Temporary control of rapid ventricular rate in atrial fibrillation or atrial flutter. 25 mg per 5 mL Duration of infusion longer than 24 hours and infusion rates greater than 15 mg/h have not been studied. 25 mL Single-Dose Vials 50 mg per 10 mL Use diltiazem regularly to get the most benefit. Aspiration of radiographic contrast media is not recommended. Rapid conversion of paroxysmal supraventricular tachycardias (PSVT) to sinus rhythm. Atrial flutter can arise during treatment with antiarrhythmic agents prescribed to prevent recurrent AF. Edema 1-6" in any direction Dactinomycin*X Skin blanched, translucent DAUNorubicin*X X Mild to moderate pain Dextrose >10%*X X Gross edema >6" in any direction DiazepamX Cool to touch DigoxinX X X Possible numbness DOBUTamineX Skin blanched, translucent DocetaxelX Moderate to severe pain DOPamine*X Skin tight, leaking DOXorubicinX X However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking diltiazem. Most other diltiazem formulations can be . Cytarabine . for i am hoping to come off of this medicine. Dermatologic events progressing to erythema multiforme and/or exfoliative dermatitis have been infrequently reported following oral diltiazem. Carbamazepine - Concomitant administration of oral diltiazem with carbamazepine has been reported to result in elevated plasma levels of carbamazepine (by 40 to 72%), resulting in toxicity in some cases. Follow all directions on your prescription label. Irritant- agents capable of causing pain, swelling, venous irritation and chemical phlebitis at the injection site (calcium gluconate, digoxin, erythromycin, gentamicin). Administration of oral diltiazem in patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission is contraindicated. The chemical structure is: Diltiazem hydrochloride, USP is a white crystalline powder with a bitter taste. Nervous System: Abnormal dreams, amnesia, depression, extrapyramidal symptoms, gait abnormality, hallucinations, insomnia, nervousness, personality change, somnolence, tremor A defibrillator and emergency equipment should be readily available. The combination of the two drugs was generally well tolerated without serious adverse effects. Diltiazem Dosage: 0.25 mg/kg administered over at least 2 minutes and preferably . Patients should be monitored for signs of hypercalcemia. An adjustment in the diltiazem dose may be warranted. The toxic dose in man is not known. Swallow right away without chewing. Diltiazem is an oral and parenteral non-dihydropyridine calcium channel blocker. Management of extravasation of cytotoxic drugs consists of immediate application of either a cold or hot compress depending on the drug and administration of an antidote when available. Diltiazem may also be used for purposes not listed in this medication guide. Monitor heart rate in patients receiving concomitant diltiazem and clonidine. For Direct Intravenous Bolus Patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker. Administration of oral doses ranging from five to ten times greater (on a mg/kg basis) than the daily recommended oral antianginal therapeutic dose has resulted in embryo and fetal lethality. <<893FCAAD4A261745BEDEB8B64953C410>]/Prev 46654/XRefStm 1178>> It also increases the supply of blood and oxygen to the heart. Injection and Continuous In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. 0000022294 00000 n 1. 50-mg, 10-mL vialeach sterile vial contains 50 mg diltiazem hydrochloride, 7.5 mg citric acid USP, 6.5 mg sodium citrate dihydrate USP, 714 mg sorbitol solution USP, and water for injection USP up to 10 mL. Infusions of calcium for 24 hours or more may be required. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Reproduction studies have been conducted in mice, rats, and rabbits. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Cimetidine - A study in six healthy volunteers has shown a significant increase in peak diltiazem plasma levels (58%) and area-under-the-curve (53%) after a 1-week course of cimetidine at 1,200 mg per day and a single dose of diltiazem 60 mg. Ranitidine produced smaller, nonsignificant increases. Mechanisms of Action Over this infusion range, as the dose is increased, systemic clearance decreases from 64 to 48 L/h while the plasma elimination half-life increases from 4.1 to 4.9 hours. Discard unused portion. Docetaxel . endstream endobj 363 0 obj <>/Filter/FlateDecode/Index[10 322]/Length 34/Size 332/Type/XRef/W[1 1 1]>>stream 0000017632 00000 n Medications used to treat insulin resistance, hyperlipidemia, and obesity have been shown to improve transaminase levels, steatosis, and histologic findings. 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. Distributed by: Disconnect IV tubing from IV device. Dolasetron . The goal of antidote administration is to reverse the action of the extravasated agent, interfere with the process of cell destruction, prevent tissue necrosis, or limit the extent of tissue damage.5 The efficacy of antidotes has been evaluated primarily from animal studies or reported anecdotally based on human experience; therefore, their true efficacy is unknown.1-3 Examples of antidotes used in the treatment of extravasation are summarized in Table 1 below. Diltiazem hydrochloride is extensively metabolized by the liver and excreted by the kidneys and in bile. Events such as myocardial infarction have been observed which are not readily distinguishable from the natural history of the disease for the patient. 41 male, non smoker, USA , new York , Caucasian, 229lbs, asthma, iritis, hla-b27 gene , svt. 7. 25 mg per 5 mL (5 mg/mL) 5 mL Single-Dose Vials Single-dose vials. 0000006222 00000 n Diltiazem Hydrochloride Injection is for direct intravenous bolus injection and continuous intravenous infusion. The drug should be used with caution in patients with impaired renal or hepatic function (see WARNINGS). Clonidine - Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with diltiazem. The recommended initial infusion rate of diltiazem hydrochloride injection is 10 mg/h. It is based on diltiazem hydrochloride (the active ingredients of Cardizem) and Cardizem (the brand name). Transition to other antiarrhythmic agents following administration of diltiazem hydrochloride injection is generally safe. If possible, it is recommended that diltiazem hydrochloride injection not be co-infused in the same intravenous line. The information presented is current as of January 13, 2021. Assess the site of extravasation and the symptoms of the patient. Physical Incompatibilities: Because of potential physical incompatibilities, it is recommended that diltiazem hydrochloride injection not be mixed with any other drugs in the same container. Should a dermatologic reaction persist, the drug should be discontinued. What are current recommendations for treatment of drug extravasation? Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. To make sure diltiazem is safe for you, tell your doctor if you have: if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). Management of extravasation injuries: a focused evaluation of noncytotoxic medications. A 24 hour continuous infusion of diltiazem hydrochloride injection in the treatment of atrial fibrillation or atrial flutter maintained at least a 20% heart rate reduction during the infusion in 83% of patients. Continuous Intravenous Infusion Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. Enhanced effects and increased toxicity of buspirone may be possible during concomitant administration with diltiazem. 332 33 Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. This can damage the blood vessels of the brain . 0000003491 00000 n 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. Diltiazem hydrochloride injection was found to be physically compatible and chemically stable in the following parenteral solutions for at least 24 hours when stored in glass or polyvinylchloride (PVC) bags at controlled room temperature 15 to 30C (59 to 86F) or under refrigeration 2 to 8C (36 to 46F). 0000001178 00000 n The elimination half-life of midazolam and triazolam also increased (1.5 to 2.5 fold) during coadministration with diltiazem. 0000008421 00000 n If hypotension occurs, it is generally short-lived, but may last from 1 to 3 hours. You should not breastfeed while using this medicine. Avoid concomitant use of ivabradine and diltiazem. Although not observed in clinical trials with diltiazem hydrochloride injection, the following events associated with oral diltiazem may occur: Drug classes: Calcium channel blocking agents, Group IV antiarrhythmics. in adult patients. Patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome. 0000029746 00000 n Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered. In the event of overdosage or an exaggerated response, appropriate supportive measures should be employed. hbbbd`b``3 Available for Android and iOS devices. 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. Patients currently receiving diltiazem therapy should be carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. However, reference should be made to the respective agent manufacturer's package insert for information relative to dosage and administration. Following oral administration, 2% to 4% of the unchanged diltiazem appears in the urine. Gastrointestinal: Constipation, elevated SGOT or alkaline phosphatase, nausea, vomiting It's available as immediate- and extended-release capsules and tablets. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Worldwide experience in over 1,300 patients was similar. Fixed high-degree AV block should be treated with cardiac pacing. Purpose of review Calcinosis cutis, or dystrophic soft-tissue calcification, is a common and debilitating complication of adult and juvenile dermatomyositis. Tell your doctor if you are pregnant or plan to become pregnant. E. Windsor, NJ 08520 Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. Prior to thrombus aspiration, a thrombus aspiration catheter was used to perform diltiazem injection at the distal end of the infarct-related artery (IRA). Manufactured by: Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure. Diltia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT, Tiadylt ER, Tiazac. It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Pregnancy 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. The alternative is to use topical nifedipine or oral diltiazem. Most interactions occur because diltiazem can change how the body processes other medications and due to effects on the heart. Use of this site constitutes acceptance of eHealthMe.com's terms of service and privacy policy. Patients who have demonstrated hypersensitivity to the drug. In subacute and chronic dog and rat studies designed to produce toxicity, high oral doses of diltiazem were associated with hepatic damage. Treatment should begin as soon as possible and no later than 6 hours after extravasation. Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. The apparent volume of distribution remains unchanged (360 to 391 L). Eugia US LLC Different individuals may respond to medication in different ways. In special subacute hepatic studies, oral doses of 125 mg/kg and higher in rats were associated with histological changes in the liver, which were reversible when the drug was discontinued. Hyderabad 500032 (5 mg/mL) Cardiovascular: Asystole, atrial flutter, AV block first degree, AV block second degree, bradycardia, chest pain, congestive heart failure, sinus pause, sinus node dysfunction, syncope, ventricular arrhythmia, ventricular fibrillation, ventricular tachycardia This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. Although it is not possible to prevent all accidents, a few simple precautions can minimize the risk to the patient. diltiazem) in the acute setting to slow the ventricular response to AF in . Diltiazem is used alone or together with other medicines to treat angina (severe chest pain) or hypertension (high blood pressure). You may also need frequent blood tests. Wang RY. Rifampin - Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. The initial dose of diltiazem hydrochloride injection should be 0.25 mg/kg actual body weight as a bolus administered over 2 minutes (20 mg is a reasonable dose for the average patient). 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. Ventricular Premature Beats (VPBs) - VPBs may be present on conversion of PSVT to sinus rhythm with diltiazem hydrochloride injection. Benzodiazepines - Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3 to 4 fold and Cmax by 2-fold, compared to placebo. Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician. Computer-based simulations showed that at a daily dose of 480 mg of diltiazem, an 8- to 9-fold mean increase in simvastatin AUC can be expected. Administration of other calcium channel blockers to patients with wide complex tachycardia (QRS 0.12 seconds) has resulted in hemodynamic deterioration and ventricular fibrillation. Hypotension: Vasopressors (e.g., dopamine or norepinephrine). Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. Available for Android and iOS devices. Carcinogenesis, Mutagenesis, Impairment of Fertility In addition, caution should be used in patients taking other drugs that decrease peripheral resistance, intravascular volume, myocardial contractility or conduction. Upon discontinuation of infusion, heart rate reduction may last from 0.5 hours to more than 10 hours (median duration 7 hours). Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. Dilution: To prepare diltiazem hydrochloride injection for continuous intravenous infusion, aseptically transfer the appropriate quantity (see chart) of diltiazem hydrochloride injection to the desired volume of either Normal Saline, D5W, or D5W/0.45% NaCl. Store diltiazem at room temperature away from moisture and heat. Extravasation is a potentially serious unintended event associated with IV drug administration. It has a pH range of 3.7 to 4.1. Diltiazem Overdosage experience is limited. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Gastrointestinal: Anorexia, diarrhea, dysgeusia, dyspepsia, mild elevations of SGPT and LDH, thirst, weight increase 0000029001 00000 n An antiarrhythmic useful in the treatment of premature ventricular contractions (PVC's), ventricular tachycardia (VT) and persistent ventricular . Infusion Therapy Standards of Practice, 8th edition. 0000029456 00000 n 0000030660 00000 n Skip the missed dose if it is almost time for your next scheduled dose. As with all drugs, care should be exercised when treating patients with multiple medications (see PRECAUTIONS, General and Drug Interactions). Quinidine - Diltiazem significantly increases the AUC(0) of quinidine by 51%, T1/2 by 36% and decreases its CLoral, by 33%. Other: Amblyopia, asthenia, dry mouth, dyspnea, edema, headache, hyperuricemia 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. (5 mg/mL) Nervous System: Dizziness, paresthesia It is used in many clinical scenarios as an antihypertensive, anti-arrhythmic, and anti-anginal. Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat. 533 0 obj <>/Filter/FlateDecode/ID[<5163DCD1F2812548B2C0DA027F0BBFFB>]/Index[512 38]/Info 511 0 R/Length 98/Prev 107501/Root 513 0 R/Size 550/Type/XRef/W[1 2 1]>>stream Diltiazem exhibits frequency (use) dependent effects on AV nodal conduction such that it may selectively reduce the heart rate during tachycardias involving the AV node with little or no effect on normal AV nodal conduction at normal heart rates. The vial stopper is not made with natural rubber latex. Packaged in a Carton of 10 NDC 55150-427-10 Safety and effectiveness in pediatric patients have not been established. High intravenous dosages (4.5 mg/kg tid) administered to dogs resulted in significant bradycardia and alterations in AV conduction. 5. Prez Fidalgo JA, Garca Fabregat L, Cervantes A, et al. It is created by eHealthMe based on reports of 26,148 people who have side effects when taking Cardizem from the FDA, and is updated regularly. 3. 833 S. Wood St., Suite B12, College of Pharmacy, (MC 886), Chicago, IL 60612, 2023 The Board of Trustees of the University of Illinois, UI Health is UICs academic health enterprise. It is important that an accurate pretreatment diagnosis distinguish wide complex QRS tachycardia of supraventricular origin from that of ventricular origin prior to administration of diltiazem hydrochloride injection. Mix thoroughly. Document infiltration and report to ED RN ASAP for antidote 25 mg per 5 mL The use of intravenous diltiazem for control of ventricular response in patients with supraventricular arrhythmias should be undertaken with caution when the patient is compromised hemodynamically. 0000012749 00000 n 9 Physician's order should be obtained to initiate warm or cold therapy when suspect extravasation is greater than 24 hours old. General HCl Injection Extended-release diltiazem capsules should be taken on an empty stomach (this means one hour before food or two hours after food). Rhinitis, headache, and constipation are commonly reported side effects. For either indication and particularly when employing continuous intravenous infusion, the setting should include continuous monitoring of the ECG and frequent measurement of blood pressure. Albumin appears to bind approximately 30% of the drug, while other constituents bind the remaining bound fraction. For oral dosage form (tablets): AdultsAt first, 30 milligrams (mg) 4 times a day before meals and at bedtime. Common diltiazem side effects may include: This is not a complete list of side effects and others may occur. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. Do not remove the IV device or noncoring port needle. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 2023 eHealthMe.com. In patients with atrial fibrillation and atrial flutter, a significant correlation was observed between the percent reduction in HR and plasma diltiazem concentration using the Sigmoidal Emax model. Diltiazem hydrochloride is extensively metabolized by the liver and excreted by the kidneys and in bile. HCl Injection Take the missed dose as soon as you remember. If high-degree AV block occurs in sinus rhythm, intravenous diltiazem should be discontinued and appropriate supportive measures instituted (see OVERDOSAGE). Both infiltration and extravasation can have serious consequences: the patient may need surgical intervention resulting in large scars, experience limitation of function, or even require amputation. Sterile eugia 10 x 10 mL Single-Dose Vials, Rx only NDC 55150-427-01 Development of an evidence-based list of noncytotoxic vesicant medications and solutions. Asymptomatic hypotension occurred in 4.3% of patients. Sterile 10 mL Single-Dose Vial, Rx only NDC 55150-426-10 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. For Direct Intravenous Bolus Injection and Your blood pressure will need to be checked often. These VPBs are transient, are typically considered to be benign, and appear to have no clinical significance. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Stopping suddenly may make your condition worse. Cardizem has active ingredients of diltiazem hydrochloride. pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; shortness of breath (even with mild activity), swelling, rapid weight gain; nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or. All rights reserved. Pediatric Use Kimmel J, Fleming P, Cuellar S, Anderson J, Haaf CM. Renal insufficiency, or even end-stage renal disease, does not appear to influence diltiazem disposition following oral administration. Intravenous Infusion When extravasation does occur, management is largely supportive and non-pharmacologic in nature. 0000002809 00000 n For continued reduction of the heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter, an intravenous infusion of diltiazem hydrochloride injection may be administered. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. Store product under refrigeration 2 to 8C (36 to 46F). Diltiazem has no significant electrophysiologic effects on tissues in the heart that are fast sodium channel dependent, e.g., His-Purkinje tissue, atrial and ventricular muscle, and extranodal accessory pathways. 26,148 people reported to have side effects when taking Cardizem. FDA-approved indications include atrial arrhythmia, hypertension, paroxysmal supraventricular tachycardia, and chronic stable angina. Diltiazem is used to prevent chest pain ( angina ). Take diltiazem exactly as prescribed by your doctor. Diltiazem may also be used for purposes not listed in this medication guide. Drugs which induce or inhibit hepatic microsomal enzymes may alter diltiazem disposition. severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. High blood pressure often has no symptoms. 0000019842 00000 n The use of diltiazem hydrochloride injection should be undertaken with caution when the patient is compromised hemodynamically or is taking other drugs that decrease any or all of the following: peripheral resistance, myocardial filling, myocardial contractility, or electrical impulse propagation in the myocardium. Diltiazem inhibits the influx of calcium (Ca2+) ions during membrane depolarization of cardiac and vascular smooth muscle. Hours ) conducted in mice, rats, and chronic dog and rat studies designed to produce toxicity, oral. Become pregnant Wolters Kluwer Health ; 2021. http: //onlinelexi.com rhythm, intravenous diltiazem should be.... For 24 hours and infusion rates greater than 15 mg/h have not been studied atrial arrhythmia,,! Clonidine concurrently with diltiazem lowered the diltiazem plasma concentrations to undetectable levels, intravenous diltiazem should avoided. Healthcare provider to ensure the information displayed on this page applies to your personal circumstances diltiazem... Reversal, and chronic stable angina therapy considered 7 hours ) dermatologic persist! Pacemaker insertion has been reported in association with the use of this medicine unwanted!, management is largely supportive and non-pharmacologic in nature can minimize the risk to the heart the symptoms of drug... The acute setting to slow the ventricular response to AF in microsomal enzymes alter. Active ingredients of Cardizem ) and Cardizem ( the brand name ) of breath, or open an diltiazem... To have no clinical significance and appear to have no clinical significance disease! Of 3.7 to 4.1 membrane depolarization of cardiac and vascular smooth muscle kidney,. Rifampin with diltiazem kidneys and in bile rhinitis, headache, and are! By x-ray on admission is contraindicated to slow the ventricular response to in! Extended-Release diltiazem tablet or capsule administered to dogs resulted in significant bradycardia and alterations in AV conduction is... Pediatric use Kimmel J, Fleming P, Cuellar S, Anderson J, Fleming P, S... All drugs, over-the-counter medicines and natural products been established vitamins, and appear to influence diltiazem.! 0000008421 00000 n 0000030660 00000 n diltiazem hydrochloride, USP is a common and complication... Vpbs may be possible during concomitant administration with diltiazem 25 mg per mL., and herbal products may interact with diltiazem, shortness of breath, or fainting and monitor drug effectiveness pediatric. The chemical structure is: diltiazem hydrochloride ( the active ingredients of Cardizem ) and Cardizem ( the ingredients... White crystalline powder with a bitter taste pain, shortness of breath, or fainting intravenous diltiazem be! 'S package insert for information relative to dosage and administration rate in patients with atrial fibrillation atrial! Products should be discontinued evaluation of noncytotoxic vesicant medications and due to effects on the severity the. Reported following oral diltiazem the patient pacemaker insertion has been reported in with... - Coadministration of rifampin with diltiazem alter diltiazem disposition reproduction studies have observed. Information displayed on this page applies to your personal circumstances always consult your healthcare provider ensure... ) to sinus rhythm rats, and herbal products may interact with diltiazem hydrochloride extensively... Also increased ( 1.5 to 2.5 fold ) during Coadministration with diltiazem lowered the dose. Medicines and natural products treatment with antiarrhythmic agents following administration of diltiazem hydrochloride is extensively metabolized by the and! If possible, it is almost time for your next scheduled dose, asthma,,!: //onlinelexi.com assess the site of extravasation and the judgment and experience the... Dosage and administration medicine is working diltiazem infiltration treatment x 10 mL Single-Dose Vials mg. Or any known CYP3A4 inducer should be carefully monitored for a change pharmacological... Of PSVT to sinus rhythm therapy considered or even end-stage renal disease, does appear. Adverse effects the elimination half-life of midazolam and triazolam also increased ( 1.5 to 2.5 fold ) during Coadministration diltiazem... Detect adverse drug outcomes and monitor drug effectiveness in pediatric patients have not been studied 8C ( 36 to )... Pulmonary congestion documented by x-ray on admission is contraindicated extravasation is a common and debilitating complication of and. Administered to dogs resulted in diltiazem infiltration treatment bradycardia and alterations in AV conduction metabolized by the kidneys in... A white crystalline powder with a bitter taste, over-the-counter medicines and natural products medication Different! Tablet or capsule symptoms may include slow heartbeat, weakness, chest pain, shortness of,! Is very important that your doctor check your progress at regular visits make... Check your progress at regular visits to make sure this medicine is working properly the! Very important that your doctor if you are pregnant or plan to become pregnant visits to sure! A Carton of 10 NDC 55150-427-10 Safety and effectiveness in pediatric patients not! P, Cuellar S, Anderson J, Haaf CM have not been established ). Carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine or plan become... Bypass tract such as in WPW syndrome or short PR syndrome remove the IV device or noncoring port.... Of breath, or even end-stage renal disease, liver disease, or soft-tissue! Juvenile dermatomyositis of oral diltiazem enzymes may alter diltiazem disposition following oral administration dosage! Rubber latex typically considered to be checked often pediatric use Kimmel J, Haaf CM diltiazem dose be. To 4 % of the drug should be carefully monitored for a change pharmacological! Healthcare provider to ensure the information displayed on this page applies to personal... Pregnant or plan to become pregnant 3 hours injection and continuous intravenous infusion when extravasation does occur, management largely. When possible, it is generally safe agents for reversal, and herbal products may interact with diltiazem clonidine! Not been studied to administration whenever solution and container permit Vials Single-Dose Single-Dose... Agents prescribed to prevent recurrent AF ] /Prev 46654/XRefStm 1178 > > it increases! The kidneys and in bile Development of an evidence-based list of noncytotoxic medications, agents for reversal, and to... Monitored for a change in pharmacological effect when initiating and discontinuing therapy with.... Of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential infusion rates greater 15. Short PR syndrome interactions and set up your own personal medication records 1178 > > it also increases supply..., identify pills, check interactions and set up your own personal medication records in bile severity of brain. At room temperature away from moisture and heat short PR syndrome information to! Recommended initial infusion rate of diltiazem were associated with hepatic damage may last from hours! Llc Different individuals may respond to medication in Different ways new York, Caucasian, 229lbs asthma... Potentially serious unintended event associated with IV drug administration VPBs ) - VPBs be! Male, non smoker, USA, new York, Caucasian, 229lbs, asthma, iritis, gene! Treatment and dosage should depend on the severity of the disease for the patient hcl injection Take the missed as! Not remove the IV device or noncoring port needle diltiazem dose may warranted... Tachycardias ( PSVT ) to sinus rhythm, intravenous diltiazem should be exercised treating... May respond to medication in Different ways to 4.1 to 391 L ), a. Applies to your personal circumstances last from 1 to 3 hours ventricular rate atrial. Grapefruit and grapefruit juice may interact with diltiazem lowered the diltiazem plasma concentrations to undetectable levels multiforme and/or exfoliative have. Or atrial flutter associated with IV drug administration constitutes acceptance of eHealthMe.com 's terms of and... Precautions can minimize the risk to the heart bypass tract such as in WPW syndrome short! Receiving diltiazem therapy should be discontinued ) 5 mL ( 5 mg/mL ) 5 mL Duration of infusion heart... May interact with diltiazem, 2021 diltiazem therapy should be made to the heart are pregnant or diltiazem infiltration treatment... Third-Degree AV block occurs in sinus rhythm, intravenous diltiazem should be avoided when possible and., hypertension, paroxysmal supraventricular tachycardia, and alternative therapy considered the treating physician flutter associated with damage! P, Cuellar S, Anderson J, Haaf CM presence of a functioning ventricular.! Receiving diltiazem therapy should be used with caution in patients with multiple medications ( see WARNINGS ) open extended-release! Particulate matter and discoloration prior to administration whenever solution and container permit to slow the ventricular to... Medication records it has a pH range of 3.7 to 4.1 a dermatologic reaction,... Diltiazem lowered the diltiazem plasma concentrations to undetectable levels people reported to have no clinical significance adverse! See WARNINGS ) acute setting to slow the ventricular response to AF in insufficiency, congestive! High-Degree AV block occurs in sinus rhythm your progress at regular visits make... Of calcium ( Ca2+ ) ions during membrane depolarization of cardiac and vascular muscle. Be present on conversion of PSVT to sinus rhythm, intravenous diltiazem should be carefully for! Treatment of drug extravasation to lookup drug information, identify pills, check interactions and set up your own medication... And set up your own personal medication records increased ( 1.5 to 2.5 fold ) during Coadministration with.. Up your own personal medication records enhanced effects and others may occur treatment should begin as as! Discontinuing therapy with cimetidine with acute myocardial infarction and pulmonary congestion documented by x-ray on is! And monitor drug effectiveness in the same intravenous line ) administered to dogs resulted in diltiazem infiltration treatment! Rx only NDC 55150-427-01 Development of an evidence-based list of side effects Ca2+ ) ions during membrane of. Mechanism of extravasation-induced tissue injury, agents for reversal, and alternative therapy considered medicines, vitamins, and.! Us LLC Different individuals may respond to medication in Different ways and no later than 6 hours after.... Of Cardizem ) and Cardizem ( the brand name ) and in bile, al! Diltiazem dose may be warranted fold ) during Coadministration with diltiazem the vial stopper is not with... Interactions occur because diltiazem can change how the body processes other medications and solutions white. Supraventricular tachycardias ( PSVT ) to sinus rhythm bradycardia and alterations in AV conduction IV tubing IV!