Diltiazem Hydrochloride (Antihypertensive/Antianginal)

Question 1

What are the brand names for diltiazem hydrochloride?

Answer 1

Cardizem (CD), Cartia, Dilacor, Dilt-XR, Tiazac

Question 2

What are the strengths of tablets available for diltiazem hydrochloride?

Answer 2

30mg, 60mg, 90mg, 120mg

Question 3

What strength 12 hour sustained release capsules are available for diltiazem hydrochloride?

Answer 3

60mg, 90mg, 120mg

Question 4

What strength 24 hour sustained release capsules are available for diltiazem hydrochloride?

Answer 4

120mg, 180mg, 240mg, 300mg, 360mg, 420mg

Question 5

What strength 24 hour sustained release tablets exist for diltiazem hydrochloride?

Answer 5

120mg, 180mg, 240mg, 360mg, 420mg

Question 6

What strength of diltiazem hydrochloride is available as an injection?

Answer 6

5mg/mL in 25 mg and 50 mg vials

Question 7

What is the FDA indicated dosage of diltiazem hydrochloride when being used to treat angina pectoris due to coronary artery spasm and chronic stable angina?

Answer 7

Initially, 30 mg QID before meals and at bedtime. Dosage should be increased gradually at 1 to 2 day intervals until optimum response is obtained. The usual optimum dosage range is 180mg to 360mg per day given and three or four divided doses.

(Immediate-release tablets only)

Question 8

What is the FDA indicated dosage of diltiazem hydrochloride when being used for the treatment of hypertension?

Answer 8

Initially, 120 to 240mg daily in one or two doses. Usual afternoon dosage range is 240 to 360 mg per day in one or two doses.

Question 9

What is the FDA indicated dosage of diltiazem hydrochloride when being used for the temporary control of atrial fibrillation or atrial flutter and rapid conversion of paroxysmal supraventricular tachycardia’s to sinus rhythm (injection only)?

Answer 9

Initial bolus dose of 0.25mg/kg over two minutes. Repeat with 0.35mg/kg in 15 minutes if necessary. Begin continuous infusion of 10 to 15 mg/h after second bolus dose.

Question 10

What should the providers monitor when their patient is taking diltiazem hydrochloride?

Answer 10

Blood pressure

Question 11

What is the mechanism of action for diltiazem hydrochloride?

Answer 11

It is a calcium channel blocker

Question 12

What are the drug interactions for Cartia?

Answer 12

• May enhance the actions of cyclosporine.
• Cimetidine may increase plasma levels.
• May increase plasma levels of carbamazepine.
• Grapefruit juice has little to no effect on plasma levels.

Question 13

What are the Contra indications of Cardizem?

Answer 13

• Use is contraindicated in patients with sick sinus syndrome and second- or third- degree AV block except in the presence of a functioning ventricular pacemaker and in patients with hypertension (less than 90 mmHg systolic).
• Use with caution and pregnant or nursing women, and patients with cardiac conduction defects (sick sinus syndrome), congestive heart failure, hypertension, and then patient with impaired renal or hepatic function.
• Pregnancy Category C

Question 14

What are the adverse effects for Dilacor?

Answer 14

Peripheral edema, bradycardia, flushing, headache, dizziness, asthenia, and AV block.

Question 15

What should the RPh tell the patient when counseling on diltiazem hydrochloride?

Answer 15

• Take each dose on an empty stomach at least one hour before or two hours after a meal unless otherwise directed by physician
• May cause dizziness. Use caution while operating machinery or when mental alertness is required.
• If a dose is missed, take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.