The medication a person is on is often a very important part of the management of their heart disease. The decisions related to your own personal medical management should be made by you and your personal physician.

The "Medication of the Month" section of the Baptist Health website is prepared by a Baptist Health pharmacist. It is intended for education purposes only and is not intended to promote any brand or type of medication. Remember, talk to your doctor about medications that are right for you.

This month's featured medication is:

Diltiazem (Cardizem, Cardizem SR, Cardizem CD, Tiamate, Dilacor XR, Tiazac)

Diltiazem is an important therapeutic agent with several common uses. Diltiazem acts by reducing the amount of calcium that enters tissue in the heart and blood vessels. Calcium activates these tissues and therefore diltiazem is useful when some of the tissues are too active. As a result of this action, diltiazem is useful in the following conditions:

1. Angina - which occurs when the heart works too hard for the oxygen it has available. Diltiazem will reduce the work of the heart.
2. High blood pressure - diltiazem relaxes the blood vessels and reduces the work of the heart so that blood pressure is reduced to a normal level.
3. Irregular heartbeat - diltiazem is effective in some types of irregular heart beat because it will slow the beating.
4. Occasionally, diltiazem is valuable in heart failure. It reduces the work of the heart to a level that the heart can manage.
5. Diltiazem may occasionally be used to prevent migraine headaches.

What are some of the common side effects?

As with most drugs, some patients experience side effects while taking diltiazem. Most commonly mentioned side effects include:

• dizziness, tiredness and weakness (which may be due to low blood pressure resulting from the action of diltiazem)
• headache other than migraine
• flushing (from relaxation of blood vessels)
• digital dysesthesia (numbness or altered sensation in the fingers and toes)
• constipation (diltiazem may also relax the bowels)
• swelling of ankles or fingers, coughing, wheezing and fluid on the lungs

If these side effects should occur, please report them to your physician.

Drug Interactions...

Diltiazem can increase the blood levels of cyclosporine. Be sure to check with your doctor before taking diltiazem with cyclosporine.

Special Considerations...

If the patient has a feeding tube, Cardizem immediate release tablets may be crushed and mixed with water before putting down the tube. If the sustained-release form is preferred, only Cardizem CD and Cardizem SR preparations may be used. Open the capsule and pour intact pellets down feeding tube. Do not crush or grind up the pellets inside of a capsule. Whether using the crushed tablet or the pellets, the feeding tube should be flushed with 1 ounce (30 ml) of sterile water before and after medication administration. Be sure to check with your doctor before switching from a brand name of diltiazem to a generic formulation.

If you have further questions about Diltiazem, please talk to your doctor or pharmacist.

Prepared by: Cheryl Born, PharmD
Edited by: Scott Harris, PharmD