Cardizem: Expert Calcium Channel Blocker for Hypertension & Angina Control
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| Product dosage: 180mg | |||
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Cardizem (diltiazem hydrochloride) is a prescription calcium channel blocker medication clinically proven to manage hypertension and chronic stable angina. Developed with precision pharmacokinetics, it works by relaxing blood vessels and reducing cardiac workload, offering targeted cardiovascular protection. Trusted by cardiologists for decades, Cardizem represents a cornerstone therapy in evidence-based cardiovascular risk management with well-established efficacy and safety profiles.
Features
- Contains diltiazem hydrochloride as the active pharmaceutical ingredient
- Available in immediate-release tablets, extended-release capsules, and intravenous formulations
- Multiple strength options (30 mg, 60 mg, 90 mg, 120 mg, 180 mg, 240 mg, 300 mg, 360 mg)
- Bioavailability of approximately 40% due to first-pass metabolism
- Half-life ranges from 3-4.5 hours (immediate-release) to 6-9 hours (extended-release)
- Hepatic metabolism via CYP3A4 enzyme system
- Renal excretion of metabolites (2-4% unchanged drug)
Benefits
- Effectively lowers blood pressure through vascular smooth muscle relaxation
- Reduces angina frequency and severity by decreasing myocardial oxygen demand
- Provides 24-hour blood pressure control with extended-release formulations
- Demonstrates favorable safety profile compared to other antihypertensive classes
- May be used as monotherapy or in combination with other cardiovascular agents
- Offers flexible dosing regimens tailored to individual patient needs
Common use
Cardizem is primarily indicated for the management of hypertension (high blood pressure) and treatment of chronic stable angina. It may also be used off-label for certain arrhythmias (specifically atrial fibrillation and flutter), Raynaud’s phenomenon, and as adjunct therapy in subarachnoid hemorrhage. The medication is typically prescribed as part of a comprehensive cardiovascular risk reduction strategy that may include lifestyle modifications and other pharmacological interventions.
Dosage and direction
Dosage must be individualized based on therapeutic response and tolerability. For hypertension: Initial dose typically 180-240 mg once daily (extended-release), maximum dose 540 mg daily. For angina: Initial dose 30-60 mg four times daily (immediate-release) or 120-180 mg once daily (extended-release), maximum dose 360 mg daily. Tablets should be swallowed whole with water, with or without food, at approximately the same time each day. Extended-release formulations must not be crushed, chewed, or divided. Dosage adjustments are required in hepatic impairment and elderly patients.
Precautions
Regular blood pressure monitoring is essential during therapy. Use with caution in patients with heart failure (may worsen condition), hepatic impairment (reduce dosage), renal impairment (monitor renal function), and elderly patients (increased sensitivity). May cause dizziness—caution when operating machinery or driving. Abrupt discontinuation may cause rebound hypertension or angina exacerbation. Periodic liver function tests recommended during long-term therapy.
Contraindications
Cardizem is contraindicated in patients with: sick sinus syndrome (except with functioning ventricular pacemaker), second- or third-degree AV block (except with functioning ventricular pacemaker), hypotension (systolic <90 mmHg), acute myocardial infarction with pulmonary congestion, hypersensitivity to diltiazem or any component, and concurrent intravenous beta-blocker therapy.
Possible side effect
Common side effects (>1%): headache, dizziness, edema, asthenia, flushing, nausea. Less common: bradycardia, AV block, palpitations, hypotension, rash, constipation, dyspepsia. Rare but serious: hepatotoxicity, Stevens-Johnson syndrome, leukopenia, thrombocytopenia, gingival hyperplasia. Most side effects are dose-dependent and often diminish with continued therapy.
Drug interaction
Significant interactions occur with: beta-blockers (increased risk of bradycardia and heart block), CYP3A4 inhibitors (clarithromycin, ketoconazole—increased diltiazem levels), CYP3A4 inducers (rifampin—decreased diltiazem levels), digoxin (increased digoxin levels), statins (increased risk of myopathy), cyclosporine (increased cyclosporine levels), anesthetics (enhanced cardiovascular effects). Always review complete medication profile before prescribing.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed dose. For once-daily formulations: if remembered within 12 hours of missed dose, take immediately; if more than 12 hours, skip missed dose. Maintain regular dosing schedule thereafter.
Overdose
Symptoms include severe hypotension, bradycardia, heart failure, and cardiac arrest. Management involves gastric lavage if recent ingestion, activated charcoal, cardiovascular monitoring, and supportive care. Specific treatments include intravenous calcium gluconate, atropine for bradycardia, vasopressors for hypotension, and cardiac pacing for conduction disturbances. Hemodialysis is not effective due to high protein binding.
Storage
Store at controlled room temperature (20-25°C/68-77°F). Protect from light and moisture. Keep in original container with tight closure. Do not store in bathroom or damp areas. Keep out of reach of children and pets. Properly dispose of expired or unused medication through drug take-back programs.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual responses to medication may vary. Proper diagnosis and therapeutic monitoring are essential for safe and effective use.
Reviews
Clinical studies demonstrate Cardizem’s efficacy with 70-80% of hypertensive patients achieving blood pressure control. Angina patients show 40-60% reduction in attack frequency. Long-term safety data from decades of use support its favorable risk-benefit profile. Cardiology guidelines consistently recommend calcium channel blockers like Cardizem as first-line therapy for hypertension and angina management.