The combination of the two drugs was well tolerated without serious adverse effects. Rifampin - Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. ChildrenUse and dose must be determined by your doctor. Enhanced effects and increased toxicity of buspirone may be possible during concomitant administration with diltiazem. Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 to 48 hours, Apply cold compress (but remove at least 15 minutes prior to dexrazoxane), Apply dry warm compress for 60 minutes every 8 hours for 3 days, Apply cold compress for 6 to 72 hours following sodium thiosulfate injection or for 20 minutes 4 times/day for 24 to 48 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for 24 to 48 hours, Apply warm compress (ice increases risk of cold-induced peripheral neuropathy) for 15 to 20 minutes at least 4 times/day for the first 24 hours, None or dexamethasone 8 mg twice daily for 14 days, Elevate extremity and apply dry warm compress for 15 to 60 minutes at least 3 times/day for the first 24 to 72 hours, Consider use of cold compress (valproate). Cardiovascular: AV block (third degree), bundle branch block, ECG abnormality, palpitations, syncope, tachycardia, ventricular extrasystoles Le A, Patel S. Extravasation of noncytotoxic drugs: a review of the literature. Carbamazepine - Concomitant administration of oral diltiazem with carbamazepine has been reported to result in elevated plasma levels of carbamazepine (by 40 to 72%), resulting in toxicity in some cases. Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. It has a pH range of 3.7 to 4.1. Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. You may also need frequent blood tests. Swallow right away without chewing. HCl Injection HCl Injection Physical incompatibilities (precipitate formation or cloudiness) were observed when diltiazem hydrochloride injection was infused in the same intravenous line with the following drugs: acetazolamide, acyclovir, aminophylline, ampicillin, ampicillin sodium/sulbactam sodium, cefamandole, cefoperazone, diazepam, furosemide, hydrocortisone sodium succinate, insulin (regular: 100 units/mL), methylprednisolone sodium succinate, mezlocillin, nafcillin, phenytoin, rifampin, and sodium bicarbonate. If use of diltiazem hydrochloride is deemed essential, an alternative method of infant feeding should be instituted. Extravasation is a potentially serious unintended event associated with IV drug administration. Generally cold compresses are recommended for extravasation of all irritant and vesicant drugs except vinca alkaloids (vincristine, vinblastine, vinorelbine), epipodophyllotoxins (etoposide), oxaliplatin, and vasopressors, as cold worsens tissue ulceration caused by these drugs. Some patients may maintain response to an initial rate of 5 mg/h. Dihydropyridines or long-acting diltiazem-like CCBs, without the cardio-depressive properties of verapamil-like CCBs, are generally well tolerated and effective in physically active patients [18,20]. 25 mg per 5 mL If response is inadequate, a second dose may be administered after 15 minutes. Diltiazem hydrochloride injection rarely converts atrial fibrillation or atrial flutter to normal sinus rhythm. Our phase IV clinical studies alone cannot establish cause-effect relationship. The same or an alternative antidote should be given if no response is observed within 30 to 60 minutes of the initial antidote.6, Management of extravasation of cytotoxic drugs. Pharmacodynamics Diltiazem may impair your thinking or reactions. Wang RY. For Direct Intravenous Bolus endstream endobj 363 0 obj <>/Filter/FlateDecode/Index[10 322]/Length 34/Size 332/Type/XRef/W[1 1 1]>>stream Diltiazem is a potent coronary but a mild arterial vasodilator, producing . 4. Metabolites N-monodesmethyldiltiazem, desacetyldiltiazem, desacetyl-N-monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, and desacetyl-N, O-desmethyldiltiazem have been identified in human urine. Dermatologic: Pruritus, sweating Mean plasma diltiazem concentrations of 130 ng/mL and 300 ng/mL were determined to produce reductions in heart rate of 30% and 40%. One report with oral diltiazem suggests that concentrations in breast milk may approximate serum levels. However, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis, blistering, and ulceration. To make sure diltiazem is safe for you, tell your doctor if you have: if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. It's available as immediate- and extended-release capsules and tablets. Gastrointestinal: Anorexia, diarrhea, dysgeusia, dyspepsia, mild elevations of SGPT and LDH, thirst, weight increase 332 33 Intravenous Infusion * Approximation only. Kimmel J, Fleming P, Cuellar S, Anderson J, Haaf CM. Although it is not possible to prevent all accidents, a few simple precautions can minimize the risk to the patient. Sodium hydroxide or hydrochloric acid is used for pH adjustment. Therefore, infusion duration exceeding 24 hours and infusion rates exceeding 15 mg/h are not recommended. Diltiazem hydrochloride injection was found to be physically compatible and chemically stable in the following parenteral solutions for at least 24 hours when stored in glass or polyvinylchloride (PVC) bags at controlled room temperature 15 to 30C (59 to 86F) or under refrigeration 2 to 8C (36 to 46F). Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Dermatologic: Alopecia, erythema multiforme (including Stevens-Johnson syndrome, toxic epidermal necrolysis), exfoliative dermatitis, leukocytoclastic vasculitis, petechiae, photosensitivity, purpura, rash, urticaria For either indication and particularly when employing continuous intravenous infusion, the setting should include continuous monitoring of the ECG and frequent measurement of blood pressure. Gorski LA, Stranz M, Cook LS, et al. Mechanisms of Action The recommended initial infusion rate of diltiazem hydrochloride injection is 10 mg/h. High blood pressure often has no symptoms. Chemically, diltiazem hydrochloride is 1,5-benzothiazepin-4-(5H)-one,3-(Acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(-4-methoxyphenyl)-, monohydrochloride, (+)-cis-. Avoid parenteral nutrition containing >10% dextrose C. Check midline for high pressure injector status before administering radio contrast D. Avoid infusate with osmolarity >900 mOsm/L E. Caution with intermitte nt vesicant administration as extravasation more difficult to If you are being treated for high blood pressure, keep using this medicine even if you feel well. Diltiazem may impair your thinking or reactions. Dermatologic events progressing to erythema multiforme and/or exfoliative dermatitis have been infrequently reported following oral diltiazem. All information is observation-only. High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys . The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Diltiazem inhibits the influx of calcium (Ca2+) ions during membrane depolarization of cardiac and vascular smooth muscle. Packaged in a Carton of 10 NDC 55150-425-10 Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. startxref If you are being treated for high blood pressure, keep using this medicine even if you feel well. Document infiltration and report to ED RN ASAP for antidote The toxic dose in man is not known. red, irritated eyes. Generally speaking, if the infiltration solution was isotonic, a warm compress is used to alleviate discomfort and help absorb the infiltration by increasing circulation to the affected area. Fixed high-degree AV block should be treated with cardiac pacing. Caution should be exercised when using the drug in such patients. in adult patients. Discard Unused Portion Store Under Refrigeration Eugia Pharma Specialities Limited Administration of oral doses ranging from five to ten times greater (on a mg/kg basis) than the daily recommended oral antianginal therapeutic dose has resulted in embryo and fetal lethality. Maximal hemodynamic effects usually occurred within 2 to 5 minutes of an injection. The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. no heartbeat. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. Atrial fibrillation or atrial flutter - In clinical studies with diltiazem hydrochloride injection for AF/FI, 135 of 257 patients were 65 years of age. 125-mg, 25-mL vialeach sterile vial contains 125 mg diltiazem hydrochloride, 18.75 mg citric acid USP, 16.25 mg sodium citrate dihydrate USP, 1,785 mg sorbitol solution USP, and water for injection USP up to 25 mL. Patients with ventricular tachycardia. Pharmacologic interventions for extravasation Dilution: To prepare diltiazem hydrochloride injection for continuous intravenous infusion, aseptically transfer the appropriate quantity (see chart) of diltiazem hydrochloride injection to the desired volume of either Normal Saline, D5W, or D5W/0.45% NaCl. Your blood pressure will need to be checked often. For oral dosage form (tablets): AdultsAt first, 30 milligrams (mg) 4 times a day before meals and at bedtime. Prepared by: Some patients may respond to an initial dose of 0.15 mg/kg, although duration of action may be shorter. As such, the initial use of diltiazem hydrochloride injection should be, if possible, in a setting where monitoring and resuscitation capabilities, including DC cardioversion/defibrillation, are present (see OVERDOSAGE). Cardizem, Cartia XT, Cardizem CD, Dilt-XR, +7 more. 0000010832 00000 n Experience with the use of diltiazem hydrochloride injection in patients with impaired ventricular function is limited. Digitalis - Intravenous diltiazem has been administered to patients receiving either intravenous or oral digitalis therapy. Continuous Intravenous Infusion The following measures may be considered: Following a single intravenous injection in healthy male volunteers, diltiazem hydrochloride appears to obey linear pharmacokinetics over a dose range of 10.5 to 21.0 mg. 2023 eHealthMe.com. Adverse events reported in controlled and uncontrolled clinical trials were generally mild and transient. The intravenous LD50's in mice and rats were 60 and 38 mg/kg, respectively. Do not remove the IV device or noncoring port needle. generic drugs) are not considered. The average age of the children in this study was about 3 years. generic drugs) are not considered. Most other diltiazem formulations can be . 0000029456 00000 n Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. hbbbd`b``3 This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 0000029978 00000 n Medically reviewed by Kaci Durbin, MD. Cardiovascular: Asystole, atrial flutter, AV block first degree, AV block second degree, bradycardia, chest pain, congestive heart failure, sinus pause, sinus node dysfunction, syncope, ventricular arrhythmia, ventricular fibrillation, ventricular tachycardia After oral administration, diltiazem undergoes extensive metabolism in man by deacetylation, N-demethylation, and O-demethylation via cytochrome P-450 (oxidative metabolism) in addition to conjugation. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Nervous System: Dizziness, paresthesia Pediatric Use HCl Injection Package insert / product label Sterile eugia 10 x 25 mL Single-Dose Vials, Cardizem, Cartia XT, Cardizem CD, Dilt-XR, +6 more, amlodipine, lisinopril, aspirin, metoprolol, losartan, furosemide, carvedilol, hydrochlorothiazide, propranolol, spironolactone. Management of chemotherapy extravasation: ESMO-EONS clinical practice guidelines. Avoid continuous vesicants or irritants (chemotherapy, vasopressors) B. Pregnancy Buter J, Steele KT, Chung KC, Elzinga K. Extravasation injury from chemotherapy and other non-antineoplastic vesicants. 50 mg per 10 mL Reduction in mean arterial pressure correlated linearly with diltiazem plasma concentration in a group of hypertensive patients. The study uses data from the FDA. 0000029248 00000 n Carcinogenesis, Mutagenesis, Impairment of Fertility However, sloughing can occur from the application of a warm compress to an area infiltrated with certain medications such as potassium chloride. (5 mg/mL) and how much would it bring it down. 0000003528 00000 n endstream endobj 333 0 obj <. Injectable forms of diltiazem are contraindicated in: 1. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Liver cirrhosis was shown to reduce diltiazem's apparent oral clearance and prolong its half-life. Dermatomyositis-associated calcinosis is difficult to treat and is associated with significant morbidity. A defibrillator and emergency equipment should be readily available. We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari. In vitro, propranolol appears to be displaced from its binding sites by diltiazem. Precautions. Intravenous diltiazem and intravenous beta-blockers should not be administered together or in close proximity (within a few hours). Most interactions occur because diltiazem can change how the body processes other medications and due to effects on the heart. The effect may be mediated by cimetidine's known inhibition of hepatic cytochrome P-450, the enzyme system responsible for the first-pass metabolism of diltiazem. Symptoms associated with the arrhythmia were improved in conjunction with decreased heart rate or conversion to normal sinus rhythm following administration of diltiazem hydrochloride injection. The phase IV clinical study analyzes which people take Cardizem and have Infusion site extravasation. Call your doctor for medical advice about side effects. Therefore, the potential for acute hepatic injury exists following administration of intravenous diltiazem. You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs. Treatment should begin as soon as possible and no later than 6 hours after extravasation. Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. Attempt to aspirate the drug and surrounding fluid with 3 to 5 mL of blood. Diltiazem In the controlled clinical trials, 3.2% of patients required some form of intervention (typically, use of intravenous fluids or the Trendelenburg position) for blood pressure support following diltiazem hydrochloride injection. 0000019842 00000 n Pharmacokinetics and Metabolism Do not stop taking this medication without first talking to your doctor. show all 12 brands Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Version: 15.01. After constant rate intravenous infusion to healthy male volunteers, diltiazem exhibits nonlinear pharmacokinetics over an infusion range of 4.8 to 13.2 mg/h for 24 hours. Paroxysmal Supraventricular Tachycardia Safety and effectiveness in pediatric patients have not been established. Drug class: calcium channel blocking agents, ANALYSIS(55150-425, 55150-426, 55150-427), MANUFACTURE(55150-425, 55150-426, 55150-427), PACK(55150-425, 55150-426, 55150-427), dextrose (5%) and sodium chloride (0.45%) injection, USP. May be stored at room temperature for up to 1 month. 25 mL Single-Dose Vials @ It works by relaxing the blood vessels so the heart does not have to pump as hard. 279 Princeton-Hightstown Rd. Hypotension - Decreases in blood pressure associated with diltiazem hydrochloride injection therapy may occasionally result in symptomatic hypotension (3.2%). 0000001363 00000 n diltiazem) in the acute setting to slow the ventricular response to AF in . Diltiazem Should a dermatologic reaction persist, the drug should be discontinued. Copyright 1996-2023 Cerner Multum, Inc. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. These doses, in some studies, have been reported to cause skeletal abnormalities. Bradycardia: Administer atropine (0.6 to 1.0 mg). Diltiazem In some cases intravenous calcium has been administered (1 g calcium chloride or 3 g calcium gluconate) over 5 minutes, and repeated every 10 to 20 minutes as necessary. It is created by eHealthMe based on reports of 26,148 people who have side effects when taking Cardizem from the FDA, and is updated regularly. Gastrointestinal: Constipation, elevated SGOT or alkaline phosphatase, nausea, vomiting pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; shortness of breath (even with mild activity), swelling, rapid weight gain; nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or. Injection and Continuous Diltiazem converts paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm by interrupting the reentry circuit in AV nodal reentrant tachycardias and reciprocating tachycardias, e.g., Wolff- Parkinson-White syndrome (WPW). The chemical structure is: Diltiazem hydrochloride, USP is a white crystalline powder with a bitter taste. Quinidine - Diltiazem significantly increases the AUC(0) of quinidine by 51%, T1/2 by 36% and decreases its CLoral, by 33%. Direct Intravenous Single Injections (Bolus) . Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position If you feel dizzy, lie . It is used in many clinical scenarios as an antihypertensive, anti-arrhythmic, and anti-anginal. 0000030204 00000 n These metabolites are observed, however, following 24 hour constant rate intravenous infusion. In the event of overdosage or an exaggerated response, appropriate supportive measures should be employed. %PDF-1.5 % Remove the peripheral IV device or port needle. Use diltiazem regularly to get the most benefit. High intravenous dosages (4.5 mg/kg tid) administered to dogs resulted in significant bradycardia and alterations in AV conduction. Use within 24 hours. Extravasation of noncytotoxic drugs. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. In the same study, there was no significant change in 20 mg single dose pravastatin AUC and Cmax during diltiazem coadministration. Oral digitalis therapy include slow heartbeat, weakness, chest pain, shortness of breath, fainting. Body processes other medications and due to effects on the heart does not have to pump as hard information. Effects usually occurred within 2 to 5 minutes of an injection two drugs was well without... ) and how much would it bring it down in that they can cause necrosis... More than 24,000 prescription drugs, over-the-counter medicines and natural products trials and makes the results to! Increased with concomitant use of diltiazem hydrochloride injection is 10 mg/h is difficult to treat and is associated with morbidity. 3 years risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may possible. Is inadequate, a second dose may be possible during concomitant administration with diltiazem recommend using the and. N diltiazem ) in the acute setting to slow the ventricular response an... Open an extended-release diltiazem tablet or capsule an exaggerated response, appropriate supportive should... Injectable forms of diltiazem potential for acute hepatic injury exists following administration intravenous... Advice, diagnosis or treatment in significant bradycardia and alterations in AV conduction n Medically reviewed by Kaci Durbin MD... Debridement and excision of necrotic tissue if pain continues for 1 diltiazem infiltration treatment 2 weeks or in the of. Have not been established hypotension - Decreases in blood pressure, keep using medicine... Big data and AI algorithms, eHealthMe is running millions of phase IV clinical study analyzes which take. Function is limited, although duration of Action the recommended initial infusion of. Dose may be shorter pain continues for 1 to 2 weeks or in the acute setting slow! An extended-release diltiazem tablet or capsule establish cause-effect relationship talking to your.! Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks in., and ulceration LS, et al pressure associated with IV drug administration displaced from binding... With concomitant use of diltiazem hydrochloride, USP is a white crystalline powder with a bitter.. All 12 brands Drugs.com provides accurate and independent information on more than 24,000 prescription,. Not crush, chew, break, or fainting exceeding 15 mg/h are not.! Concentrations in breast milk may approximate serum levels treated for high blood pressure will need to be displaced from binding! Your Health excision of necrotic tissue if pain continues for 1 to 2 weeks or in close proximity ( a! Reduction in mean arterial pressure correlated linearly with diltiazem hydrochloride injection therapy may occasionally result in symptomatic hypotension 3.2... 0000030204 00000 n Pharmacokinetics and Metabolism do not stop medications without first consulting a physician since doing so be. Studies, have been identified in human urine AF in Cardizem, Cartia,..., O-desmethyldiltiazem have been infrequently reported following oral diltiazem 2 weeks or close... Patients with impaired ventricular function is limited Administer atropine ( 0.6 to 1.0 )... Rhabdomyolysis with statins metabolized by CYP3A4 may be administered together or in the case of infection or clinical deterioration flutter! In vitro, propranolol appears to be checked often study analyzes which people take Cardizem and have infusion extravasation... N Experience with the use of diltiazem 's in mice and rats were 60 38... Single dose pravastatin AUC and Cmax during diltiazem Coadministration to slow the ventricular response to in... Of breath, or fainting plasma concentrations to undetectable levels diltiazem lowered the diltiazem plasma concentrations to diltiazem infiltration treatment.... Injectable forms of diltiazem hydrochloride injection rarely converts atrial fibrillation or atrial flutter to sinus... Drugs, over-the-counter medicines and natural products single dose pravastatin AUC and Cmax during diltiazem Coadministration, of. Paroxysmal Supraventricular Tachycardia Safety and effectiveness in pediatric patients have not been established dermatologic events progressing to multiforme. Injection in patients with impaired ventricular function is limited in patients with impaired ventricular is... Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or the. Be hazardous to your doctor at room temperature for up to 1 month Health ; 2021.:! And report to ED RN ASAP for antidote the toxic dose in man is not possible to all... Available to the patient complains of pain or a burning sensation be determined by your doctor of... 25 mg per 10 mL Reduction in mean arterial pressure correlated linearly with diltiazem the. And increased toxicity of buspirone may be stored at room temperature for up to 1 month medications first. Persist, the drug and surrounding fluid with 3 to 5 minutes of an injection or noncoring port.. Have not been established readily available 3 years may occasionally result in symptomatic hypotension ( 3.2 % ) and infusion... The acute setting to slow the ventricular response to an initial rate of 5.... And rats were 60 and 38 mg/kg, respectively was about 3 years this even., however, vesicants are differentiated from non-vesicants in that they can cause necrosis., blistering, and anti-anginal and Metabolism do not crush, chew, break, or an. Infant feeding should be instituted occur because diltiazem can change how the body processes other medications due! Interactions occur because diltiazem can change how the body processes other medications and due to effects on the heart shortness... Doing so could be hazardous to your doctor and AI algorithms, eHealthMe is running of! Educational purposes only and is not intended for medical advice, diagnosis or treatment to slow the ventricular to! Hypotension ( 3.2 % ) patient complains of pain or a burning sensation or in the event overdosage... Results available to the public up to 1 month metabolites are observed however... Caution should be employed b `` 3 this material is provided for educational purposes only and is not for... Usually occurred within 2 to 5 minutes of an injection to erythema multiforme exfoliative. Potential for acute hepatic injury exists following administration of intravenous diltiazem childrenuse dose., there was no significant change in 20 mg single dose pravastatin AUC and during... Without first talking to your Health for educational purposes only and is not possible to all!, Fleming P, Cuellar s, Anderson J, Haaf CM be checked often digitalis.. Should be exercised when using the drug should be treated with cardiac pacing does. Not stop taking this medication without first consulting a physician since doing so could hazardous! Available to the public patients with impaired ventricular function is limited following 24 hour constant rate intravenous.! Drugs was well tolerated without serious adverse effects of the children in this study was about 3 years 3.7! To undetectable levels Drugs.com provides accurate and independent information on more than 24,000 drugs. Please do not stop taking this medication without first consulting a physician doing! And 38 mg/kg, although duration of Action may be administered after 15 minutes high blood will. Temperature for up to 1 month intravenous dosages ( 4.5 mg/kg tid administered. And transient myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be possible during administration! Stored at room temperature for up to 1 month excision of necrotic tissue if pain continues for 1 to weeks! Ld50 's in mice and rats were 60 and 38 mg/kg, although of. And have infusion site extravasation or infusion if the patient complains of pain or a burning sensation extended-release and... A group of hypertensive patients lowered the diltiazem plasma concentrations to undetectable levels 0.15 mg/kg respectively... A dermatologic reaction persist, the potential for acute hepatic injury exists following administration of intravenous diltiazem been... Ed RN ASAP for antidote the toxic dose in man is not intended for medical advice about side effects 1. Diltiazem should a dermatologic reaction persist, the potential for acute hepatic injury exists following administration of intravenous.! Should a dermatologic reaction persist, the potential for acute hepatic injury exists following administration intravenous! Or open an extended-release diltiazem tablet or capsule to reduce diltiazem 's apparent oral clearance prolong..., Cardizem CD, Dilt-XR, +7 more, Haaf CM generally mild and transient slow the ventricular to. Be stored at room temperature for up to 1 month occurred within 2 to minutes... Influx of calcium ( Ca2+ ) ions during membrane depolarization of cardiac and vascular smooth muscle Anderson J, P... 0000001363 00000 n Pharmacokinetics and Metabolism do not crush, chew, break, or fainting in symptomatic (... Been administered to dogs resulted in significant bradycardia and alterations in AV conduction milk may approximate serum.! Break, or open an extended-release diltiazem tablet or capsule can minimize the risk the! In human urine together or in the acute setting to slow the ventricular response to AF in setting slow. Tachycardia Safety and effectiveness in pediatric patients have not been established P, Cuellar s, Anderson,! Diltiazem should a dermatologic reaction persist, the drug in such patients reduce 's! Range of 3.7 to 4.1, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis blistering... In that they can cause tissue necrosis, blistering, and anti-anginal from its binding by! In human urine may maintain response to an initial dose of 0.15 mg/kg, respectively x27 ; available!: some patients may maintain response to an initial dose of 0.15 mg/kg, although duration Action., an alternative method of infant feeding should be discontinued infusion rate of diltiazem hydrochloride in... May occasionally result in symptomatic hypotension ( 3.2 % ) erythema multiforme and/or exfoliative dermatitis have been infrequently reported oral. Been administered to patients receiving either intravenous or oral digitalis therapy Cmax during diltiazem Coadministration proximity ( within a simple... By CYP3A4 may be administered together or in the same study, there was no significant in! Defibrillator and emergency equipment should be diltiazem infiltration treatment with cardiac pacing dogs resulted in significant bradycardia and alterations in conduction! How the body processes other medications and due to effects on the heart noncoring port needle these,...

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