About Cardizem
Cardizem belongs to a class of drugs known as calcium channel
blockers. They work by blocking calcium ions from some cell walls,
inhibiting the contraction of coronary and peripheral arteries.
The reduced electrical activity in the cardiovascular system results
in lowered oxygen requirements for the heart muscle, decreased likelihood
of spasm and contraction in the arteries, and prevents the heart
from exerting itself too rapidly or forcefully. Benefits should
be seen within 1-4 weeks of consistent use.
This medication is primarily prescribed to treat: angina (Prinzmetal's
variant angina) not caused by exertion, classic angina caused by
exertion related to atherosclerosis, and high blood pressure (hypertension),
and fibrillation of the heart.
Other uses for which it is acceptable include: halt the progression
of artherosclerosis, reduces symptoms of Raynaud's syndrome (cold,
tingling, or numb extremities), decreases heart attack risk after
coronary bypass surgery, treats unstable angina, congestive heart
failure, prevents migraine, treats protein excretion in urine, prevents
abnormal growth of the heart after a heart attack, some esophageal
disorders, eases overactive thyroid gland, may preserve function
after kidney and heart transplants, may slow low tension glaucoma,
may prevent blockage in heart transplant patients.
Medication for high blood pressure or other cardiovascular problems
may have to continue for the duration of the patient's life, there
are currently no treatments that will reverse these conditions.
It's important that medication prescribed to treat these ailments
be taken regularly, as there may be no obvious symptoms before serious
damage is done to the body.
Cardizem is only available by prescription.
Cardizem Side Effects
Possible Side Effects: Change in menstrual cycle, constipation,
diarrhea, dizziness, fast heartbeat, flushing or warmth, headache,
low blood pressure (hypotension), nausea, sweating, swollen feet
or ankles, unusual tiredness.
Adverse Side Effects: Report any of the following infrequent
to rare symptoms to your doctor. If you experience any serious side
effects, seek medical treatment.
Mild
: Allergy (fever, hives, itching, rash), coughing, difficulty
breathing, dizziness, fatigue, flushing, headache, indigestion,
muscle cramps, nausea, poor circulation to extremities (cold or
numbness in hands or feet), reversible infertility in men, sleep
disorder, shortness of breath, tremors, unusual conditions of the
gums (bleeding, growth, tenderness), wheezing.
Serious
: Allergy (severe rash), bleeding or swollen gums,
chest pain, congestive heart failure (rare), decreased circulation
in fingers, fainting induced by low blood pressure, fluid in the
lungs, kidney damage, liver damage, low blood sugar (hypoglycemia),
more frequent angina, pain or swelling in joints, racing or irregular
heartbeat, reduced blood clotting, revealing movement disorders
(rare), trouble seeing.
Cautions: This medication may not be suitable for everyone.
Discuss any history of the following conditions with your doctor,
and carefully examine your treatment options.
- Allergies: An allergic reaction to this drug in the past
is an indication that you should not use it. If you develop a
skin condition while undergoing treatment, tell your doctor at
once. Inform you doctor if you have had a poor response to another
calcium channel blocker, or have any other allergies (food, dye,
medications).
- Aortic Stenosis: Speak to a specialist regarding treatment
options, this medication will probably not be the correct treatment
for you.
- Circulatory or Heart Conditions: Any history of heart
attack, stroke, congestive heart failure, heart rhythm disorders,
or any other condition of the circulatory system needs to be discussed
with your prescribing physician.
- Congestive Heart Failure/2nd or 3rd Degree Heart Block:
You should not use this medication.
- Diabetes: Consult your specialist.
- Gangrene: Discuss use with your doctor.
- Glaucoma: If you have glaucoma, and must administer any
of the following beta blocker eye drops, consult your physician
regarding possible interactions: Betagan (levobunolol), Betoptic
(betaxolol), OptiPranolol (metipranolol), or Timoptic (timolol).
- Heart Medications: If you take any other medication for
a cardiovascular condition, there may be a risk of significant,
possibly dangerous, drug interactions.
- Kidney Disease: One of the best drugs of its class to use when the kidneys are compromised, as it's mainly removed through the liver. Caution should still be exercised, as this medication has caused kidney damage in rare cases.
- Liver Disease: You should not take a dose higher than
90 mg daily. In rare cases, this drug has caused liver damage,
and should be prescribed with caution to individuals whose livers
have been damaged by other drugs. Speak with your doctor to weight
the benefits and risks.
- Low Blood Pressure (Hypotension): Do not use.
- Muscular Dystrophy: Consult your specialist.
- Poor Circulation: Frequently cold or tinging extremities
should be discussed with your doctor.
- Recent Heart Attack: Use with caution.
- Recent Stroke: Use with caution.
Cardizem Interactions
This medication may interact with other treatments. Always keep
your prescribing physician informed about any prescription or over
the counter preparations you may use. While some of the following
medications may be used with Cardizem even though there is a possibility
for interaction, some should not be mixed. Your doctor will have
to make this determination based on the necessity of treatment,
the possibility of dosage adjustments, and your medical history.
- Alcohol - Use with caution as directed by your doctor.
Alcohol may lower blood pressure too much, and its side
effects may be more pronounced when used with this medication.
- Anti-diabetic drugs or Insulin - This combination may
result in undesirably low blood sugar, regular testing for
hypoglycemia is recommended.
- Azole antifungals - Diflucan
(fluconazole), Nizoral
(ketoconazole), Sporanox
(itraconazole), and possibly others, may cause Cardizem
toxicity.
- Beta Blockers - Drugs like Blocadren (timolol), Cartrol
(carteolol), Corgard (nadolol), Inderal
(propranolol), Kerlone (betaxolol), Levatol (penbutolol),
Lopressor (metoprolol),
Normodyne (labetalol), Sectral (acebutolol), Sotacor (sotalol),
Tenormin (atenolol),
Trasicor (oxprenolol), or Visken (pindolol) may alter heart
rhythm and blood pressure undesirably when used with calcium
channel blockers. The beta blocker drops administered by
eye as a treatment for glaucoma may also interact with Cardizem,
speak to your doctor if you take Betagan (levobunolol),
Betoptic (betaxolol), OptiPranolol (metipranolol), or Timoptic
(timolol) drops.
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline,
Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur,
etc...) - May be toxic when mixed with Cardizem, as well
as reducing benefits of treatment.
- Calcium - Supplemental calcium may reduce the effectiveness
of calcium channel blockers. Take any vitamin supplement
containing calcium either 2 hours before, or 2 hours after,
taking your medicine.
- Cerebyx (fosphenytoin) or Dilantin
(phenytoin) - May build up to toxic levels in the body
when used with Cardizem treatment.
- Cordarone (amiodarone) - This combination may cause cardiac
arrest.
- Coumadin (warfarin)
- Increased risk of gastrointestinal hemorrhage.
- Digitalis glycosides - Toxicity may occur when these compounds
are combined with calcium channel blockers.
- Lanoxin (digoxin) -
Toxicity may occur when these compounds are combined with
calcium channel blockers.
- Magnesium - May further lower blood pressure, consult
your doctor about vitamin supplements and dosage adjustments.
- Nicotine (chewing tobacco, cigarettes, nicotine gum or
patches) - This substance may reduce the effectiveness of
your treatment. Do not combine.
- Norpace (disopyramide) - Undesirable Cardizem buildup
may occur. Increased muscle weakness may occur when these
treatments are combined.
- Oncovin (vincristine) - May build up to toxic levels.
- Prograf (tacrolimus) - Effects of Prograf may be increased.
- Pronestyl (procainamide) - Calcium channel blockers can
increase the effects of this drug.
- Protease inhibitors such as Agenerase (amprenavir), Norvir
(ritonavir), and perhaps others, may lead to higher levels
of Cardizem in the body.
- Quinaglute (quinidine) - Calcium channel blockers increase
the risk of quinidine side effects.
- Rifampin (Rifadin, Rimactane) - May decrease usefulness
of Cardizem.
- Sandimmune (cyclosporine) - Increased risk of side effects.
- Synercid (dalfopristin, quinupristin) - The effects of
Cardizem may be increased.
- Tagamet (cimetidine)
- Can increase Cardizem's effects.
- Tambocor (flecainide) - Calcium channel blockers can increase
the effects of this drug.
- Tegretol (carbamazepine)
- Tegretol may build up to toxic levels in the body.
- Zantac (ranitidine)
- May increase Cardizem side effects.
Cardizem Dosages
This medication is available in the following dosages and forms
of delivery:
- Immediate Release (tablets): 30 mg, 60 mg, 90 mg, 120 mg
- Extended Release (capsules): 120 mg, 180 mg, 240 mg, 300 mg
(Tiazac only: 360 mg, 420 mg)
- Sustained Release (capsules): 60 mg, 90 mg, 120 mg
If you get your prescription refilled, and the dosages look different,
doublecheck the dosage with your pharmacist. Various brands of this
medication can have different dosages.
The following are general guidelines for adults, your doctor will
need to give you a specific dosage depending on your body size and
medical history. Dosage should not generally exceed 540 mg daily
for extended release formulations, or 480 mg daily for sustained
release. Your doctor will probably start with the minimum dose and
gradually increase as needed. Follow your doctor's instructions
for use exactly, as each patient will need to be given an individual
dosage and schedule.
- Angina: 120 mg - 480 mg daily, in sustained release form.
- Hypertension: 60 mg - 120 mg twice daily, or 180 mg - 360 mg
once daily, sustained release form. Up to 540 mg daily of the
extended release form may be used.
Cardizem Directions
If you miss a dose of Cardizem, take it as soon as you remember,
unless it is almost time for the next one. In that case, skip the
missed dose and go back to your schedule. Taking double doses of
Cardizem is not recommended. This medication is most effective
when it is used consistently according to the schedule recommended
by your doctor. The extended release forms are usually taken at
bedtime to ensure that peak drug levels occur in the morning, when
there is a greater likelihood of heart attack.
Notify any health care personnel that you take this medication.
Carry a card or alert bracelet in case you should require emergency
services. Nitroglycerin, or another nitrate medication, is a safe
treatment for any acute angina episodes.
Cardizem tablets are most comfortably taken with food. All forms
of this medication should be swallowed whole. Do not take this medication
with grapefruit juice, or within two hours of a calcium supplement.
Stopping this Cardizem abruptly may lead to rebound angina. Decrease
your dose gradually according to the advice of your doctor if you
must stop treatment for any reason.
Store Cardizem away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep Cardizem away from children; both when storing it, and when
discarding any unused medication.
Cardizem and Pregnancy
In animal studies, this medication caused a greater incidence of
growth problems with the unborn child, but did not cause birth defects.
Cardizem should not be used at all during the first trimester,
consult with your doctor about treatment during the rest of your
pregnancy. Inform you doctor if you are planning a pregnancy, use
effective contraception while taking.
This drug only appears in very small quantities in breast milk.
If you wish to combine treatment with breastfeeding, consult with
your doctor and monitor your child's condition.
Cardizem and Children
This medication has not been established as as safe and effective treatment for children.
Cardizem and Seniors
There is a greater likelihood of dizziness, fainting, falls, or
weakness. Changes in thirst or urination should be reported to your
doctor immediately.
Cardizem and Cardizem CD are trademarks of Biovail
Tiazac is a trademark of Forest
Generic Diltiazem manufactured by Mylan and Watson
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The information contained in this document is provided for educational purposes
and information only. It is not a
substitute for consultation with a physician or Health professional, either to diagnose
symptoms or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor or
pharmacist exactly when taking medication. We have made every effort to
ensure that this information is accurate, but only your doctor,
physician or Health professional can say
if a medication, a drug alternative or drug combination, is safe for you. Information
intended for US residents only.
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