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Cardizem LA
Overview
What is Cardizem LA?
CARDIZEM LA (diltiazem hydrochloride) is a nondihydropyridine calcium channel blocker (slow channel blocker or calcium antagonist). Chemically, diltiazem hydrochloride is 1,5-benzothiazepin-4(5)-one, 3-(acetyloxy)-5-[2-(dimethylamino)ethyl]-2, 3-dihydro-2-(4-methoxyphenyl)-, monohydrochloride, (+)--. The structural formula is:
Diltiazem hydrochloride is a white to off-white crystalline powder with a bitter taste. It is soluble in water, methanol and chloroform. It has a molecular weight of 450.99. CARDIZEM LA is formulated as a once-a-day extended-release tablet for oral administration containing 120 mg, 180 mg, 240 mg, 300 mg, 360 mg or 420 mg of diltiazem hydrochloride.
Tablets also contain: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, ethyl acrylate and methyl methacrylate copolymer dispersion, hydrogenated vegetable oil, hypromellose, magnesium stearate, microcrystalline cellulose, microcrystalline wax, polydextrose, polyethylene glycol, polysorbate, povidone, pregelatinized starch, simethicone, sodium starch glycolate, sucrose stearate, talc, and titanium dioxide.
What does Cardizem LA look like?
What are the available doses of Cardizem LA?
Extended-release tablets with 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, or 420 mg diltiazem hydrochloride per tablet. CARDIZEM LA Tablets are white, capsule-shaped, and debossed with "B" on one side and the diltiazem content (mg) on the other.
What should I talk to my health care provider before I take Cardizem LA?
How should I use Cardizem LA?
CARDIZEM LA is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
CARDIZEM LA may be used alone or in combination with other antihypertensive medications.
Take CARDIZEM LA once a day at approximately the same time. Do not chew or crush the tablet.
What interacts with Cardizem LA?
Sorry No Records found
What are the warnings of Cardizem LA?
Sorry No Records found
What are the precautions of Cardizem LA?
Sorry No Records found
What are the side effects of Cardizem LA?
Sorry No records found
What should I look out for while using Cardizem LA?
CARDIZEM LA is contraindicated in:
What might happen if I take too much Cardizem LA?
The oral LD is 415 to 740 mg/kg in mice and 560 to 810 mg/kg in rats. The intravenous LD is 60 mg/kg in mice and 38 mg/kg in rats. The oral LD in dogs is considered to be in excess of 50 mg/kg, while lethality was seen in monkeys at 360 mg/kg.
The toxic dose in man is not known. Blood levels after a standard dose of diltiazem can vary over tenfold, limiting the usefulness of blood levels in overdose cases.
There have been 29 reports of diltiazem overdose in doses ranging from less than 1 g to 18 g. Sixteen of these reports involved multiple drug ingestions.
Twenty-two reports indicated patients had recovered from diltiazem overdose ranging from less than 1 g to 10.8 g. There were seven reports with a fatal outcome; although the amount of diltiazem ingested was unknown, multiple drug ingestions were confirmed in six of the seven reports.
Events observed following diltiazem overdose included bradycardia, hypotension, heart block, and cardiac failure. Most reports of overdose described some supportive medical measure and/or drug treatment. Bradycardia frequently responded favorably to atropine as did heart block, although cardiac pacing was also frequently utilized to treat heart block. Fluids and vasopressors were used to maintain blood pressure and in cases of cardiac failure, inotropic agents were administered. In addition, some patients received treatment with ventilatory support, gastric lavage, activated charcoal, and/or intravenous calcium.
In the event of overdose or exaggerated response, institute appropriate supportive measures and gastrointestinal decontamination. Diltiazem does not appear to be removed by peritoneal or hemodialysis. Limited data suggest that plasmapheresis or charcoal hemoperfusion may hasten diltiazem elimination following overdose. Based on the known pharmacological effects of diltiazem and/or reported clinical experiences, the following measures may be considered:
Bradycardia:
High-degree AV Block:
Cardiac Failure:
Hypotension:
Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician.
How should I store and handle Cardizem LA?
Store at 20° to 25°C (68° to 77°F)Protect from moisture.Store at 20° to 25°C (68° to 77°F)Protect from moisture.CARDIZEM LA is supplied as white, capsule-shaped tablets debossed with "B" on one side and the diltiazem content (mg) on the other.Storage conditions: Store at 25°C (77°F); excursions permitted to 15° to 30° C (59° to 86°F) [see USP Controlled Room Temperature].Avoid excessive humidity and temperatures above 30°C (86°F). Dispense in tight, light resistant container as defined in USP.CARDIZEM LA is supplied as white, capsule-shaped tablets debossed with "B" on one side and the diltiazem content (mg) on the other.Storage conditions: Store at 25°C (77°F); excursions permitted to 15° to 30° C (59° to 86°F) [see USP Controlled Room Temperature].Avoid excessive humidity and temperatures above 30°C (86°F). Dispense in tight, light resistant container as defined in USP.CARDIZEM LA is supplied as white, capsule-shaped tablets debossed with "B" on one side and the diltiazem content (mg) on the other.Storage conditions: Store at 25°C (77°F); excursions permitted to 15° to 30° C (59° to 86°F) [see USP Controlled Room Temperature].Avoid excessive humidity and temperatures above 30°C (86°F). Dispense in tight, light resistant container as defined in USP.CARDIZEM LA is supplied as white, capsule-shaped tablets debossed with "B" on one side and the diltiazem content (mg) on the other.Storage conditions: Store at 25°C (77°F); excursions permitted to 15° to 30° C (59° to 86°F) [see USP Controlled Room Temperature].Avoid excessive humidity and temperatures above 30°C (86°F). Dispense in tight, light resistant container as defined in USP.
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
The therapeutic effects of diltiazem are believed to be related to its ability to inhibit the cellular influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle.
Hypertension:
Angina:
In animal models, diltiazem interferes with the slow inward (depolarizing) current in excitable tissue. Diltiazem causes excitation-contraction uncoupling in various myocardial. Diltiazem produces relaxation of coronary vascular smooth muscle and dilation of both large and small coronary arteries at drug levels which cause little or no negative inotropic effect. The resultant increases in coronary blood flow (epicardial and subendocardial) occur in ischemic and nonischemic models and are accompanied by dose-dependent decreases in systemic blood pressure and decreases in peripheral resistance.
Non-Clinical Toxicology
CARDIZEM LA is contraindicated in:Although the pressor activity of desmopressin acetate is very low compared with the antidiuretic activity, use of doses as large as 0.3 mcg/kg of desmopressin acetate with other pressor agents should be done only with careful patient monitoring. The concomitant administration of drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, NSAIDs, lamotrigine and carbamazepine) should be performed with caution.
Desmopressin acetate has been used with epsilon aminocaproic acid without adverse effects.
CARDIZEM LA may cause abnormally slow heart rates or second- or third-degree AV block. Patients with sick sinus syndrome are at increased risk of bradycardia. Concomitant use of diltiazem with beta-blockers or digitalis may result in additive effects on cardiac conduction. A patient with Prinzmetal's angina developed periods of asystole (2 to 5 seconds) after a single dose of 60 mg of diltiazem . Monitor for effects on heart rate and cardiac conduction.
The following adverse reactions are described in greater detail, in other sections:
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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