Dilt-CD (Oral)

Diltiazem is used by itself or with other medicines to treat angina (severe chest pain) or hypertension (high blood pressure). High blood pressure increases the strain on the heart and arteries. If it lasts a long time, it can cause the heart and arteries to not work properly. This can harm the blood vessels in the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. High blood pressure may also raise the risk of heart attacks. Controlling blood pressure may help reduce the chances of these problems.

Diltiazem is a calcium channel blocker. It works by changing how calcium moves into the cells of the heart and blood vessels. This relaxes the blood vessels, lowers blood pressure, and improves the flow of blood and oxygen to the heart while decreasing its workload.

This medicine is available only with your doctor's prescription.

It is very important that your doctor check your progress at regular visits to ensure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Dizziness, lightheadedness, or fainting may happen, especially when you get up suddenly from lying down or sitting. If you feel dizzy, lie down to avoid fainting. Then sit for a few moments before standing again to help prevent the dizziness from coming back. If you faint, call your doctor right away.

Check with your doctor immediately if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be signs of a serious liver problem.

Serious skin reactions (for example, Stevens-Johnson syndrome, toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you notice blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, skin rash, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits it may provide. This decision will be made by you and your doctor. For this medicine, you should consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your health care professional know about any other allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There have not been appropriate studies on the effects of diltiazem in children. Safety and effectiveness for this age group have not been established.

Geriatric

Current studies have not shown any specific problems in older adults that would limit the usefulness of diltiazem. However, older patients are more likely to have kidney, liver, or heart issues related to aging, which may require caution and a dose adjustment for those taking diltiazem.

Breast Feeding

Research in women suggests that this medication poses minimal risk to an infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. If you are taking this medicine, it is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and may not include all possible interactions.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose not to treat you with this medication or change some of the other medicines you take.

• Cisapride
• Eliglustat
• Flibanserin
• Lomitapide

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you take one or both of the medicines.

• Abametapir
• Acalabrutinib
• Acebutolol
• Alfentanil
• Alprazolam
• Amiodarone
• Apixaban
• Aprepitant
• Atazanavir
• Atenolol
• Atorvastatin
• Avapritinib
• Benzhydrocodone
• Betaxolol
• Bisoprolol
• Bosutinib
• Brexpiprazole
• Brigatinib
• Buprenorphine
• Carbamazepine
• Carteolol
• Carvedilol
• Celiprolol
• Ceritinib
• Cilostazol
• Clarithromycin
• Clonidine
• Clopidogrel
• Clozapine
• Cobicistat
• Cobimetinib
• Codeine
• Colchicine
• Conivaptan
• Crizotinib
• Cyclosporine
• Dantrolene
• Daridorexant
• Darunavir
• Deflazacort
• Digoxin
• Dihydrocodeine
• Domperidone
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Droperidol
• Elacestrant
• Elexacaftor
• Encorafenib
• Entrectinib
• Epirubicin
• Eplerenone
• Erythromycin
• Esmolol
• Everolimus
• Fedratinib
• Fentanyl
• Fexinidazole
• Finerenone
• Fingolimod
• Fosaprepitant
• Fosnetupitant
• Gepirone
• Hydrocodone
• Ibrutinib
• Ifosfamide
• Infigratinib
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Labetalol
• Lacosamide
• Larotrectinib
• Lemborexant
• Levobunolol
• Lovastatin
• Lumateperone
• Lurasidone
• Lurbinectedin
• Mavacamten
• Melphalan
• Meperidine
• Methadone
• Metipranolol
• Metoprolol
• Mitapivat
• Mobocertinib
• Morphine
• Morphine Sulfate Liposome
• Nadolol
• Naloxegol
• Nebivolol
• Netupitant
• Nilotinib
• Olaparib
• Omaveloxolone
• Oxprenolol
• Oxycodone
• Pacritinib
• Palovarotene
• Pemigatinib
• Penbutolol
• Pentazocine
• Pexidartinib
• Phenobarbital
• Pindolol
• Piperaquine
• Pixantrone
• Ponesimod
• Pralsetinib
• Primidone
• Propranolol
• Ranolazine
• Rimegepant
• Rivaroxaban
• Selpercatinib
• Selumetinib
• Simeprevir
• Simvastatin
• Siponimod
• Sirolimus Protein-Bound
• Sonidegib
• Sotalol
• Sparsentan
• St John's Wort
• Sufentanil
• Tacrolimus
• Tazemetostat
• Tezacaftor
• Timolol
• Tolvaptan
• Tramadol
• Ubrogepant
• Venetoclax
• Venlafaxine
• Voclosporin
• Zanubrutinib
• Zolpidem

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be necessary for your treatment. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfuzosin
• Amlodipine
• Buspirone
• Cimetidine
• Colestipol
• Dalfopristin
• Digitoxin
• Dutasteride
• Efavirenz
• Enflurane
• Fosphenytoin
• Guggul
• Indinavir
• Lithium
• Methylprednisolone
• Midazolam
• Moricizine
• Nevirapine
• Phenytoin
• Quinupristin
• Rifampin
• Rifapentine
• Sirolimus
• Suvorexant
• Triazolam

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used near the time of eating food or certain types of food as interactions may occur. Using alcohol or tobacco with some medicines may also cause interactions. The following interactions have been chosen based on their potential significance and may not include all possible interactions.

Other Medical Problems

Having other medical problems may affect how this medicine works for you. Make sure to tell your doctor if you have any other medical issues, especially:

• Severe bowel blockage
• Congestive heart failure—Use with caution. May worsen these conditions.
• Heart attack or
• Heart block (a type of abnormal heart rhythm; can be used if you have a working pacemaker) or
• Severe hypotension (low blood pressure) or
• Lung problem (e.g., pulmonary congestion) or
• Sick sinus syndrome (a type of abnormal heart rhythm; can be used if you have a working pacemaker)—Should not be used in patients with these conditions.
• Kidney disease or
• Liver disease—Use with caution. Effects may be increased due to slower removal of the medicine from the body.

Along with its necessary effects, a medicine can also cause some unwanted effects. Not all of these side effects may happen, but if they do, you may need to seek medical attention.

Check with your doctor right away if any of the following side effects happen:

More common

• Body aches or pain
• congestion
• cough
• dryness or soreness of the throat
• fever
• hoarseness
• runny nose
• tender or swollen glands in the neck
• trouble swallowing
• voice changes

Less common

• Chest pain, discomfort, or tightness
• chills
• diarrhea
• difficult or labored breathing
• feeling faint, dizzy, or lightheaded
• feeling of warmth or heat
• flushing or redness of the skin, especially on the face and neck
• general feeling of discomfort or illness
• headache
• joint pain
• loss of appetite
• muscle aches and pains
• nausea
• shivering
• slow or irregular heartbeat
• sweating
• swelling of the hands, ankles, feet, or lower legs
• trouble sleeping
• unusual tiredness or weakness
• vomiting

Incidence not known

• Blistering, peeling, or loosening of the skin
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• no heartbeat
• red skin lesions, often with a purple center
• red, irritated eyes
• sores, ulcers, or white spots in the mouth or on the lips

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body gets used to the medicine. Your health care professional may also be able to tell you how to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

More common

• Sneezing
• stuffy nose

Less common

• Acid or sour stomach
• belching
• constipation
• continuing ringing or buzzing or other unexplained noise in the ears
• degenerative disease of the joint
• difficulty with moving
• hearing loss
• heartburn
• indigestion
• lack or loss of strength
• muscle aching or cramping
• muscle pains or stiffness
• pain or tenderness around the eyes and cheekbones
• rash
• stomach discomfort, upset, or pain
• swollen joints

Incidence not known

• Loss or thinning of the hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Cardizem
• Cardizem CD
• Cardizem LA
• Cartia XT
• Dilacor XR
• Dilt-CD
• Diltia XT
• Dilt-XR
• Diltzac
• Matzim LA
• Taztia XT
• Tiazac

Available Dosage Forms:

• Capsule, Extended Release
• Tablet
• Capsule, Extended Release, 24 HR
• Tablet, Extended Release
• Capsule, Extended Release, 12 HR
• Tablet, Extended Release, 24 HR

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Calcium Channel Blocker

Chemical Class: Benzothiazepine

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

You may swallow whole, crush, or chew the 30 milligrams (mg), 60 mg, 90 mg, or 120 mg tablet. Do not split the 30 mg tablet.

Swallow the extended-release tablet or extended-release capsule whole. Do not open, crush, or chew it. It is best to take the extended-release capsule on an empty stomach.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For chest pain: For oral dosage form (extended-release capsules): Adults—At first, 120 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For oral dosage form (extended-release tablets): Adults—At first, 180 milligrams (mg) once a day, either in the morning or evening. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 30 milligrams (mg) 4 times a day before meals and at bedtime. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor.

• For high blood pressure: For oral dosage form (extended-release capsules): Adults—At first, 180 to 240 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For oral dosage form (extended-release tablets): Adults—At first, 180 to 240 milligrams (mg) once a day, either in the morning or at bedtime. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.