Unstable angina pectoris including angina due to coronary artery spasm or following MI. Spontaneous coronary artery spasm presenting as Prinzmetal's variant angina. Management of chronic stable angina in patients who cannot tolerate therapy w/ β-blockers &/or nitrates or those who remain symptomatic despite adequate doses of these agents. In HTN, either alone or in combination w/ other antihypertensives eg, diuretics. Prevention of graft failure following kidney transplantation. Reduction of ciclosporin A nephrotoxicity during immunosuppressive therapy after kidney transplantation.
Ischemic heart disease (exertional angina pectoris due to atherosclerotic CAD or angina pectoris at rest due to coronary artery spasm) Initially 120 mg daily in equally divided doses. Gradually increase in equally divided doses (bid-qid) at 1-2-day intervals until optimum response is obtained. Optimum dose range: 180-360 mg daily. Up to 480 mg daily in some cases. HTN Initially 120-240 mg daily in equally divided doses. Usual dose range: 240-360 mg daily. Kidney transplantation Initially 120 mg daily in 2 equally divided doses. May be increased up to a max of 360 mg daily in 3 equally divided doses. Optimum dose range: 180-360 mg daily.
View Dilzem overdosage for action to be taken in the event of an overdose.
Administration
Should be taken on an empty stomach: Preferably taken before meals & at bedtime. SA & SR tab: Swallow whole, do not chew/crush.
Contraindications
Hypersensitivity. Sick sinus syndrome or 2nd- or 3rd-degree AV block, except in the presence of a functioning ventricular pacemaker. Hypotension (<90 mmHg systolic), acute MI, X-ray documented pulmonary congestion.
Prolongs AV node refractory periods w/o significantly prolonging sinus node recovery time, except in patients w/ sick sinus syndrome. Patients w/ impaired ventricular, renal, or hepatic function. Symptomatic hypotension. Acute hepatic injury. Discontinue if dermatological reactions persist. Monitor lab parameters at regular intervals when given over prolonged periods. Concomitant use w/ β-blockers or digitalis. Pregnancy & lactation. Childn.
Increased exposure (Cmax, AUC) of ivabradine. Increased propranolol levels. Increased peak plasma levels & AUC w/ cimetidine. May potentiate depression of cardiac contractility, conductivity, & automaticity as well as the vascular dilation associated w/ anesth. Increased plasma level of ciclosporin. May enhance plasma levels of carbamazepine & consequently the risk of toxicity. Risk for heart irregularities or long QT manifestations w/ erythromycin. Increased AUC of some statins. Increased risk of myopathy & rhabdomyolysis w/ statins. Increased Cmax & AUC of sirolimus. May increase blood conc of everolimus. Digoxin, warfarin, rifampin or lithium.
C08DB01 - diltiazem ; Belongs to the class of benzothiazepine derivative selective calcium-channel blockers with direct cardiac effects. Used in the treatment of cardiovascular diseases.
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