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Cardizem

Generic name: Diltiazem

What are diltiazem tablets?

DILTIAZEM (Cardizem®) is a calcium-channel blocker. It affects the amount of calcium found in your heart and muscle cells. This results in relaxation of blood vessels, which can reduce the amount of work the heart has to do. Diltiazem relieves different types of chest pain (angina); it is not a cure. Generic diltiazem tablets are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• heart problems, low blood pressure, irregular heartbeat
• liver disease
• previous heart attack
• an unusual or allergic reaction to diltiazem, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take diltiazem tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Take diltiazem tablets on an empty stomach, at least 1 hour before or 2 hours after food. Do not significantly increase grapefruit juice intake while taking this drug, or avoid grapefruit juice if possible. Take your doses at regular intervals. Do not take your medicine more often then directed. Do not stop taking except on your prescriber's advice.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What drug(s) may interact with diltiazem?

Do not take Diltiazem with any of the following:

• astemizole
• cisapride
• grapefruit juice
• pimozide
• terfenadine

Diltiazem may also interact with the following medications:

• alfuzosin
• alosetron
• antiinflammatory drugs (NSAIDs, such as ibuprofen)
• aspirin
• barbiturates such as phenobarbital
• bosentan
• certain antibiotics (clarithromycin, erythromycin, telithromycin, troleandomycin)
• certain medicines used to treat cancer
• certain medicines to treat migraine (ergotamine, dihydroergotamine, methysergide)
• cevimeline
• cilostazol
• cimetidine
• clonidine
• cyclosporine
• doxercalciferol
• fentanyl
• galantamine
• herbal or dietary supplements such as ginger, ginkgo biloba, ginseng, hawthorn, ma huang (ephedra), melatonin, St. John's wort, red yeast rice
• lithium
• local anesthetics or general anesthetics
• medicines for anxiety or difficulty sleeping (examples: alprazolam, buspirone, midazolam, triazolam)
• medicines for depression or mental problems (imipramine, fluoxetine, fluvoxamine, nefazodone, ziprasidone)
• medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
• medicines for heart-rhythm problems (amiodarone, digoxin, disopyramide, dofetilide, encainide, flecainide, moricizine, procainamide, quinidine)
• medicines for high cholesterol (atorvastatin, cerivastatin, colesevelam, lovastatin, simvastatin)
• medicines for high blood pressure or heart problems
• medicines for HIV infection or AIDS
• medicines for prostate problems
• medicines for seizures (carbamazepine, clonazepam, ethosuximide, phenobarbital, phenytoin, primidone, zonisamide)
• methadone
• monoamine oxidase inhibitors (Azilect®, Eldepryl®, Emsam®, Marplan®, Nardil®, Parnate®, Zelapar.)
• paricalcitol
• rifampin, rifabutin, or rifapentine
• sildenafil
• sirolimus
• tacrolimus
• theophylline or aminophylline
• water pills (diuretics)
• yohimbine
• zafirlukast
• zileuton

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking diltiazem?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• confusion, mental depression
• fainting spells, lightheadedness
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• skin rash, itching
• slow heartbeat, irregular heartbeat
• swelling of the feet and ankles
• unusual weakness or tiredness
• unusual bleeding or bruising, pinpoint red spots on the skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• constipation or diarrhea
• difficulty sleeping
• drowsiness or dizziness
• facial flushing
• headache
• nausea, vomiting
• sexual dysfunction

What should I watch for while taking diltiazem?

Check your blood pressure and pulse rate regularly; this is important while you are taking diltiazem. Ask your prescriber or health care professional what your blood pressure and pulse rate should be and when you should contact him or her.

You may feel dizzy or lightheaded. Do not drive, use machinery, or do anything that needs mental alertness until you know how diltiazem affects you. To reduce the risk of dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Avoid alcoholic drinks; they can make you more dizzy or increase flushing and rapid heartbeats.

If you are going to have surgery, tell your prescriber or health care professional that you are taking diltiazem.

Do not suddenly stop taking diltiazem. Ask your prescriber or health care professional how to gradually reduce the dose.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from humidity. Throw away any unused medicine after the expiration date.