Cardizem (Diltiazem Hydrochloride)

(dil tye' a zem)

Diltiazem is used to treat high blood pressure and to control angina (chest pain). Diltiazem is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart. High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Diltiazem comes as a tablet, an extended-release (long-acting) tablet, and an extended-release capsule to take by mouth. The regular tablet is usually taken three or four times a day. The extended-release capsule and tablet are usually taken one or two times a day. Ask your pharmacist if you should take diltiazem with or without food, because instructions may vary with each product. Take diltiazem at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diltiazem exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the extended-release capsules and tablets whole; do not chew or crush them. Your doctor will probably start you on a low dose of diltiazem and gradually increase your dose, not more than once every 7 to 14 days if you are taking the extended-release tablet or capsule and not more than once every 1 to 2 days if you are taking the regular tablet. If taken regularly, diltiazem may control chest pain, but it does not stop chest pain once it starts. Your doctor may give you a different medication to take when you have chest pain. Diltiazem controls high blood pressure and chest pain (angina) but does not cure them. It may take up to 2 weeks before you feel the full benefit of diltiazem. Continue to take diltiazem even if you feel well. Do not stop taking diltiazem without talking to your doctor.

Before taking diltiazem,
• tell your doctor and pharmacist if you are allergic to diltiazem, any other medications, or any of the ingredients in diltiazem. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: atazanavir (Reyataz); benzodiazepines such as midazolam (Versed) and triazolam (Halcion); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol, metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Inderal, Innopran, in Inderide); buspirone; carbamazepine (Carbatrol, Epitol, Equetro, Tegretol); cimetidine (Tagamet); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); lovastatin (Altoprev, Mevacor, in Advicor); quinidine (in Nuedexta); and rifampin (Rifadin, in Rifamate, in Rifater, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with diltiazem, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had a myocardial infarction (MI); a narrowing or blockage of your digestive system or any other condition that causes food to move through your digestive system more slowly; low blood pressure; or heart, liver, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking diltiazem, call your doctor.
• if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking diltiazem.

If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Diltiazem may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness or lightheadedness
• flushing
• headache
• weakness
• slow heartbeat
• vomiting
• diarrhea
• constipation
• nasal congestion
• cough

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

• swelling of the face, eyes, lips, tongue, hands, arms, feet, ankles, or lower legs
• difficulty breathing or swallowing
• fainting
• rash
• yellowing of the skin or eyes
• nausea
• extreme tiredness
• unusual bleeding or bruising
• lack of energy
• loss of appetite
• pain in the upper right part of the stomach
• flu-like symptoms
• increase in frequency or severity of chest pain (angina)

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to diltiazem. Your doctor may ask you to check your pulse (heart rate) daily and will tell you how fast it should be. If your pulse is slower than it should be, call your doctor for directions on taking diltiazem that day. Ask your doctor or pharmacist to teach you how to check your pulse. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. ¶ This branded product is no longer on the market. Generic alternatives may be available.