Pharmacopeia

CWP-0082

DILTIAZEM

Cardiovascular · Cardiovascular · Level 3

Core pharmacology

Legacy Cicm Level

Level 3

Introduction

Benzothiazepine
(Non-dihydropyridine calcium channel blocker)

Indications Uses

It is used for angina and
hypertension

Presentation

sustained and immediate release oral formulations, 60-360mg

Mechanism of action

Similar to the other Ca Channel blockers in terms of blood pressure.

Physiological effects

Produces
more peripheral vasodilation than verapamil and more conduction delay than the
dihydropyridines such as nifedipine

Adverse Effects Toxicity

Peripheral oedema is a common side effect, 2-3 weeks post initiation of therapy.
Other side effects include ushing, vertigo, headaches, hypotension and
parathesias.

Protein binding

70% to 80%

Volume of distribution

3-13 L/kg

Metabolism

Hepatic active metabolites desacetyl-diltiazem

Excretion

Urine ( 4% as unchanged, 7% as metab); faeces

Half-life

3-4.5 hours (↑ in renal failure)

Route And Dose

PO/IV 30-80mg TDS

Onset Peak Duration

on/dur PO: 30-60 min; IV: 3 mins

Cardiovascular · Cardiovascular

Class Group

(CCB) Ca channel blocker – Class III

Antiarrhythmic –
Vaughan Williams Class IV

Absorption

PO/IV.
BA 40% Well absorbed high -first pass metabolism
on/dur PO: 30-60 min; IV: 3 mins

Class Group

Antiarrhythmic –
Vaughan Williams Class IV

(CCB) Ca channel blocker – Class III

Absorption

PO/IV.
BA 40% Well absorbed high -first pass metabolism