Diltiazem pills 60mg 30pcs

Composition

One tablet contains:  active substance: diltiazem hydrochloride 60 mg

Pharmacological action

Antianginal, antihypertensive, vasodilator, antiarrhythmic.

By blocking calcium channels, it reduces the flow of calcium ions into myocardial cells.

Diltiazem-Teva causes dilation of the coronary arteries, thereby increasing coronary blood flow.

Reduces the smooth muscle tone of peripheral arteries and OPSS.

Indications

Angina pectoris (prevention of seizures), arterial hypertension, prevention of attacks of supraventricular arrhythmias (paroxysmal tachycardia, atrial fibrillation or flutter, extrasystole).

Contraindications

Hypersensitivity, sinus node weakness syndrome, grade II-III AV block, cardiogenic shock, acute heart failure, chronic heart failure, severe bradycardia, hypotension, severe hepatic-renal failure, childhood.

Side effects

Weakness, dizziness, headaches, sinus bradycardia, impaired AV conduction, symptoms of heart failure, hypotension, nausea, constipation or diarrhea, flatulence, transient increase in hepatic transaminase activity, redness of the skin, itching.

Interaction

When used concomitantly with beta-blockers (including propranolol, atenolol, metoprolol, pindolol, sotalol), an additive cardiodepressive effect is possible along with an increase in antianginal action in most patients. Patients with previous left ventricular dysfunction or conduction disorders are at an increased risk of developing severe and threatening bradycardia. Diltiazem inhibits the metabolism of propranolol, metoprolol, but not atenolol.

When used concomitantly with amiodarone, the negative inotropic effect, bradycardia, conduction disturbances, and AV block are enhanced.

Since diltiazem inhibits the CYP3A4 isoenzyme, which is involved in the metabolism of atorvastatin, lovastatin and simvastatin, drug interactions are theoretically possible due to increased statin concentrations in blood plasma. Cases of rhabdomyolysis are described.

When used concomitantly with buspirone, the concentration of buspirone in the blood plasma increases, its therapeutic and side effects increase.

When used concomitantly with vecuronium chloride, it is possible to increase the duration of neuromuscular blockade.

When used concomitantly with digoxin, digitoxin, it is possible to increase the concentrations of digoxin and digitoxin in blood plasma.

When used concomitantly with imipramine, the concentration of imipramine in the blood plasma increases and there is a risk of undesirable ECG changes.

There are cases of increased plasma concentrations of trimipramine and nortriptyline when used concomitantly with diltiazem. Diltiazem increases the bioavailability of imipramine by reducing its clearance. Changes in the ECG are caused by an increase in the concentration of imipramine in blood plasma and the additive inhibitory effect of diltiazem and imipramine on AV conduction. It is believed that diltiazem interacts in the same way with trimipramine and nortriptyline.

When used concomitantly with insulin, a case of a decrease in the effectiveness of insulin is described.

Due to the inhibition of the metabolism of anticonvulsants in the liver under the influence of diltiazem and a decrease in their clearance from the body, it is possible to increase the concentrations of carbamazepine and phenytoin in blood plasma with the risk of toxic effects.

When used concomitantly with lithium carbonate, cases of acute Parkinsonism syndrome and psychosis have been described.

When used concomitantly with midazolam, triazolam, the concentration of midazolam and triazolam in blood plasma increases and their effects are enhanced due to the inhibition of the CYP3A4 isoenzyme under the influence of diltiazem, with the participation of which the metabolism of these benzodiazepines is carried out.

When used concomitantly with sodium amidotrizoate, the antihypertensive effect of diltiazem may be enhanced.

When used concomitantly with sodium nitroprusside, it is possible to significantly increase the effectiveness of controlled arterial hypotension.

When used concomitantly with nifedipine, the antihypertensive effect increases.

Rifampicin induces the activity of liver enzymes, accelerating the metabolism of diltiazem, which leads to a decrease in its effectiveness. When used concomitantly with theophylline, there may be a slight decrease in theophylline metabolism in the liver, apparently due to inhibition of the CYP1A2 isoenzyme under the influence of diltiazem.

When used concomitantly with cisapride, a case of impaired consciousness has been described, apparently due to a pronounced prolongation of the QT interval. It is believed that diltiazem inhibits the activity of the CYP3A4 isoenzyme, which leads to an increase in the concentration of cisapride in blood plasma and, possibly, an increase in its cardiotoxicity.

When used concomitantly, diltiazem inhibits cyclosporine metabolism in the liver, which leads to a decrease in its excretion and an increase in its concentration in blood plasma. At the same time, there was a decrease in the manifestations of nephrotoxicity and an increase in the immunosuppressive effect.

When used concomitantly with cimetidine, the concentration of diltiazem in blood plasma increases due to inhibition of its oxidative metabolism in the liver under the influence of cimetidine. The effects of diltiazem may be increased.

When used concomitantly with enflurane, cases of impaired AV conduction of the myocardium have been noted.

How to take, course of use and dosage

of Diltiazem is taken orally, before meals, without chewing, with a small amount of water.

The dose is set individually. 1 tablet 3 times a day.

With insufficient severity of the therapeutic effect-up to 2 tablets. 3 times a day.

The maximum daily dose is 360 mg.

Special instructions

It is used with caution in patients with grade I AV block, intraventricular conduction disorders, in patients prone to arterial hypotension, chronic heart failure, myocardial infarction with left ventricular insufficiency, ventricular tachycardia with QRS complex expansion, hepatic insufficiency, renal insufficiency, in elderly patients, in children (efficacy and safety of use have not been studied).

Concomitant use of beta-blockers and diltiazem for parenteral use is not recommended.

Sudden withdrawal of diltiazem can lead to the development of a tonsillitis attack.

Patients with impaired liver and/or kidney function and the elderly need to adjust the dosage regimen.

Storage conditions

The drug should be stored out of the reach of children at a temperature not exceeding 25°C.

Active ingredient

Diltiazem

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults as directed by your doctor

Indications

Hypertension, Angina, Arrhythmia