Diltiazem Cardizem LA is a medication used to treat hypertension high blood pressure and chest pain. Common side effects with diltiazem are hypotension abnormally low blood pressurebradycardia abnormally low heart beatheadache, fatigue, weakness, drowsiness, constipation or diarrhea, nausea, vomiting, facial flushing, and difficulty sleeping.

A normal heart rate or heart beat is 60 to beats per minute. A heart beat less than 60 beats per minute is defined as bradycardia.

Some people with a slow heart beat are completely healthy, for example athletes tend to have a slower heart rate. But for other people, a slow heart beat may mean that not enough blood is being pumped to the body, diltiazem lp 90 mg.

This slow heart beat can cause fatigue and other symptoms. If you are experiencing a slow heart rate, consult with your physician or cardiologist right away.

This is not a complete list of the side effects associated with diltiazem.

For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U. Food and Drug Administration by visiting diltiazem. Can diltiazem cause you to retain fat?

According to the manufacturer of diltiazem Cardizemthe most common side effects reported are dizziness, headache, cough, feeling tired, slowing of the heart rate, and swelling of the legs peripheral edema. Swelling of the legs can add weight to the body. During clinical trials, peripheral edema occurred in about 4. In another study, diltiazem lp 90 mg, swelling of diltiazem lower limbs occurred in about 6. The amount of swelling was not indicated by the drug manufacturer. Other side effects reported with diltiazem are weight loss, weight gain, diarrhea or constipation, nausea and vomiting.

The manufacturer reports that about 1 to 3 percent of patients are affected. A search of the prescribing information for diltiazem Cardizem did not specifically list fat retention as a side effect.

Drugs can cause weight gain in several different ways. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, diltiazem lp 90 mg, the effect of prescription drugs on body diltiazem is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss, diltiazem lp 90 mg.

Also, the same medications can methotrexate injections better than tablets weight gain in certain individuals and weight loss in others.

There are also drugs that initially cause weight loss and then lead to weight gain with long-term use, diltiazem lp 90 mg. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose diltiazem first talking to your provider.

This is not a common side effect of diltiazem Cardizem. Lori Mendoza, PharmD Q: I take Cardizem for high blood pressure, and lately I've had acne on my face.

Could that be caused by the medication? A variety of skin rashes and diltiazem have been reported in patients taking Cardizem diltiazem, diltiazem lp 90 mg. Most aren't serious, diltiazem lp 90 mg, but they should be evaluated by your health care provider. If you experience fever, sore throat, and headache with a severe blistering, peeling, and red skin rash, contact your doctor at once.

The most common occurrences from these studies, as well their frequency of presentation, are edema 2. Nervous System Abnormal dreamsamnesiadepression, gait diltiazem, hallucinations, insomnia, nervousness, paresthesiapersonality change, somnolencetremor. Dermatological Petechiaephotosensitivity diltiazem, pruritusurticaria.

Other AmblyopiaCPK elevation, dry mouthdyspneaepistaxiseye irritation, hyperglycemiadiltiazem lp 90 mg, hyperuricemiaimpotencemuscle cramps, diltiazem lp 90 mg, nasal congestionnocturiaosteoarticular pain, polyuriasexual difficulties, tinnitus.

There have been observed cases of a generalized rash, some characterized as leukocytoclastic vasculitis. In addition, events such as myocardial infarction have been observed, which are not readily distinguishable from the natural history of the disease in these patients. Exfoliative dermatitis proven by rechallenge has also been reported. As with all drugs, care should be exercised when treating patients with treating alcohol withdrawal with xanax medications.

Diltiazem is both a substrate and an inhibitor of the cytochrome P 3A4 enzyme system. Other drugs that are specific substrates, inhibitors, or inducers of this enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem.

Anesthetics The depression of cardiac contractility, conductivity, and automaticity, as well as the vascular dilation associated with anesthetics, diltiazem be potentiated by calcium channel blockers.

When used concomitantly, anesthetics and calcium blockers should be titrated carefully. Benzodiazepines Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3-to 4-fold and the Cmax by 2-fold, compared to placebo. The elimination half-life of midazolam and triazolam also increased 1. These pharmacokinetic effects seen during diltiazem coadministration can result in increased clinical effects e.

Available data are not sufficient, however, to predict the effects of concomitant treatment, particularly in patients with left diltiazem dysfunction or cardiac conduction abnormalities, diltiazem lp 90 mg. In vitro, propranolol appears to be displaced from its binding sites by diltiazem.

Buspirone In nine healthy subjects, diltiazem significantly increased the mean buspirone AUC 5. Enhanced effects and increased toxicity of buspirone may be possible diltiazem concomitant administration with diltiazem, diltiazem lp 90 mg. Subsequent dose adjustments may be necessary during coadministration, and should be based on clinical assessment.

Patients receiving these drugs concurrently should be monitored for a potential drug interaction. Ranitidine produced smaller, nonsignificant increases. The effect may be mediated by cimetidine's known inhibition of hepatic diltiazem P, 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. Clonidine Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with diltiazem. Monitor heart rate in patients receiving concomitant diltiazem and clonidine.

Cyclosporine Diltiazem pharmacokinetic interaction between diltiazem and cyclosporine has been observed during studies involving renal and cardiac transplant patients.

If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted, diltiazem lp 90 mg, or discontinued. The effect of cyclosporine on diltiazem plasma concentrations has not been evaluated. Another investigator found no increase in digoxin levels in 12 patients with coronary artery disease.

Monitoring for quinidine adverse effects may be warranted and the dose adjusted accordingly.

Rifampin 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.

The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. When possible, use a non-CYP3A4-metabolized statin together with diltiazem; otherwise, dose adjustments for both diltiazem and the statin should be considered along with close monitoring for signs and symptoms of any statin related adverse events.

Subjects with increased average steady-state exposures of diltiazem showed a greater fold increase in simvastatin exposure. Computer-based simulations showed that at a daily dose of mg of diltiazem, diltiazem lp 90 mg, an 8-to 9-fold mean increase in simvastatin AUC can be expected, diltiazem lp 90 mg.

If co-administration of simvastatin with diltiazem is required, diltiazem lp 90 mg, limit the daily doses of simvastatin to 10 mg and diltiazem to mg, diltiazem lp 90 mg. In man, Diltiazem prevents spontaneous and ergonovine-provoked coronary artery spasm. It causes a decrease in peripheral vascular resistance and a modest fall in blood pressure in normotensive individuals and in exercise tolerance studies in patients diltiazem ischemic heart disease, reduces the heart rate-blood pressure product for any given work load.

Studies to date, primarily in patients diltiazem good ventricular function, have not revealed evidence of a negative inotropic effect; cardiac output, ejection fraction, and left ventricular end diastolic pressure have not been affected.

Such data have no predictive value with respect to effects in patients with poor ventricular function, and increased heart failure has been reported in patients with preexisting impairment of ventricular function. There are as yet few data on the interaction of Diltiazem and beta-blockers in patients with poor ventricular function. Resting heart rate is usually slightly reduced by Diltiazem.

Diltiazem hydrochloride extended-release capsules produces antihypertensive effects both in the supine and standing positions. Postural hypotension is infrequently noted upon suddenly assuming an upright position.

No reflex tachycardia is associated with the chronic antihypertensive effects, diltiazem lp 90 mg. Diltiazem hydrochloride decreases diltiazem resistance, increases cardiac output by increasing stroke volumeand produces a slight decrease or no change in heart rate.

During dynamic exercise, increases in diastolic pressure are inhibited while maximum achievable systolic pressure is usually reduced. Chronic therapy with Diltiazem hydrochloride produces no change or an increase in plasma catecholamines. No increased activity of the renin-angiotensin-aldosterone axis has been observed. Diltiazem hydrochloride reduces the renal and peripheral effects of angiotensin II.

In man, transient natriuresis and kaliuresis have been reported, diltiazem lp 90 mg, but only in high intravenous doses of 0. Diltiazem-associated prolongation of the AH interval is not more pronounced in patients with first degree heart block.

In short term, double blind, placebo-controlled clinical trials, Best price for phentermine hydrochloride extended-release capsules demonstrated a dose-related antihypertensive response among patients with mild to moderate hypertension, diltiazem lp 90 mg.

In one parallel-group study of patients, Diltiazem hydrochloride extended-release capsules was given for four weeks, diltiazem lp 90 mg. The changes in diastolic blood pressure measured at trough 24 hours after the dose for placebo, 90 mg, mg, mg and mg were Supine diastolic blood pressure as well as standing diastolic and systolic blood pressures also showed diltiazem significant linear dose response effects.

In another clinical trial that followed a dose-escalation design, Diltiazem hydrochloride extended-release capsules also reduced blood pressure in a linear dose-related manner. Supine diastolic blood pressure measured following two-week intervals of treatment was reduced by At trough, 24 hours after dosing, diltiazem lp 90 mg, exercise tolerance times using a Bruce exercise protocol, increased by 14, 26, 41, 33 and 32 seconds over baseline for placebo and the mg, mg, mg, and mg treated patient groups, respectively.

At peak, 8 hours after dosing, exercise tolerance times relative to baseline were statistically significantly increased by 13, 38, 64, 55 and 42 seconds for placebo and mg, mg, mg, and mg Diltiazem hydrochloride extended-release capsule treated patients, respectively.

Compared to baseline, Diltiazem hydrochloride extended-release capsule treated patients experienced statistically significant reductions in anginal attacks and decreased nitroglycerin requirements when compared to placebo treated patients. Pharmacokinetics and Metabolism Diltiazem is well absorbed from the gastrointestinal tract but undergoes substantial hepatic first-pass effect.

The plasma elimination half-life of Diltiazem is approximately 3. Drugs which induce or inhibit hepatic microsomal enzymes may alter Diltiazem disposition.

There is a departure from linearity when dose strengths are increased; the half-life is slightly increased with dose. The two primary metabolites of Diltiazem are desacetylDiltiazem and desmethylDiltiazem. However, diltiazem studies employing sensitive and specific analytical methods have confirmed the existence of several sequential metabolic pathways of Diltiazem.

As many as hydrocodone overdose hours Diltiazem diltiazem have been identified in the urine of humans.

Total radioactivity measurements following single intravenous dose administration in healthy volunteers suggest the presence of other unidentified metabolites. These metabolites are more slowly excreted with a half-life of total radioactivity of approximately 20 hoursand attain concentrations in excess of Diltiazem.

90 mg CARDIZEM (Cardizem 90 mg)

Competitive in vitro ligand binding studies have also shown Diltiazem HCl binding is not altered by therapeutic concentrations of digoxin, hydrochlorothiazide, phenylbutazone, propranolol, salicylic acid, or warfarin, diltiazem lp 90 mg. Diltiazem hydrochloride Extended-Release Capsules. When Diltiazem hydrochloride extended-release capsules was coadministered with a high diltiazem content breakfast, the extent of Diltiazem absorption was not affected; T max, however, occurred slightly earlier.

The apparent elimination half-life after single or multiple dosing is 4 to 9. Diltiazem hydrochloride extended-release capsules demonstrates non-linear pharmacokinetics. As the daily dose of Diltiazem hydrochloride extended-release capsules capsules is increased from to mg, there was a more than proportional increase in Diltiazem plasma concentrations as evidenced by an increase of AUC, C max and C min of 6, diltiazem lp 90 mg.

Indications and Usage for Diltiazem Hypertension: Diltiazem hydrochloride extended-release capsules are indicated for the treatment of hypertension. It may be used alone or in combination diltiazem other antihypertensive medications.

Diltiazem hydrochloride extended-release capsules are indicated for the treatment of chronic stable angina.

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