmed by x-ray, and concomitant use with strong CYP3A4 inhibitors in patients with impaired liver or kidney function.

Possible side effects

Common side effects (≥1%) include headache, dizziness, edema, asthenia, flushing, nausea, and bradycardia. Less frequent adverse reactions (0.1-1%) include constipation, dyspepsia, rash, palpitations, syncope, and elevated liver enzymes. Rare but serious side effects (<0.1%) include symptomatic hypotension, heart failure exacerbation, severe bradycardia, AV block, hepatotoxicity, and leukopenia. Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment.

Drug interaction

Cardizem interacts significantly with CYP3A4 substrates, inhibitors, and inducers. Concomitant use with beta-blockers may potentiate bradycardia and AV conduction disturbances. Co-administration with digoxin may increase digoxin levels by 20-50%. Simvastatin and lovastatin concentrations may increase significantly. Diltiazem may potentiate effects of neuromuscular blocking agents. CYP3A4 inhibitors (ketoconazole, ritonavir, erythromycin) increase diltiazem exposure. CYP3A4 inducers (rifampin, phenytoin) decrease diltiazem efficacy. Concomitant use with nitrates or other antihypertensives may cause additive hypotension.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. For once-daily formulations, if missed for more than 12 hours, skip the missed dose and resume regular schedule. For multiple daily dosing regimens, if remembered within 4 hours of scheduled time, take immediately; otherwise, skip and resume normal schedule. Maintain consistent dosing intervals to ensure stable therapeutic levels.

Overdose

Cardizem overdose may manifest as severe hypotension, bradycardia, heart failure, AV conduction disturbances, and cardiac arrest. Management includes cardiovascular monitoring, IV fluids, vasopressors (dopamine, norepinephrine), atropine for bradycardia, and calcium gluconate administration. Cardiac pacing may be necessary for conduction abnormalities. Hemodialysis is not effective due to high protein binding. Gastric lavage may be considered if presented early. Symptomatic treatment should continue until cardiovascular stability is achieved.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in original container. Protect from light, moisture, and excessive heat. Keep tightly closed and out of reach of children. Do not store in bathroom medicine cabinet due to humidity fluctuations. Discard any medication that appears discolored or shows signs of degradation. Properly dispose of unused medication through drug take-back programs.

Disclaimer

This information does not replace professional medical advice. Consult a healthcare provider for proper diagnosis and treatment. Dosage and administration should be determined by a qualified physician based on individual patient factors. Do not initiate or discontinue Cardizem without medical supervision. Report any adverse effects to your healthcare provider immediately.

Reviews

Clinical studies demonstrate Cardizem’s efficacy with 70-80% of hypertensive patients achieving blood pressure control. Angina patients show 40-60% reduction in attack frequency. Long-term studies confirm maintained efficacy over 2-5 years of treatment. Patient satisfaction surveys indicate improved quality of life metrics related to cardiovascular symptoms. Healthcare providers report favorable tolerability profile compared to other antihypertensive classes.