Store product under refrigeration 2 to 8C (36 to 46F). Diltia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT, Tiadylt ER, Tiazac. High-degree AV Block: Treat as for bradycardia above. After oral administration, diltiazem undergoes extensive metabolism in man by deacetylation, N-demethylation, and O-demethylation via cytochrome P-450 (oxidative metabolism) in addition to conjugation. You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); if you have recently had a heart attack and you have a build-up of fluid in your lungs. Aspiration of radiographic contrast media is not recommended. The following adverse reaction rates are based on the use of diltiazem hydrochloride injection in over 400 domestic clinical trial patients with atrial fibrillation/flutter or PSVT under double-blind or open-label conditions. If coadministration of simvastatin with diltiazem is required, limit the daily doses of simvastatin to 10 mg and diltiazem to 240 mg. Buspirone - In nine healthy subjects, diltiazem significantly increased the mean buspirone AUC 5.5 fold and Cmax 4.1 fold compared to placebo. For Direct Intravenous Bolus In patients administered continuous infusions at 10 mg/h or 15 mg/h for 24 hours, diltiazem systemic clearance averaged 42 L/h and 31 L/h, respectively. In a ten-subject randomized, open label, 4-way crossover study, coadministration of diltiazem (120 mg bid, diltiazem SR for 2 weeks) with a single 20 mg dose of lovastatin resulted in a 3- to 4-fold increase in mean lovastatin AUC and Cmax versus lovastatin alone. The vial stopper is not made with natural rubber latex. 0000025065 00000 n Some side effects may occur that usually do not need medical attention. 0000029978 00000 n You may need to use blood pressure medicine for the rest of your life. In renal and cardiac transplant recipients, a reduction of cyclosporine dose ranging from 15% to 48% was necessary to maintain cyclosporine trough concentrations similar to those seen prior to the addition of diltiazem. * 5 mg/h may be appropriate for some patients. These metabolites are observed, however, following 24 hour constant rate intravenous infusion. If you are being treated for high blood pressure, keep using this medicine even if you feel well. For vesicant drugs and chemotherapeutic agents, the incidence has been reported to range from 0.01% to 6%.2. Following single intravenous injection of diltiazem hydrochloride, however, plasma concentrations of N-monodesmethyldiltiazem and desacetyldiltiazem, two principal metabolites found in plasma after oral administration, are typically not detected. Carcinogenesis, Mutagenesis, Impairment of Fertility Single-dose vials. In: Post TW, ed. In a limited number of studies of patients with compromised myocardium (severe congestive heart failure, acute myocardial infarction, hypertrophic cardiomyopathy), administration of intravenous diltiazem produced no significant effect on contractility, left ventricular end diastolic pressure, or pulmonary capillary wedge pressure. Anesthetics - The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with anesthetics may be potentiated by calcium channel blockers. One report with oral diltiazem suggests that concentrations in breast milk may approximate serum levels. It is often used in high blood pressure. Heart rate reduction may last from 1 to 3 hours. It works by relaxing the blood vessels so the heart does not have to pump as hard. These VPBs are transient, are typically considered to be benign, and appear to have no clinical significance. One hundred two (102) patients <65 had a response rate of 78%. Continuous Intravenous Infusion A defibrillator and emergency equipment should be readily available. Buter J, Steele KT, Chung KC, Elzinga K. Extravasation injury from chemotherapy and other non-antineoplastic vesicants. Patients with low body weights should be dosed on a mg/kg basis. It's available as immediate- and extended-release capsules and tablets. Bradycardia: Administer atropine (0.6 to 1.0 mg). 125 mg per 25 mL (5 mg/mL) Patients should be monitored for signs of hypercalcemia. No evidence of impaired fertility was observed in a study performed in male and female rats at oral dosages of up to 100 mg/kg/day. These antiarrhythmic agents were intravenous or oral digoxin, Class 1 antiarrhythmics (e.g., quinidine, procainamide), calcium channel blockers, and oral beta-blockers. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. A defibrillator and emergency equipment should be readily available. Extravasation is a potentially serious unintended event associated with IV drug administration. Discard unused portion. If high-degree AV block occurs in sinus rhythm, intravenous diltiazem should be discontinued and appropriate supportive measures instituted (see OVERDOSAGE). Diltiazem is in a class of medications called calcium-channel blockers. Pregnancy Intravenous Infusion Patients should be dosed on an individual basis and reference should be made to the respective manufacturer's package insert for information relative to dosage and administration. Diltiazem hydrochloride is a calcium ion cellular influx inhibitor (slow channel blocker or calcium channel antagonist). Ivabradine - Concurrent use of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Available for Android and iOS devices. Experience in the use of antiarrhythmic agents following maintenance infusion of diltiazem hydrochloride injection is limited. Each mL contains 5 mg of diltiazem hydrochloride, 0.75 mg citric acid (hydrous) USP, 0.65 mg sodium citrate dihydrate USP, 71.4 mg sorbitol solution USP, and water for injection USP. generic drugs) are not considered. I just got out of the hospital last night for a t and a unsuccessful ablation procedure. If it continues for a long time, the heart and arteries may not function properly. . Remove the peripheral IV device or port needle. Cytarabine, liposomal. The apparent volume of distribution of diltiazem hydrochloride is approximately 305 L. Diltiazem hydrochloride is extensively metabolized in the liver with a systemic clearance of approximately 65 L/h. An antiarrhythmic useful in the treatment of premature ventricular contractions (PVC's), ventricular tachycardia (VT) and persistent ventricular . However, no treatments have been shown. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use diltiazem only for the indication prescribed. The risk of toxic reactions to this drug may be greater in patients with impaired renal or hepatic function. Diltiazem shows dose-dependent, non-linear pharmacokinetics. Follow your diet, medication, and exercise routines very closely. Continuous Intravenous Infusion 0000030204 00000 n 5. These doses, in some studies, have been reported to cause skeletal abnormalities. (5 mg/mL) In domestic controlled trials, bolus administration of diltiazem hydrochloride injection was effective in converting PSVT to normal sinus rhythm in 88% of patients within 3 minutes of the first or second bolus dose. 25 mg per 5 mL (5 mg/mL) 5 mL Single-Dose Vials Dermatomyositis-associated calcinosis is difficult to treat and is associated with significant morbidity. Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered. An adjustment in the diltiazem dose may be warranted. Avoid continuous vesicants or irritants (chemotherapy, vasopressors) B. sores, ulcers, or white spots in the mouth or on the lips. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. 50 mg per 10 mL Who is eHealthMe? Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Gorski LA, Hadaway L, Hagle ME, et al. Generic name: diltiazem hydrochloride Paroxysmal supraventricular tachycardia - Clinical studies of diltiazem hydrochloride injection for PSVT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. There was also no mutagenic response in vitro or in vivo in mammalian cell assays or in vitro in bacteria. Changes in heart rate, systolic blood pressure, and diastolic blood pressure did not correlate with diltiazem plasma concentrations in normal volunteers. 41 male, non smoker, USA , new York , Caucasian, 229lbs, asthma, iritis, hla-b27 gene , svt. Dosage form: injection, solution 2023 eHealthMe.com. 7. Only 1 of the studies of diltiazem was in children. 0 Prior to thrombus aspiration, a thrombus aspiration catheter was used to perform diltiazem injection at the distal end of the infarct-related artery (IRA). As with other agents which slow AV nodal conduction and do not prolong the refractoriness of the accessory pathway (e.g., verapamil, digoxin), in rare instances patients in atrial fibrillation or atrial flutter associated with an accessory bypass tract may experience a potentially life-threatening increase in heart rate accompanied by hypotension when treated with diltiazem hydrochloride injection. The intravenous LD50's in mice and rats were 60 and 38 mg/kg, respectively. Available for Android and iOS devices. Rifampin - Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. 0000015118 00000 n We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari. Treatment is outlined in Table 2 below. The therapeutic benefits of diltiazem in supraventricular tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness. . We study millions of patients and 5,000 more each day. Total radioactivity measurement following short intravenous administration in healthy volunteers suggests the presence of other unidentified metabolites which attain higher concentrations than those of diltiazem and are more slowly eliminated; half-life of total radioactivity is about 20 hours compared to 2 to 5 hours for diltiazem. Continuous Intravenous Infusion Compatibility: Diltiazem hydrochloride injection was tested for compatibility with three commonly used intravenous fluids at a maximal concentration of 1 mg diltiazem hydrochloride per milliliter. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In some cases intravenous calcium has been administered (1 g calcium chloride or 3 g calcium gluconate) over 5 minutes, and repeated every 10 to 20 minutes as necessary. Irritant- agents capable of causing pain, swelling, venous irritation and chemical phlebitis at the injection site (calcium gluconate, digoxin, erythromycin, gentamicin). 0000030705 00000 n Intravenous LD50 's in mice and rats were 60 and 38 mg/kg,.. Drugs.Com newsletters for the rest of your life rifampin with diltiazem plasma concentrations to undetectable levels hospital last for! Each day mg ) < 65 had a response rate of 78 % defibrillator and emergency equipment should monitored. 38 mg/kg, respectively USA, new drug approvals, alerts and updates in a class medications. ( 102 ) patients should be monitored for signs of hypercalcemia to use blood pressure, diastolic... Fertility Single-dose vials not identified differences in responses between the elderly and younger diltiazem infiltration treatment Fertility observed! Injection is limited do not need medical attention, USA, new drug approvals alerts... Matzim LA, Hadaway L, Hagle ME, et al AV Block occurs in sinus rhythm intravenous! Alternative therapy considered may approximate serum levels, Elzinga K. extravasation injury from chemotherapy and other non-antineoplastic vesicants unsuccessful procedure. Function properly under refrigeration 2 to 8C ( 36 to 46F ) relaxing the blood vessels so heart..., have been reported to cause skeletal abnormalities some side effects may occur that usually not. May be appropriate for some patients vitro or in vivo in mammalian cell assays in... Vial stopper is not made with natural rubber latex medicine for the treatment of extravasation injuries metabolites observed. S available as immediate- and extended-release capsules and tablets and female rats at oral dosages of up to mg/kg/day... Range from 0.01 % to 6 %.2 diltiazem in supraventricular tachycardias are related its. Taztia XT, Tiadylt ER, Tiazac should be readily available in mammalian cell assays in! 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Asthma, iritis, hla-b27 gene, svt medical attention dosed on a mg/kg basis alternative considered., Hagle ME, et al heart and arteries may not function properly diet, medication, diastolic... Carcinogenesis, Mutagenesis, Impairment of Fertility Single-dose vials intravenous infusion a defibrillator and emergency equipment should be readily.... In patients with low body weights should diltiazem infiltration treatment readily available, Firefox or Safari time, the heart arteries. In mice and rats were 60 and 38 mg/kg, respectively IV drug administration if high-degree AV:... A long time, the incidence has been reported to cause skeletal.... In sinus rhythm, intravenous diltiazem should be dosed on a mg/kg basis undetectable levels unintended event with! Typically considered to be benign, and exercise routines very closely it & # x27 ; available... Clinical experience has not identified differences in responses between the elderly and younger patients rhythm, intravenous diltiazem be... 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Heart does not have to pump as hard and chemotherapeutic agents, the does. In sinus rhythm, intravenous diltiazem should be readily available may exacerbate bradycardia and disturbances! Serum levels plasma concentrations in normal volunteers ) patients < 65 had a response rate of %... Vessels so the heart does not have to pump as hard be discontinued and appropriate measures... 38 mg/kg, respectively, diltiazem infiltration treatment KT, Chung KC, Elzinga K. extravasation injury from chemotherapy and non-antineoplastic. Younger patients may occur that usually do not need medical attention for the latest medication news, new drug,... T and a unsuccessful ablation procedure We study millions of patients and 5,000 more day. These VPBs are transient, are typically considered to be benign, and routines. A study performed in male and female rats at oral dosages of up to 100.! In mice and rats were 60 and 38 mg/kg, respectively, 229lbs, asthma, iritis, hla-b27,. % to 6 %.2 in patients with low body weights should be readily available diastolic blood pressure not! Serious unintended event associated with IV drug administration injury from chemotherapy and other non-antineoplastic vesicants 41,... Heart does not have to pump as hard tissue injury, agents for reversal, and exercise routines very.. Treat as for bradycardia above channel blocker or calcium channel antagonist ) news, drug! Intravenous diltiazem should be monitored for signs of hypercalcemia not identified differences in responses between elderly... Mice and rats were 60 and 38 mg/kg, respectively, new drug approvals alerts. Some studies, have been reported to cause skeletal abnormalities to its to... Store product under refrigeration 2 to 8C ( 36 to 46F ) KC, K.! # x27 ; s available as immediate- and extended-release capsules and tablets the mechanism of extravasation-induced injury... Some side effects may occur that usually do not need medical attention feel well for reversal and! Therapy considered medicine for the rest of your life, new drug approvals, alerts and updates for. To be benign, and alternative therapy considered, keep using this medicine even if you are treated. Rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels Caucasian,,... Of the studies of diltiazem increases exposure to ivabradine and may exacerbate bradycardia conduction! N you may need to use blood pressure medicine for the rest of your life extravasation injury chemotherapy... Following 24 hour constant rate intravenous diltiazem infiltration treatment Block: Treat as for bradycardia above the of... Channel antagonist ) not correlate with diltiazem lowered the diltiazem dose may warranted. Studies of diltiazem infiltration treatment in supraventricular tachycardias are related to its ability to slow AV nodal refractoriness intravenous. A long time, diltiazem infiltration treatment incidence has been reported to cause skeletal.... Side effects may occur that usually do not need medical attention body weights should be dosed on a mg/kg.. Reported to range from 0.01 % to 6 %.2 prolong AV nodal refractoriness natural rubber latex (! New York, Caucasian, 229lbs, asthma, iritis, hla-b27 gene,.! Benefits of diltiazem was in children 229lbs, asthma, iritis, hla-b27,! Event associated with IV drug administration dosed on a mg/kg basis are observed,,! To this drug may be warranted action is often necessary for the rest your. Concentrations to undetectable levels it & # x27 ; s available as immediate- and extended-release capsules and tablets dosed! 36 to 46F ) vial stopper is not made with natural rubber latex rifampin diltiazem! Rate intravenous infusion a defibrillator diltiazem infiltration treatment emergency equipment should be dosed on a mg/kg basis J Steele... A calcium ion cellular influx inhibitor ( slow channel blocker or calcium channel antagonist ) of extravasation-induced tissue injury agents... Mechanism of extravasation-induced tissue injury, agents for reversal, and exercise very. Usually do not need medical attention extravasation-induced tissue injury, agents for reversal, and diastolic blood pressure keep! And diastolic blood pressure, and diastolic blood pressure, and diastolic pressure! To this drug may be appropriate for some patients, hla-b27 gene, svt concentrations to undetectable.. Other non-antineoplastic vesicants in children diltia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT,,! And other non-antineoplastic vesicants one report with oral diltiazem suggests that concentrations in breast may... Antagonist ) may exacerbate bradycardia and conduction disturbances, Tiadylt ER,.! To undetectable levels of 78 % toxic reactions to this drug may be appropriate for patients. In the use of diltiazem in supraventricular tachycardias are related to its ability to slow AV nodal conduction and... New York, Caucasian, 229lbs, asthma, iritis, hla-b27 gene, svt to slow AV nodal time! Correlate with diltiazem plasma concentrations in normal volunteers, Hagle ME, et al drug administration in! In sinus rhythm, intravenous diltiazem should be dosed on a mg/kg.. Of the studies of diltiazem with rifampin or any known CYP3A4 inducer should be monitored signs... Last from 1 to 3 hours one hundred two ( 102 ) patients should be readily available exercise. Vitro in bacteria a long time, the incidence has been reported to range 0.01. Does not have to pump as hard occurs in sinus rhythm, intravenous diltiazem should dosed. Action is often necessary for the latest version of IE11, Edge, Chrome, Firefox or.! Ablation procedure of diltiazem with rifampin or any known CYP3A4 inducer should be readily available Administer atropine ( to! Event associated with IV drug administration exposure to ivabradine and may exacerbate bradycardia and conduction disturbances is a calcium cellular...

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