Apo-Diltiaze

Country of origin - Canada
Pharm-Group - Calcium channel blockers of the benzodiazepine group

Manufacturers - Apotex Inc (Canada)
International name - Diltiazem
Synonyms - Aldizem, Altiazem RR, Angizem, Blockalcin 60, Blockalcin 90 retard, Herbesser, Diazem, Dilakor XR, Deley Tiazim SR, Dilzhina, Dilzem, Dilcardia, Dilcardia retard, Diltiazem, Diltiazem Hexal retard, Diltiazem hydrochloride, Diltiazem Lannacher, Diltiazem Niko
Dosage forms - tablets 60 mg
Composition - Active ingredient - Diltiazem.
Indications for use - Angina pectoris; prevention of coronary spasm during coronary angiography or coronary artery bypass surgery; arterial hypertension: after myocardial infarction (mainly retard forms, when beta-blockers are contraindicated), in patients with concomitant angina (in the presence of contraindications to the use of beta-blockers), in patients with diabetic nephropathy (when angiotensin-converting enzyme inhibitors are contraindicated). IV - ventricular fibrillation and flutter, relief of paroxysmal atrial fibrillation (in combination with digoxin), paroxysmal supraventricular tachycardia. In transplantology: after kidney transplantation (prevention of graft failure), during immunosuppressive therapy (to reduce the nephrotoxicity of cyclosporine A).

Contraindications - Hypersensitivity, cardiogenic shock, left ventricular systolic dysfunction, incl. in acute myocardial infarction, sinus bradycardia, sick sinus syndrome, sinoatrial and AV block II-III degree, severe aortic stenosis, Wolff-Parconson-White syndrome and Lown-Ganong-Levine syndrome with paroxysms of atrial fibrillation or flutter, impaired liver function and kidneys, childhood, pregnancy, lactation.

Side effect - Transient hypotension; bradycardia, conduction disorder I degree, decrease in cardiac output, palpitations, fainting, eosinophilia; headache, dizziness, weakness, feeling tired; peripheral edema, impaired potency; dyspeptic symptoms, hyperplasia of the gum mucosa; sweating, redness of the skin; Allergic reactions (skin rash and itching), rarely - exudative erythema multiforme; increased activity of transaminases (ALT, AST), lactate dehydrogenase and alkaline phosphatase, hyperglycemia.

Interaction - Increases plasma levels of carbamazepine, theophylline, cyclosporine A, digoxin. Weakens the nephrotoxic effects of cyclosporine A. May enhance the inhibitory effect of anesthetics on contractility, conductivity and automaticity of the heart. Antiarrhythmic drugs and beta-blockers contribute to the development of bradycardia, AV conduction disorders, and symptoms of heart failure. Antihypertensive drugs enhance the hypotensive effect. Cimetidine increases the plasma level of diltiazem, digoxin potentiates the effectiveness in the tachysystolic form of atrial fibrillation. Diltiazem solution is chemically incompatible with furosemide solution.

Overdose - Symptoms: bradycardia, hypotension, intracardiac block and heart failure. Treatment: gastric lavage, administration of activated carbon, plasmapheresis and hemoperfusion using activated carbon. Calcium preparations have antidote properties.

Special instructions - While taking long-acting dosage forms, intravenous administration of beta-blockers is not recommended. It should be used with caution to normalize heart rhythm in patients with impaired hemodynamics or in conjunction with drugs that reduce total peripheral vascular resistance, myocardial contractility and conductivity. Parenteral administration is possible if funds and equipment are available to provide emergency care. With prolonged use