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CARDIOVASCULAR SYSTEM › VASOPROTECTIVES › AGENTS FOR TREATMENT OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE › Muscle relaxants
diltiazem
C05AE03
Forms & Strengths
- Tablets: 30mg, 60mg, 90mg, 120mg
- Capsules: 30mg, 60mg, 90mg, 120mg, 180mg, 240mg, 300mg, 360mg
- Injection: 5mg/mL
- Topical: 2%, 3% gel
Adult Dosing
- Angina: 30mg PO qid, up to 120mg qid
- Hypertension: 120-240mg PO bid or 180-240mg PO qd
- Arrhythmias: 0.25mg/kg IV bolus, up to 0.35mg/kg
- Topical (anal fissure): apply 1 inch ribbon tid and bid
Pediatric Dosing
- 1-2 years: not recommended
- 2-12 years: 0.5-1mg/kg PO tid, max 2mg/kg/day
- 12-18 years: follow adult dosing with caution
Indications
- Stable angina
- Vasospastic angina
- Hypertension
- Atrial fibrillation
- Atrial flutter
- Anal fissure
Mechanism of Action
- Calcium channel blockade
- Inhibits L-type calcium channels
- Reduces myocardial contractility
- Dilates coronary arteries
- Prolongs AV node conduction
Contraindications
- Sick sinus syndrome
- 2nd or 3rd degree AV block
- Severe hypotension
- Pulmonary congestion
- Known hypersensitivity
Adverse Reactions
- Headache
- Dizziness
- Nausea
- Edema
- Fatigue
- AV block
- Constipation
Drug Interactions
- Beta blockers: increased risk of AV block
- Digoxin: increased toxicity risk
- Anesthetics: enhanced hypotensive effect
- Cimetidine: increased diltiazem levels
- Cyclosporine: increased toxicity risk
Curated Content: Needs Vetting Before Put to Clinical Use