Country of origin - Italy
Pharm-Group - Calcium channel blockers of the benzodiazepine group
Manufacturers - Alpha Schiapparelli Wasserman (Italy)
International name - Diltiazem
Synonyms - Aldizem, Altiazem RR, Angizem, Apo-Diltiaz, 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, D
Dosage forms - tablets 60 mg
Composition - Active ingredient - Diltiazem.
Indications for use:
- Angina;
- 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.
- Reduces 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.
- Use with caution to normalize heart rhythm in patients with impaired hemodynamics or in conjunction with drugs that reduce total peripheral vascular resistance, contractility and conductivity.