For oral dosage form (tablets): Adults—At first, 30 milligrams (mg) 4 times a day before meals and at bedtime
It works by affecting the movement of calcium into the cells of the heart and blood vessels
Chemically, diltiazem hydrochloride is 1,5-Benzothiazepin-4(5H)-one, 3-(acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(4-methoxyphenyl)-, monohydrochloride,(+)-cis-
Why is this medication prescribed? Diltiazem is used to treat high blood pressure and to control angina (chest pain)
Diltiazem Hydrochloride in Dextrose Injection is a sterile, clear, colorless solution in a single-dose bag supplied as: 125 mg/125 mL (NDC 51754-3000-1) 250 mg/ 250 mL
Bottom line References Mykola Sosiukin/iStock via Getty Images Diltiazem is a medication that treats various heart conditions
14
IV over 2 minutes
Immediate-release diltiazem tablets are usually taken three or four times a day
Diltiazem hydrochloride is extensively metabolized by the liver and excreted by the kidneys and in bile
The infusion rate may be increased in 5 mg/h increments up to 15 mg/h as needed, if further reduction in heart rate is required
As with any drug given over prolonged periods, laboratory parameters of renal and hepatic function should be monitored at regular intervals
Use diltiazem as a continuous IV infusion for rate control in supraventricular tachycardia in patients without concomitant LV systolic dysfunction
depression, psychomotor impairment, severe hypotension (incl
Cardizem CD, Cartia XT, Dilt-CD: 120-180 mg/day PO; titrate over 7-14 days; maintenance range usually 120-320 mg/day; not to exceed 480 mg/day
I generally hold meds for sbp below 100 and/dbp below 50 unless there are other parameters
The drug should be used with caution in patients with impaired renal or hepatic
25mg/kg (Max dose: 25mg) IV bolus x1
IV to PO diltiazem: Oral dose = (IV drip rate [in mg/hr] x 3 + 3) x10 Steps to covert from diltiazem IV to PO 1
Subsequent doses must be individualised for each patient
Consider addition 30mg PO IR Diltiazem q6 hours or home dose to reduce need for drip
Round dose to a 30 mg increment, Diltiazem has a wide range of side effects
In subacute and chronic dog and rat studies designed to produce toxicity, high doses of diltiazem were associated with hepatic damage
PK parameters (C max, AUC 0-t and AUC 0-∞) were predicted, and compared with actual data to establish the strength of correlation models