What is Diltiazem?

Diltiazem ointment is used to treat some skin problems. Diltiazem is an antihypertensive drug that helps relax the smooth muscles in blood vessels. This causes blood vessels to dilate and lower blood pressure. Diltiazem works by blocking calcium channels in the smooth muscle cells of the walls of blood vessels and the heart. In the following, we will examine the uses, methods of use and side effects of this product.

Pharmaceutical forms of diltiazem

At the time of prescribing, doctors should prescribe different pharmaceutical forms of drugs according to the condition of the disease, the age of the patient (adults, children and the elderly) and the physical condition. Some medicinal forms include tablets, serum, injectable solution, capsule, syrup, etc., each of which has a different absorption power. Diltiazem in long-term release capsule dosage forms 120 mg, 180 mg, 240 mg, 300 mg, 360 mg and 420 mg, injectable solution 5 mg, topical ointment or cream, regular tablet 30 mg, 60 mg, 90 mg and 120 mg.

Uses of Diltiazem

Diltiazem tablets or ampoules are used to prevent chest pain (angina). This medicine will help increase your ability to exercise and reduce the number of angina attacks. This drug is called a calcium channel blocker and works by relaxing blood vessels in the body and heart, which results in a decrease in heart rate. This product causes blood to flow more easily in the body and your heart works less to pump blood. Its most important uses include angina, blood pressure, paroxysmal supraventricular tachycardia and atrial fibrillation or flutter.

Uses of diltiazem tablets in adults

1. angina
2. blood pressure
3. Paroxysmal supraventricular tachycardia
4. Atrial fibrillation or flutter
5. Treatment of anal fissure (use only in ointment)

Uses of diltiazem tablets in children

1. high blood pressure

Pharmacological effects and mechanism of action of diltiazem drug

A non-dihydropyridine calcium channel blocker inhibits the influx of extracellular calcium ions into the membrane of myocardial cells and vascular smooth muscle cells, thereby inhibiting cardiac and vascular smooth muscle contraction. Also, it causes dilation of the main coronary and systemic arteries. No effect on serum calcium concentration; It exerts significant inhibitory effects on the cardiac conduction system, in the AV node, with some effects in the sinus node. This drug is metabolized by hepatic CYP3A4 and finally excreted in urine (2-4% unchanged, 7-6% as metabolite) and feces.

Dosage of diltiazem tablets

Take diltiazem orally before meals and before going to bed as prescribed by your doctor (usually 3 to 4 times a day). Use this medicine regularly to get the most benefit from it. This medicine should be taken regularly to prevent angina. In case of a worse condition such as severe chest pain, avoid using this medicine without a prescription. Read the drug information on the product package carefully before using it. The manufacturer of the drug has told you the amount and time of general consumption of the pill.

How to take diltiazem tablets in adults

1. The usual dose for angina is 30 mg every 6 hours, increased every 1 or 2 days until angina is controlled (usually 180-360 mg/day divided into 6-8 hours). The daily use and consumption of this pill should not exceed 360 mg.
2. The dosage for blood pressure is 180 to 240 mg per day, depending on the doctor’s prescription. For this case, the total amount of consumption should not be more than 480 mg per day.
3. The recommended dose for paroxysmal supraventricular tachycardia is 25 mg/kg (average adult dose, 20 mg), which may be increased by 0.35 mg/kg body weight within 2 days if the first dose is tolerated but has an inadequate response. minutes (average adult dose, 25 mg) repeat the drug.
4. Atrial fibrillation or flutter is 25 mg/kg (usual adult dose, 20 mg) after 15 minutes. If the first dose is tolerated but the response is insufficient, the prescription may be repeated by prescribing 0.35 mg/kg actual body weight over 2 minutes (average adult dose, 25 mg). Some doctors recommend additional doses every 15 minutes.
5. The recommended dose for continuous infusion is 10 mg/h initially and increases to more than 15 mg/h by 24 hours.

Time to use diltiazem ointment

Diltiazem ointment or tablets are used in children and the elderly, which must be used with a doctor’s prescription. The use of this product in the elderly is very sensitive, so you should consult a doctor regarding its complications and risks. The time to use this medicine in children with high blood pressure is 1.5 to 2 mg every 8 hours for general use. If the child has medical records, the dosage should be determined by the doctor.

Precautions

Patients, before taking diltiazem tablets or ointment, read the drug information on the product packaging. If you are allergic to any of the ingredients in Diltiazem ointment, tablets, capsules or ampoules, do not use it. This product may contain inactive ingredients that can cause allergic reactions or sensitivities. Before taking any medicine, it is better to consult your doctor or pharmacist regarding its side effects and precautions. If you develop serious side effects or problems after taking the medicine, stop taking the medicine and see a doctor.

1. The use of this drug may cause an abnormally slow heart rate. Patients with second- or third-degree AV block with sick sinus syndrome are at increased risk for bradycardia (the risk is increased with agents known to slow cardiac conduction).
2. Stevens-Johnson syndrome, toxic epidermal necrosis, erythema multiforme or exfoliative dermatitis have been reported in some patients.
3. A significant increase in liver enzymes such as alkaline phosphatase, LDH, AST (SGOT) and signs of acute liver damage have been reported.
4. A slight increase in transaminases was observed with and without simultaneous increase in alkaline phosphatase and bilirubin.
5. Symptomatic hypotension with or without syncope has been reported.
6. Peripheral edema occurs within 2-3 weeks from the start of treatment in some patients.
7. Use with caution in hypertrophic obstructive karyomyopathy, liver or kidney failure, left ventricular dysfunction.
8. Concomitant use of diltiazem with beta blockers or digitalis may lead to increased effects on cardiac conduction. Sinus bradycardia leading to hospitalization has been reported with the concomitant use of clonidine and other drugs that slow cardiac conduction.
9. This drug can increase the risk of cardiac side effects in patients with heart failure due to negative inotropic effects.

Contraindications to the use of diltiazem

The best way to make sure what medication is right for you is to talk to your doctor or pharmacist. Based on your medical history and physical condition, your doctor can decide on the most appropriate treatment drug for you and also tell you the warnings and contraindications of the drugs. It is also important to follow your doctor’s instructions and inform him of all medications and supplements you may be taking. Diltiazem drug, like many pharmaceutical products, has cautions and contraindications, which we will discuss further.

1. Hypersensitivity
2. Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome, severe symptomatic hypotension (systolic BP < 90 mm Hg), sick sinus syndrome (if not pacemakered)
3. Use in infants (due to benzyl alcohol), simultaneous beta blocker treatment, cardiac shock, ventricular tachycardia
4. Pregnancy or breastfeeding

Side effects of diltiazem ointment

Dizziness, lightheadedness, weakness, nausea, flushing, constipation and headache are some of the side effects of diltiazem. If any of these effects persist or worsen, tell your doctor or pharmacist right away. In case of drowsiness and dizziness, avoid doing work that requires high alertness (such as driving, working with equipment and heavy machinery). Most people who use this drug do not experience serious side effects. Some serious side effects include nausea or vomiting that does not stop, fainting, new or worsening symptoms of heart failure (such as shortness of breath, ankle swelling, unusual tiredness, unusual or sudden weight gain), slow or fast heart rate, mental and mood changes. (such as depression, restlessness) and…

1. human
2. Headache, dizziness and drowsiness
3. peripheral edema
4. brady arrhythmia
5. blood pressure
6. Nausea and vomiting
7. Diarrhea or constipation
8. Vascular dilation
9. Extrasystole
10. hot flashes
11. Drug-induced gingival hyperplasia
12. myalgia

Drug interaction of diltiazem

Patients, before visiting the doctor, prepare a list of chemical and herbal medicines you use and show them to him. Drug interactions may change how your medications work or increase your risk of serious side effects. Digoxin, fingolimod, azole antifungals (such as ketoconazole), cimetidine, macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin, rifampin), St. John’s yeast, etc. cause drug interactions with diltiazem. This drug can slow down the elimination of some drugs such as aprepitant or fosapropitant, asunaprevir, buspirone, colchicine, estrant, flibanserin, ivabradine, lomitapide, certain benzodiazepines (triazolam, midazolam) from your body.

Diltiazem use during pregnancy and breastfeeding

Pregnant women should not take any chemical or herbal products during pregnancy without a doctor’s prescription. There is still no specific information regarding the effect of diltiazem ointment or tablets on the fetus and pregnant women. But this drug enters the mother’s milk, and due to the risk of serious side effects in breastfed babies, the decision to stop breastfeeding or stop taking the drug should be made considering the importance of the drug for the mother. Existing animal studies have shown little risk for pregnant women, but experience has proven that the use of this pill in humans is a little different than in other animals. Therefore, avoid taking this medicine on your own without a prescription.

Diltiazem ointment storage conditions

Diltiazem should be stored at room temperature away from light and moisture. Only gel or ointment forms of this medicine should be kept in a cool place so that the medicine does not spoil. Keep all chemical and herbal medicines out of the reach of children and animals. Dispose of this product properly when it has expired or is no longer needed. Avoid pouring all kinds of medicines into the toilet well, street and sewer.

The last word about diltiazem ointment

As we said in this article from Positive Green Pharmacy magazine, diltiazem ointment consists of natural and semi-synthetic compounds and has a unique mechanism of action that helps to stabilize and improve the skin. The results of recent research have also confirmed the effectiveness of this ointment in improving skin problems such as cracks. If any serious side effects occur, such as fainting, new or worsening symptoms of heart failure, slow or fast heart rate, mental and mood changes (such as depression, restlessness), etc., stop taking the medicine.

Site source: Medscape