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Dilacor xr

Category: Blood Pressure

Description

Cardizem is used for treating supraventricular tachycardia, a rhythm disturbance of the heart.

Active Ingredient: Diltiazem

Cardizem (Dilacor xr) as known as: Acalix, Acasmul, Adizem, Alandiem, Aldizem, Altiazem, Altizem, Angiazem, Angiodrox, Angiolong, Angiotrofin, Angiozem, Angitil, Angizem, Balcor, Beatizem, Bi-tildiem, Blocalcin, Cal-antagon, Calnurs, Cardiser, Cardium, Carreldon, Cartia, Channel, Clarute, Clobendian, Cohlen, Conductil, Coramil, Coras, Corazem, Cordisil, Cordizem, Coridil, Corodrox, Coroherser, Corolater, Cortiazem, Corzem, Cronodine, Daltazen gmp, Dasav, Dazil, Deltazen lp, Denazox, Diacor, Diacordin, Dial, Diazem, Dil-sanorania, Dilaclan, Dilacor xr, Diladel, Dilatam, Dilcardia, Dilcontin, Dilcor, Dilem, Dilfar, Dilgard, Dilgina, Diliter, Dilmacor, Dilmen, Dilocard, Dilrene, Dilsal, Dilt-cd, Dilta-hexal, Diltahexal, Diltam, Diltaretard, Diltelan, Diltenk, Dilti, Dilti sr, Diltia xt, Diltiagamma, Diltiangina, Diltiastad, Diltiasyn, Diltiax, Diltiazemum, Diltiem, Diltiwas, Diltor, Diltzac, Dilzacard, Dilzem, Dilzen-g, Dilzene, Dinisor, Dipen, Doclis, Dodexen, Elvesil, Entrydil, Ergoclavin, Ergolan, Etizem, Etyzem, Evascon, Frotty, Grifodilzem, Hart, Hemarekeat, Herbesser, Hesor, Hirosutas r, Hypercard, Incoril, Iski, Kaizem cd, Kaltiazem, Korzem, Lacerol, Lanodil, Levodex, Litizem, Longazem, Lutianon r, Marumunen, Masdil, Mavitalon, Miocardie, Mono tildiem, Myonil, Nackless, Neocard, Oxycardil, Paretnamin, Pazeadin, Presoquin, Progor, Riazem, Rozen, Rubiten, Seresnatt, Slozem, Surazem, Taztia, Ternel, Tiadil, Tiazac, Tiazem, Tilazem, Tildiem, Tilhasan, Tilker, Tizem, Trumsal, Umezar, Uni masdil, Vasocardol, Viazem, Youtiazem, Zandil, Zem, Zemtard, Zildem, Zilden, Ziruvate

Dilacor-XR (Generic name - Diltiazem) Online Information

Dilacor-XR - General Information: Dilacor-XR - Pharmacology:

Possibly by deforming the channel, inhibiting ion-control gating mechanisms, and/or interfering with the release of calcium from the sarcoplasmic reticulum, dilitiazem, like verapamil, inhibits the influx of extracellular calcium across both the myocardial and vascular smooth muscle cell membranes. The resultant inhibition of the contractile processes of the myocardial smooth muscle cells leads to dilation of the coronary and systemic arteries and improved oxygen delivery to the myocardial tissue.

Dilacor-XR for patients

Take this medicine exactly as directed even if you feel well and do not notice any signs of chest pain. Do not take more of this medicine and do not take it more often than your doctor ordered. Do not miss any doses.

Diltiazem is a calcium channel blocking agent. For the calcium channel blocking agents, the following should be considered:

  • Tell your doctor if you have ever had any unusual or allergic reaction to amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, or verapamil. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
  • Calcium channel blocking agents have not been studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blocking agents cause birth defects, prolonged pregnancy, poor bone development in the offspring, and stillbirth.
  • Although bepridil, diltiazem, nifedipine, verapamil, and possibly other calcium channel blocking agents, pass into breast milk, they have not been reported to cause problems in nursing babies.
  • Although there is no specific information comparing use of this medicine in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults.
  • Elderly people may be especially sensitive to the effects of calcium channel blocking agents. This may increase the chance of side effects during treatment. A lower starting dose may be required.
  • The presence of other medical problems may affect the use of the calcium channel blocking agents. Make sure you tell your doctor if you have any other medical problems, especially
Dilacor-XR Interactions

Due to the potential for additive effects, caution and careful titration are warranted in patients receiving diltiazem hydrochloride concomitantly with other agents known to affect cardiac contractility and/or conduction. Pharmacologic studies indicate that there may be additive effects in prolonging AV conduction when using beta-blockers or digitalis concomitantly with Tiazac. As with all drugs, care should be exercised when treating patients with multiple medications. Diltiazem is both a substrate and an inhibitor of the cytochrome P-450 3A4 enzyme system. Other drugs that are specific substrates, inhibitors, or inducers of the enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem. Patients taking other drugs that are substrates of CYP450 3A4, especially patients with renal and/or hepatic impairment, may require dosage adjustment when starting or stopping concomitantly administered diltiazem in order to maintain optimum therapeutic blood levels.

Controlled and uncontrolled domestic studies suggest that concomitant use of diltiazem hydrochloride and beta-blockers is usually well tolerated, but available data are not sufficient to predict the effects of concomitant treatment in patients with left ventricular dysfunction or cardiac conduction abnormalities. Administration of diltiazem hydrochloride concomitantly with propranolol in five normal volunteers resulted in increased propranolol levels in all subjects and bioavailability of propranolol was increased approximately 50%. In vitro, propranolol appears to be displaced from its binding sites by diltiazem. If combination therapy is initiated or withdrawn in conjunction with propranolol, an adjustment in the propranolol dose may be warranted.

A study in six healthy volunteers has shown a significant increase in peak diltiazem plasma levels (58%) and AUC (53%) after a 1-week course of cimetidine 1200 mg/day and a single dose of diltiazem 60mg. Ranitidine produced smaller, nonsignificant increases. The effect may be mediated by cimetidines known inhibition of hepatic cytochrome P-450, the enzyme system responsible for the first-pass metabolism of diltiazem. Patients currently receiving diltiazem therapy should be carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine. An adjustment in the diltiazem dose may be warranted.

Administration of diltiazem hydrochloride with digoxin in 24 healthy male subjects increased plasma digoxin concentrations approximately 20%. Another investigator found no increase in digoxin levels in 12 patients with coronary artery disease. Since there have been conflicting results regarding the effect of digoxin levels, it is recommended that digoxin levels be monitored when initiating, adjusting, and discontinuing diltiazem hydrochloride therapy to avoid possible over- or under-digitalization.

The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with anesthetics may be potentiated by calcium channel blockers. When used concomitantly, anesthetics and calcium channel blockers should be titrated carefully.

A pharmacokinetic interaction between diltiazem and cyclosporine has been observed during studies involving renal and cardiac transplant patients. In renal and cardiac transplant recipients, a reduction of cyclosporine dose ranging from 15% to 48% was necessary to maintain cyclosporine trough concentrations similar to those seen prior to the addition of diltiazem. If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted, or discontinued.

The effect of cyclosporine on diltiazem plasma concentrations has not been evaluated.

Concomitant administration of diltiazem with carbamazepine has been reported to result in elevated serum levels of carbamazepine (40% to 72% increase), resulting in toxicity in some cases. Patients receiving these drugs concurrently should be monitored for a potential drug interaction.

Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3-4 fold and the Cmax by 2-fold, compared to placebo. The elimination half life of midazolam and triazolam also increased (1.5-2.5 fold) during coadministration with diltiazem. These pharmacokinetic effects seen during diltiazem coadministration can result in increased clinical effects (e.g. prolonged sodation)of both midazolam and triazolam.

In a ten-subject study, coadministration of diltiazem (120 mg bid) with lovastatin resulted in a 3-4 times increase in mean lovastatin AUC and Cmax vs. lovastatin alone; no change in pravastatin AUC and Cmax was observed during diltiazem coadministration. Diltiazem plasma levels were not significantly affected by lovastatin or pravastatin.

Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered.

Dilacor-XR Contraindications

Diltiazem is contraindicated in (1) patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker, (2) patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker, (3) patients with severe hypotension (less than 90 mm Hg systolic), (4) patients who have demonstrated hypersensitivity to the drug, and (5) patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission.

Indication, Mechanism Of Action, Food Interactions, Chemical, etc..

Other articles

Dilacor XR - patient information, description, dosage and directions

Drugs Information Online
Drugs and diseases reference index
Drugs reference index «Dilacor XR » Dilacor XR

Generic name: Diltiazem hydrochlorideBrand names: Tiazac, Dilacor XR, Cardizem CD, Cardizem LA, Cardizem SR, Cardizem

Why is Dilacor XR prescribed?

Cardizem and Cardizem CD (a controlled release form of diltiazem) are used in the treatment of angina pectoris (chest pain usually caused by lack of oxygen to the heart due to clogged arteries). Cardizem, Cardizem CD, and Cardizem LA (an extended-release, once-a-day tablet form of diltiazem) are used to control chronic stable angina (caused by exertion). Cardizem CD and Cardizem LA are also used to treat high blood pressure. Another controlled release form, Cardizem SR, is used only in the treatment of high blood pressure. Cardizem, a calcium channel blocker, dilates blood vessels and slows the heart to reduce blood pressure and the pain of angina.

Doctors sometimes prescribe Cardizem for loss of circulation in the fingers and toes (Raynaud's phenomenon), for involuntary movements (tardive dyskinesia), and to prevent heart attack.

Tiazac and Dilacor XR are used in the treatment of high blood pressure and chronic stable angina. They may be taken alone or combined with other blood pressure medications.

Most important fact about Dilacor XR

If you are taking Cardizem for high blood pressure, remember that it does not cure the problem; it merely controls it. You may need to take a blood pressure medication for the rest of your life.

If you are taking Cardizem for angina, do not stop suddenly. This can lead to an increase in your attacks.

How should you take Dilacor XR?

Cardizem should be taken before meals and at bedtime. Cardizem CD, Cardizem LA, Cardizem SR, and Dilacor XR should be swallowed whole; do not chew, crush, or divide. Tiazac capsules may be swallowed whole or opened and sprinkled on a spoonful of applesauce. Swallow the applesauce immediately, without chewing, and wash it down with a glass of cool water.

Take Dilacor XR exactly as prescribed by your doctor, even if your symptoms have disappeared.

  • If you miss a dose. If you forget to take a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and go back to your regular schedule. Never take 2 doses at the same time.
  • Storage instructions. Cardizem should be stored at room temperature; protect from moisture.
What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cardizem.

  • Side effects may include: Abnormally slow heartbeat (more common with Cardizem SR, Cardizem LA, and Cardizem CD), dizziness, fatigue, fluid retention, flushing (more common with Cardizem SR, Cardizem LA, and Cardizem CD), headache, nausea, rash, weakness
Why should Dilacor XR not be prescribed?

If you suffer from "sick sinus" syndrome or second- or third-degree heart block (various types of irregular heartbeat), you should not take diltiazem unless you have a ventricular pacemaker. Also avoid diltiazem if you've just suffered a heart attack or have lung congestion.

Do not take diltiazem if you have low blood pressure or an allergy to the drug.

Special warnings about Dilacor XR

If you have congestive heart failure or suffer from kidney or liver disease, use Cardizem with caution.

This medication may cause your heart rate to become too slow. You should check your pulse regularly.

Possible food and drug interactions when taking Dilacor XR

If Cardizem is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cardizem with the following:

Beta-blockers (heart and blood pressure drugs such as atenolol and propranolol hydrochloride)CarbamazepineCimetidineCyclosporineDigoxinLovastatinMidazolamRifampinTriazolam

Special information if you are pregnant or breastfeeding

The effects of Cardizem during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Cardizem appears in breast milk and could affect a nursing infant. If Dilacor XR is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Dilacor XR is finished.

Recommended dosage for Dilacor XR

Dosage levels are determined by each individual's needs.

The average daily dosage is between 180 milligrams and 360 milligrams, divided into 3 or 4 smaller doses.

The recommended starting dosage is 60 to 120 milligrams 2 times a day, to be increased to 240 to 360 milligrams a day.

This is a once-a-day form of Dilacor XR. For high blood pressure, starting doses range from 180 to 240 milligrams; for angina, 120 to 180 milligrams.

This is also a once-a-day drug. For high blood pressure, when used alone, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams once daily. For angina, the starting dose is 180 milligrams once daily with increases every 7 to 14 days if necessary.

This is another once-a-day drug. For high blood pressure, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams. For angina, doses start at 120 milligrams and may be increased to 480 milligrams.

The usual starting dose for high blood pressure is 120 to 240 milligrams once a day. After the drug has taken effect—in about 2 weeks—the dose can range from 120 to 540 milligrams. For angina, once-daily doses start at 120 to 180 milligrams and may be increased to 540 milligrams if necessary.

Safety and effectiveness in children have not been established.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Cardizem, seek medical attention immediately.

  • The symptoms of Cardizem overdose may include: Fainting, dizziness, and irregular pulse, heart failure, low blood pressure, very slow heartbeat
  • Dilacor XR Advanced Consumer (Micromedex) - Includes Dosage Information
  • Dilacor XR 24-Hour Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
  • Dilacor XR Prescribing Information (FDA)
  • Diltiazem Prescribing Information (FDA)
  • Cardizem Consumer Overview
  • Cardizem Prescribing Information (FDA)
  • Cardizem MedFacts Consumer Leaflet (Wolters Kluwer)
  • Cardizem CD Prescribing Information (FDA)
  • Cardizem CD 24-Hour Sustained-Release Beads Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
  • Cardizem LA Prescribing Information (FDA)
  • Cardizem LA 24-Hour Extended-Release Beads Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
  • Cartia XT Prescribing Information (FDA)
  • Diltia XT Prescribing Information (FDA)
  • Taztia XT Prescribing Information (FDA)
  • Taztia XT 24-Hour Extended-Release Beads Capsules MedFacts Consumer Leaflet (Wolters Kluwer)
  • Tiazac Prescribing Information (FDA)
  • Tiazac Consumer Overview

Dilacor XR Dilacor XR

Dilacor XR

Generic name: Diltiazem hydrochloride
Brand names: Tiazac, Dilacor XR, Cardizem SR, Cardizem LA, Cardizem CD, Cardizem

Why is Dilacor XR prescribed?

Dilacor XR and Dilacor XR CD (a controlled release form of diltiazem) are used in the treatment of angina pectoris (chest pain usually caused by lack of oxygen to the heart due to clogged arteries). Dilacor XR, Dilacor XR CD, and Dilacor XR LA (an extended-release, once-a-day tablet form of diltiazem) are used to control chronic stable angina (caused by exertion). Dilacor XR CD and Dilacor XR LA are also used to treat high blood pressure. Another controlled release form, Dilacor XR SR, is used only in the treatment of high blood pressure. Dilacor XR, a calcium channel blocker, dilates blood vessels and slows the heart to reduce blood pressure and the pain of angina.

Doctors sometimes prescribe Dilacor XR for loss of circulation in the fingers and toes (Raynaud"s phenomenon), for involuntary movements (tardive dyskinesia), and to prevent heart attack.

Tiazac and Dilacor XR are used in the treatment of high blood pressure and chronic stable angina. They may be taken alone or combined with other blood pressure medications.

Most important fact about Dilacor XR

If you are taking Dilacor XR for high blood pressure, remember that it does not cure the problem; it merely controls it. You may need to take a blood pressure medication for the rest of your life.

If you are taking Dilacor XR for angina, do not stop suddenly. This can lead to an increase in your attacks.

How should you take Dilacor XR?

Dilacor XR should be taken before meals and at bedtime. Dilacor XR CD, Dilacor XR LA, Dilacor XR SR, and Dilacor XR should be swallowed whole; do not chew, crush, or divide. Tiazac capsules may be swallowed whole or opened and sprinkled on a spoonful of applesauce. Swallow the applesauce immediately, without chewing, and wash it down with a glass of cool water.

Take Dilacor XR exactly as prescribed by your doctor, even if your symptoms have disappeared.

--If you miss a dose.

If you forget to take a dose, take it as soon as you remember. If it"s almost time for your next dose, skip the missed dose and go back to your regular schedule. Never take 2 doses at the same time.

Dilacor XR should be stored at room temperature; protect from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Dilacor XR.

  • More common side effects may include:
    Abnormally slow heartbeat (more common with Dilacor XR SR, Dilacor XR LA, and Dilacor XR CD), dizziness, fatigue, fluid retention, flushing (more common with Dilacor XR SR, Dilacor XR LA, and Dilacor XR CD), headache, nausea, rash, weakness
Why should Dilacor XR not be prescribed?

If you suffer from "sick sinus" syndrome or second- or third-degree heart block (various types of irregular heartbeat), you should not take diltiazem unless you have a ventricular pacemaker. Also avoid diltiazem if you"ve just suffered a heart attack or have lung congestion.

Do not take diltiazem if you have low blood pressure or an allergy to the drug.

Special warnings about Dilacor XR

If you have congestive heart failure or suffer from kidney or liver disease, use Dilacor XR with caution.

This medication may cause your heart rate to become too slow. You should check your pulse regularly.

Possible food and drug interactions when taking Dilacor XR

If Dilacor XR is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Dilacor XR with the following:

Beta-blockers (heart and blood pressure drugs such as Tenormin and Inderal)
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Cyclosporine (Sandimmune, Neoral)
Digoxin (Lanoxin)
Lovastatin (Mevacor)
Midazolam (Versed)
Rifampin (Rifadin)
Triazolam (Halcion)

Special information if you are pregnant or breastfeeding

The effects of Dilacor XR during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Dilacor XR appears in breast milk and could affect a nursing infant. If Dilacor XR is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Dilacor XR is finished.

Recommended dosage

Dosage levels are determined by each individual"s needs.

The average daily dosage is between 180 milligrams and 360 milligrams, divided into 3 or 4 smaller doses.

The recommended starting dosage is 60 to 120 milligrams 2 times a day, to be increased to 240 to 360 milligrams a day.

This is a once-a-day form of Dilacor XR. For high blood pressure, starting doses range from 180 to 240 milligrams; for angina, 120 to 180 milligrams.

This is also a once-a-day drug. For high blood pressure, when used alone, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams once daily. For angina, the starting dose is 180 milligrams once daily with increases every 7 to 14 days if necessary.

This is another once-a-day drug. For high blood pressure, doses start at 180 to 240 milligrams and may be increased to as much as 540 milligrams. For angina, doses start at 120 milligrams and may be increased to 480 milligrams.

The usual starting dose for high blood pressure is 120 to 240 milligrams once a day. After the drug has taken effect--in about 2 weeks--the dose can range from 120 to 540 milligrams. For angina, once-daily doses start at 120 to 180 milligrams and may be increased to 540 milligrams if necessary.

Safety and effectiveness in children have not been established.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Dilacor XR, seek medical attention immediately.

  • The symptoms of Dilacor XR overdose may include:
    Fainting, dizziness, and irregular pulse, heart failure, low blood pressure, very slow heartbeat

Where can I get more information about Dilacor XR Dilacor XR. We recommend to use www.Drugs.com
Typical mistypes for Dilacor XR Dilacor XR
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Dilacor XR (Diltiazem) - Drug Info, Side Effects, Research, Clinical Trials

Dilacor XR (Diltiazem Hydrochloride) - Summary DILACOR XR SUMMARY

DILACOR XR® (diltiazem hydrochloride, USP) is a calcium ion influx inhibitor (slow channel blocker or calcium antagonist).

Dilacor XR capsules are indicated for the treatment of hypertension. Diltiazem hydrochloride may be used alone or in combination with other antihypertensive medications, such as diuretics.

Dilacor XR capsules are indicated for the management of chronic stable angina.

NEWS HIGHLIGHTS Published Studies Related to Dilacor XR (Diltiazem)

Effects of diltiazem on pharmacokinetics of tacrolimus in relation to CYP3A5 genotype status in renal recipients: from retrospective to prospective. [2011.08]
The impact of CYP3A5*3, a CYP3A5 nonexpresser genotype, on inhibitory effects of diltiazem on tacrolimus metabolism has not been assessed. In retrospective study, when coadministered with diltiazem, mean increments in dose-adjusted C(0D7), C(max) and AUC(0-12 h) for tacrolimus were larger in CYP3A5 expressers than in CYP3A5 nonexpressers (48.7 vs 3.7%, 31.7 vs 17.2% and 38.2 vs 18.5%, respectively).

A randomized, prospective, double-blind, placebo-controlled trial of the effect of topical diltiazem on posthaemorrhoidectomy pain. [2011.03]
CONCLUSION: Perianal application of DTZ cream after haemorrhoidectomy significantly reduces postoperative pain and is perceived as beneficial, with no increase in associated morbidity. (c) 2011 The Authors. Colorectal Disease (c) 2011 The Association of Coloproctology of Great Britain and Ireland.

[A comparative study on the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate of patients with atrial fibrillation during anesthesia period]. [2010.11]
OBJECTIVE: To evaluate the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate in patients with atrial fibrillation (AF) during anesthesia period. CONCLUSIONS: Intravenous esmolol, amiodarone and diltiazem are all equally effective and safe on controlling rapid ventricular rate in patients with atrial fibrillation during the anesthesia period. Esmolol use is associated with the shortest mean reacting time and amiodarone use is associated with the lowest total side effect rate in this patient cohort.

Comparison of the effects of long-acting nifedipine CR and diltiazem R in patients with vasospastic angina: Aomori coronary spastic angina study. [2010.11]
CONCLUSION: Once-daily administration of nifedipine CR was as effective as twice-daily diltiazem R in the prevention of VSA attacks. Copyright (c) 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Clinical Trials Related to Dilacor XR (Diltiazem)

Drug-Drug Interaction Study Between Colchicine and Diltiazem ER [Completed]
Colchicine is a substrate for both cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp). Extended-release diltiazem (diltiazem ER) is a potent inhibitor of both CYP3A4 and P-gp. This study will evaluate the effect of multiple doses of diltiazem ER on the pharmacokinetic profile of a single 0. 6 mg dose of colchicine. A secondary objective is to evaluate the safety and tolerability of this regimen in healthy volunteers. All study subjects will be monitored for adverse events throughout the study period.

Treatment of Preclinical Hypertrophic Cardiomyopathy With Diltiazem [Completed]
This is a pilot clinical trial to assess whether the administration of diltiazem may be able to decrease the development or progression of hypertrophic cardiomyopathy (HCM). Diltiazem is a commonly used medication for the treatment of high blood pressure and studies on animals with HCM suggest that diltiazem decreases disease development. This study specifically targets individuals in the "prehypertrophic" phase of HCM-- those with documented sarcomere gene mutations without echocardiographic or EKG evidence of LVH, and therefore without a clinical diagnosis of HCM. The hypothesis of this study is that starting diltiazem administration early in life (in the prehypertrophic phase) will decrease the progression of HCM in individuals with sarcomere gene mutations. This will be assessed by looking at an improvement in the heart's ability to relax using echocardiography, as well as exploratory analyses of a broad range of features reflecting the heart's structure and function.

Ischaemia-r�perfusion During the Coronary Surgery With Beating Heart [Active, not recruiting]
Less oxidative stress occurs during off-pump than on-pump coronary artery bypass graft (CABG) surgery but warm ischaemia-reperfusion injury may occur following transient coronary artery clamping. The aim of this study was to compare the preventive effects of diltiazem and N-acetylcysteine (NAC), alone or in combination, on biomarkers of myocardial damage and oxidative stress during off-pump CABG surgery.

Randomized Trial Comparing Diltiazem and Metoprolol For Atrial Fibrillation Rate Control [Recruiting]
Atrial Fibrillation and atrial flutter (AF/FL) is the usually irregular beating of the heart and is a rapidly growing cause of hospitalization. Between 1993 to 2007 AF/FL hospitalizations have increased 203% compared to a 71% increase for all hospitalizations. Changing procedure management such as ablation, transesophageal have had a minimal impact on the trends and there is a need to evaluate Emergency Department (ED) management options of AF/FL that may decrease hospitalizations. The most commonly used medications to control heart rate are metoprolol (MET), a beta blocker, or diltiazem (DT), a calcium channel blocker. Beta blockers are medications that cause the heart to beat more slowly and with less force. DT also helps blood vessels open up to improve blood flow. Both DT and MET are used alone or together with other medicines to treat severe chest pain (angina), high blood pressure (hypertension) or rapid heartbeat. Both are equally acceptable according to recent guidelines for AF/FL. There are limited studies comparing MET to DT for rate control for AF/FL. The initial goal for AF/FL management in the Emergency Department is usually rate control. The most commonly used rate control medications are metoprolol (MET), a beta blocker, or diltiazem (DT) a calcium blocker. Three major guidelines, including the American College of Cardiology (ACC) and the American Heart Association (AHA) indicate beta blockers and DT are equally acceptable medications for rate control in AF (3,4,5) assuming no contraindications. There are limited studies comparing beta blockers (BB) to DT for rate control for AF: 1. Demircan, et. al. compared bolus intravenous BB and DT in 40 patients over a 20 minute period. No follow-up information after 20 minutes was reported. No attempt was made to look at intermediate or long term results. No patients converted to normal sinus rhythm over this short treatment period and there was slightly more rate decrease at 20 minutes, with DT versus BB (6). 2. Time from medication administration to heart rate and rhythm control. Additionally, currently guidelines consider BB or DT medications to slow AF/FL; however, there are some suggestions that BB may not only slow heart rate in AF/FL (as does DT) but also increase all AF/FL conversion from AF/FL to normal sinus rhythm(2), and aid in maintaining normal sinus rhythm (NSR) after cardioversion (10). With recent onset AF/FL occurring within 48 hours prior to the arrival to the ED, approximately 50% of AF/FL patients convert to normal rhythm spontaneously within 24 hours after arrival to the ED (6), making evaluation of current limited studies difficult. Thus, the investigators wish to examine the effect of initial medication strategy on time to NSR in a larger sample than has been previously performed. 3. A randomized study of 48 patients in China reported significantly slower heart rate up to 20 minutes with DT 10mg IV versus metoprolol 5mg IV but not after 30 minutes (7). 4. A retrospective study of post-operative coronary bypass patients showed the intravenous administration of the BB, esmolol, to be more effective than DT for rate control and conversion of AF/FL (8). 5. Hassan et al reported no difference in conversion to regular rhythm with esmolol verses DT in a small, under powered, randomized study of fifty ED patients (9). Conversion to sinus rhythm occurred in 10 patients (42%) in the DT group compared with 10 patients (39%) in the esmolol group (P = 1. 0). There were no statistically significant differences in heart rate between the two medications at 1, 6, 12, and 24 hours after initiation of esmolol or DT infusion. Examples of such well quoted strategy trials are the COURAGE trial published in the New England Journal of Medicine and the PROMISE Trial, a worldwide multi-centered study that is nearing completion goal of 10,000 patients of which, Charleston Area Medical Center (CAMC) has enrolled approximately 100 patients. In this trial, patients being evaluated for chest pain will be randomized to two treatment strategies and subsequent outcomes will be recorded. Strategy trials do not attempt to manage treatment after an initial management strategy has been determined by randomization, but, whether the initial treatment affects long-term outcomes. This will be a prospective, randomized study comparing the outcomes of a strategy using either MET or DT in patients with AF presenting to the Charleston Area Medical Center (CAMC) ED. After presentation and receiving consent, the patient will be randomized to receive either MET or DT.

Dilacor XR oral: Uses, Side Effects, Interactions, Pictures, Warnings - Dosing

Dilacor XR Uses

Diltiazem is used to treat high blood pressure (hypertension ) and prevent chest pain (angina ). Lowering high blood pressure helps prevent strokes, heart attacks. and kidney problems. When used regularly, diltiazem can decrease the number and severity of episodes of chest pain from angina. It may help increase your ability to exercise .

Diltiazem is called a calcium channel blocker. It works by relaxing blood vessels in the body and heart so blood can flow more easily. Diltiazem also lowers your heart rate. These effects help the heart work less hard and lower blood pressure .

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Diltiazem may also be used to control your heart rate if you have a fast/irregular heartbeat (such as atrial fibrillation ).

How to use Dilacor XR

Take this medication by mouth without food, usually once daily before breakfast or as directed by your doctor. Swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once and may increase your risk of side effects.

Your doctor may gradually increase your dose. Follow your doctor's instructions carefully. The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. For the treatment of high blood pressure, it may take 2 weeks before you get the full benefit of this drug.

This medication must be taken regularly to prevent angina. It should not be used to treat angina when it occurs. Use other medications (such as nitroglycerin placed under the tongue ) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Tell your doctor if your condition worsens (for example, your chest pain worsens or your routine blood pressure readings increase).

Side Effects

Dizziness. lightheadedness, weakness. nausea, flushing, constipation. and headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To lower the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, slow/irregular/pounding/fast heartbeat, swelling ankles/feet, shortness of breath, unusual tiredness, unexplained/sudden weight gain, mental/mood changes (such as depression, agitation), unusual dreams, severe stomach/abdominal pain, severe constipation, dark urine, persistent nausea/vomiting, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking diltiazem, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as sick sinus syndrome/atrioventricular block), liver disease, kidney disease, heart failure, narrowing of any part of the stomach/intestines.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Older adults may be more sensitive to the side effects of this drug, especially dizziness, constipation, or swelling ankles/feet.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: amiodarone, digoxin, fingolimod.

Other medications can affect the removal of diltiazem from your body, which may affect how this medication works. Examples include cimetidine, quinidine, St. John's wort, azole antifungals such as ketoconazole, macrolide antibiotics such as erythromycin, rifamycins including rifabutin and rifampin.

Diltiazem may also affect how your body gets rid of many drugs (such as aprepitant/fosaprepitant, buspirone, cyclosporine, ivabradine, certain anti-seizure drugs including carbamazepine, certain benzodiazepines including triazolam and midazolam).

Check the labels on all your medicines (such as cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction) because they may contain ingredients that could increase your blood pressure or heart rate (such as pseudoephedrine, phenylephrine, ibuprofen, naproxen). Ask your pharmacist about using these products safely.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests (such as kidney/liver function tests, pulse, blood pressure, EKG) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

There are different brands and types of this medication available. Many do not have the same effects. Do not change brands or types without consulting your doctor or pharmacist.

Have your blood pressure checked regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medication away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Information last revised December 2015. Copyright(c) 2015 First Databank, Inc.

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Cardizem (Dilacor xr) Delivery

Residents of the USA can order Cardizem (Dilacor xr) to any city, to any address, for example to Phoenix, Mesa, Columbus or Wilmington. You can order delivery of a Cardizem (Dilacor xr) to the Italy, Puerto Rico, Netherlands or any other country in the world.