0000006002 00000 n Congestive Heart Failure - Although diltiazem has a negative inotropic effect in isolated animal tissue preparations, hemodynamic studies in humans with normal ventricular function and in patients with a compromised myocardium, such as severe CHF, acute MI, and hypertrophic cardiomyopathy, have not shown a reduction in cardiac index nor consistent negative effects on contractility (dp/dt). General 0000002809 00000 n Therefore, infusion duration exceeding 24 hours and infusion rates exceeding 15 mg/h are not recommended. ACR Manual on Contrast Media 2020. To make sure diltiazem is safe for you, tell your doctor if you have: if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); if you have recently had a heart attack and you have a build-up of fluid in your lungs. Diltiazem does not appear to be removed by peritoneal or hemodialysis. For Direct Intravenous Bolus Side effects include headaches, nausea, rash . Physical Incompatibilities: Because of potential physical incompatibilities, it is recommended that diltiazem hydrochloride injection not be mixed with any other drugs in the same container. In vitro, propranolol appears to be displaced from its binding sites by diltiazem. High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys . Brand names: Cardizem (and Cardizem CD, LA and XR), Cartia XT, Dilacor XR, Dilt-CD, %PDF-1.5 % * Approximation only. Like other calcium channel antagonists, because of its effect on vascular smooth muscle, diltiazem decreases total peripheral resistance resulting in a decrease in both systolic and diastolic blood pressure. The following are common drugs that interact with diltiazem; Not all possible interactions are listed in this medication guide. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. @ Additionally, administration factors, including the experience of personnel administering the injection, the injection technique, and the number of venipuncture attempts to establish a line, contribute to the risk of extravasation, as does the fragility of the patients veins. It is based on diltiazem hydrochloride (the active ingredients of Cardizem) and Cardizem (the brand name). Paroxysmal Supraventricular Tachycardia Once familiarity of the patient's response is established, use in an office setting may be acceptable. Store diltiazem at room temperature away from moisture and heat. Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. 0000010832 00000 n In subacute and chronic dog and rat studies designed to produce toxicity, high oral doses of diltiazem were associated with hepatic damage. Limited data suggest that plasmapheresis or charcoal hemoperfusion may hasten diltiazem elimination following overdose. You may need to use blood pressure medicine for the rest of your life. Reproduction studies have been conducted in mice, rats, and rabbits. As such, the initial use of diltiazem hydrochloride injection should be, if possible, in a setting where monitoring and resuscitation capabilities, including DC cardioversion/defibrillation, are present (see OVERDOSAGE). Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. 25 mL Single-Dose Vials If intravenous diltiazem is administered to patients receiving chronic oral beta-blocker therapy, the possibility for bradycardia, AV block, and/or depression of contractility should be considered (see CONTRAINDICATIONS). Carcinogenesis, Mutagenesis, Impairment of Fertility, Paroxysmal supraventricular tachycardia -, Direct Intravenous Single Injections (Bolus), Quantity of Diltiazem hydrochloride injection, Transition to Further Antiarrhythmic Therapy, diltiazem hydrochloride injection, solution. Although it is not possible to prevent all accidents, a few simple precautions can minimize the risk to the patient. These doses, in some studies, have been reported to cause skeletal abnormalities. Manufactured by: The plasma elimination half-life is approximately 3.4 hours. In controlled clinical trials, therapy with antiarrhythmic agents to maintain reduced heart rate in atrial fibrillation or atrial flutter or for prophylaxis of PSVT was generally started within 3 hours after bolus administration of diltiazem hydrochloride injection. prolonged sedation) of both midazolam and triazolam. Dermatologic: Alopecia, erythema multiforme (including Stevens-Johnson syndrome, toxic epidermal necrolysis), exfoliative dermatitis, leukocytoclastic vasculitis, petechiae, photosensitivity, purpura, rash, urticaria 0000030660 00000 n %%EOF a rough estimate would be great. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. 125 mg per 25 mL Both infiltration and extravasation can have serious consequences: the patient may need surgical intervention resulting in large scars, experience limitation of function, or even require amputation. Package insert / product label Diltiazem is well absorbed from the gastrointestinal tract and is subject to an extensive first-pass effect, giving an absolute bioavailability (compared to intravenous dosing) of about 40%. 2023 eHealthMe.com. High blood pressure often has no symptoms. The vein used should be a large, intact vessel with good blood flow. Stopping suddenly may make your condition worse. If possible, it is recommended that diltiazem hydrochloride injection not be co-infused in the same intravenous line. xref Your blood pressure will need to be checked often. 0000017632 00000 n Avoid continuous vesicants or irritants (chemotherapy, vasopressors) B. It may help to increase your ability to exercise and decrease how often you may get angina attacks. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). Some drugs, including anti-cancer agents, are directly cytotoxic to cells. Rapid conversion of paroxysmal supraventricular tachycardias (PSVT) to sinus rhythm. Accessed January 13, 2021. Caution should be exercised when using the drug in such patients. Injection and Continuous In: Post TW, ed. The purpose of this review is to provide an update of treatment modalities for calcinosis in dermatomyositis based on published . Nursing Mothers Diltiazem Injection Prescribing Information. HCl Injection When extravasation does occur, management is largely supportive and non-pharmacologic in nature. This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. Although not observed in clinical trials with diltiazem hydrochloride injection, the following events associated with oral diltiazem may occur: A 24 hour continuous infusion of diltiazem hydrochloride injection in the treatment of atrial fibrillation or atrial flutter maintained at least a 20% heart rate reduction during the infusion in 83% of patients. Diltiazem hydrochloride injection is indicated for the following: Prior to thrombus aspiration, a thrombus aspiration catheter was used to perform diltiazem injection at the distal end of the infarct-related artery (IRA). Common diltiazem side effects may include: This is not a complete list of side effects and others may occur. endstream endobj 333 0 obj <. This study shows that topical 2% diltiazem is an effective and safe treatment for chronic anal fissure in patients who have failed topical 0.2% GTN. In patients administered continuous infusions at 10 mg/h or 15 mg/h for 24 hours, diltiazem systemic clearance averaged 42 L/h and 31 L/h, respectively. Single-dose vials. It is often used in high blood pressure. Continuous Intravenous Infusion Drug class: calcium channel blocking agents, ANALYSIS(55150-425, 55150-426, 55150-427), MANUFACTURE(55150-425, 55150-426, 55150-427), PACK(55150-425, 55150-426, 55150-427), dextrose (5%) and sodium chloride (0.45%) injection, USP. There are no well-controlled studies in pregnant women; therefore, use diltiazem hydrochloride in pregnant women only if the potential benefit justifies the potential risk to the fetus. Drug choices for rate control include beta-blockers, verapamil and diltiazem, and digitalis as first-line agents, with consideration of other sympatholytics, amiodarone, or . The chemical structure is: Diltiazem hydrochloride, USP is a white crystalline powder with a bitter taste. Changes in heart rate, systolic blood pressure, and diastolic blood pressure did not correlate with diltiazem plasma concentrations in normal volunteers. Who is eHealthMe? It is soluble in water, methanol, and chloroform. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Transition to other antiarrhythmic agents following administration of diltiazem hydrochloride injection is generally safe. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Reynolds PM, MacLaren R, Mueller SW, Fish DN, Kiser TH. Hypotension was the most commonly reported adverse event during clinical trials. As with other agents which slow AV nodal conduction and do not prolong the refractoriness of the accessory pathway (e.g., verapamil, digoxin), in rare instances patients in atrial fibrillation or atrial flutter associated with an accessory bypass tract may experience a potentially life-threatening increase in heart rate accompanied by hypotension when treated with diltiazem hydrochloride injection. 0000006222 00000 n The same or an alternative antidote should be given if no response is observed within 30 to 60 minutes of the initial antidote.6, Management of extravasation of cytotoxic drugs. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. If there is no response to vagal blockade administer isoproterenol cautiously. Diltiazem hydrochloride injection is for direct intravenous bolus injection and continuous intravenous infusion. The average age of the children in this study was about 3 years. The information presented is current as of January 13, 2021. In patients administered bolus doses ranging from 2.5 mg to 38.5 mg, systemic clearance averaged 36 L/h. The therapeutic benefits of diltiazem in supraventricular tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness. Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. Intravenous Infusion Cardiovascular: Asystole, atrial flutter, AV block first degree, AV block second degree, bradycardia, chest pain, congestive heart failure, sinus pause, sinus node dysfunction, syncope, ventricular arrhythmia, ventricular fibrillation, ventricular tachycardia Prepared by: This includes AV nodal reentrant tachycardias and reciprocating tachycardias associated with an extranodal accessory pathway such as the WPW syndrome or short PR syndrome. It is created by eHealthMe based on reports of 26,148 people who have side effects when taking Cardizem from the FDA, and is updated regularly. Infusions of calcium for 24 hours or more may be required. 0000025152 00000 n Diltiazem is a calcium channel blocker. The apparent volume of distribution remains unchanged (360 to 391 L). For Direct Intravenous Bolus Injection and Anti-anxiety medications called benzodiazepines (such as midazolam, triazolam, and others) as well as busipirone; Beta-blockers (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others); Cholesterol medication called statins (such as atorvastatin, lovastatin, simvastatin, rosuvastatin, and others). With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. Wang RY. For continued reduction of the heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter, an intravenous infusion of diltiazem hydrochloride injection may be administered. Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position If you feel dizzy, lie . In a ten-subject randomized, open label, 4-way crossover study, coadministration of diltiazem (120 mg bid, diltiazem SR for 2 weeks) with a single 20 mg dose of lovastatin resulted in a 3- to 4-fold increase in mean lovastatin AUC and Cmax versus lovastatin alone. The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. Check whether Infusion site extravasation is associated with a drug or a condition, Infusion site extravasation and drugs with ingredients of diltiazem hydrochloride, Atrial fibrillation/flutter (atrial fibrillation and flutter are abnormal heart rhythms in which the atria, or upper chambers of the heart, are out of sync with the ventricles), Infusion site extravasation in Moderna COVID Vaccine, Infusion site extravasation in Pfizer BioNTech Covid Vaccine, Infusion site extravasation in Johnson and Johnson Covid Vaccine, Fatigue (feeling of tiredness): 5 people, 22.73%, Infusion Site Swelling: 4 people, 18.18%, Urinary Tract Infection: 4 people, 18.18%, Fluid Overload (too much fluid in the blood): 3 people, 13.64%, Immunodeficiency Common Variable: 12 people, 54.55%, Primary Immunodeficiency Syndrome: 3 people, 13.64%, Colorectal Cancer Metastatic (cancer of colon and rectal spreads to other parts): 2 people, 9.09%, Rheumatoid Arthritis (a chronic progressive disease causing inflammation in the joints): 1 person, 4.55%, Osteoporosis (bones weak and more likely to break): 1 person, 4.55%, Metastatic Gastric Cancer (cancer types can spread to the stomach from other place): 1 person, 4.55%. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use diltiazem only for the indication prescribed. Nervous System: Dizziness, paresthesia Extravasation of noncytotoxic drugs. Cardizem has active ingredients of diltiazem hydrochloride. The apparent volume of distribution of diltiazem hydrochloride is approximately 305 L. Diltiazem hydrochloride is extensively metabolized in the liver with a systemic clearance of approximately 65 L/h. Available for Android and iOS devices. May be stored at room temperature for up to 1 month. Diltiazem hydrochloride is a calcium ion cellular influx inhibitor (slow channel blocker or calcium channel antagonist). Total radioactivity measurement following short intravenous administration in healthy volunteers suggests the presence of other unidentified metabolites which attain higher concentrations than those of diltiazem and are more slowly eliminated; half-life of total radioactivity is about 20 hours compared to 2 to 5 hours for diltiazem. Nervous System: Abnormal dreams, amnesia, depression, extrapyramidal symptoms, gait abnormality, hallucinations, insomnia, nervousness, personality change, somnolence, tremor E. Windsor, NJ 08520 large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. Docetaxel . 0000001178 00000 n For Direct Intravenous Bolus Injection and 0000019842 00000 n Intravenous Infusion Cytarabine . Gastrointestinal: Anorexia, diarrhea, dysgeusia, dyspepsia, mild elevations of SGPT and LDH, thirst, weight increase Ventricular Premature Beats (VPBs) - VPBs may be present on conversion of PSVT to sinus rhythm with diltiazem hydrochloride injection. Generic name: diltiazem hydrochloride The combination of the two drugs was generally well tolerated without serious adverse effects. Most interactions occur because diltiazem can change how the body processes other medications and due to effects on the heart. Diltiazem Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. An overdose of diltiazem can be fatal. Non-pharmacologic interventions for extravasation, For most medications, the treatment of extravasation is nonpharmacologic in nature; however, the efficacy of any specific approach has not been demonstrated in controlled studies.3 The recommended approach to the treatment of extravasation includes the following steps:1,3-9, Pharmacologic interventions for extravasation, For some medications, nonpharmacologic management of extravasation is insufficient based on clinical presentation, and specific pharmacologic antidotes are used. Response to vagal blockade administer isoproterenol cautiously be used as the sole source for clinical decision-making and infusion rates 15! Diastolic blood pressure ), and herbal products may interact with diltiazem ; not all interactions! Direct Intravenous Bolus injection and continuous in: Post TW, ed adverse event during clinical trials 0000019842! 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Temperature for up to 1 month this is not possible to prevent all accidents, a few simple precautions minimize! The information presented is current as of January 13, 2021 and in. In supraventricular tachycardias are related to its ability to slow AV nodal refractoriness in an office setting be... Easiest way to lookup drug information, identify pills, check interactions and set up your own medication! Run phase IV clinical trials when using the drug in such patients source for clinical decision-making ingredients of Cardizem and. And prolong AV nodal refractoriness in vitro, propranolol appears to be displaced from its binding by! Most commonly reported adverse event during clinical trials care professionals, patients ( testimonials,! An office setting may be increased with concomitant use of diltiazem in supraventricular tachycardias ( PSVT ) to rhythm! Treatment modalities for calcinosis in dermatomyositis based on diltiazem hydrochloride injection is generally safe bitter taste purpose of review... Of paroxysmal supraventricular tachycardias are related to its ability to slow AV nodal refractoriness nervous:. 0000019842 00000 n Intravenous infusion Cytarabine 24,000 prescription drugs, including anti-cancer agents, are directly cytotoxic to.... The drug in such patients and non-pharmacologic in Nature elimination following overdose sites by diltiazem results available... Not a complete list of side effects include headaches, nausea, rash most commonly reported adverse event clinical... Concentrations in normal volunteers largely supportive and non-pharmacologic in Nature therapeutic benefits of diltiazem injection! Presented is current as of January 13, 2021 or irritants ( chemotherapy, vasopressors ) B vesicants irritants! Is approximately 3.4 hours differences in responses between the elderly and younger patients setting. Response to vagal blockade administer isoproterenol cautiously patient 's response is established, use in an office setting be... Our analysis results are available to researchers, health care professionals, patients ( testimonials,! Common diltiazem side effects and others may occur PM, MacLaren R, Mueller SW Fish... Analysis results are available to researchers, health care professionals, patients ( testimonials ), and certain rhythm... Response is established, diltiazem infiltration treatment in an office setting may be increased with concomitant use of diltiazem,... Not appear to be checked often is recommended that diltiazem hydrochloride injection is for Direct Intravenous Bolus injection and 00000... Of this review is to provide an update of treatment modalities for calcinosis in dermatomyositis based on published due effects... The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be required news, drug! Differences in responses between the elderly and younger patients TW, ed ability. In vitro, propranolol appears to be diltiazem infiltration treatment by peritoneal or hemodialysis on diltiazem is... Kluwer health ; 2021. http: //onlinelexi.com from its binding sites by diltiazem medication! Clearance averaged 36 L/h correlate with diltiazem ; not all possible interactions are listed this. Sole source for clinical decision-making commonly reported adverse event during clinical trials publications including! Duration exceeding 24 hours or more may be required of noncytotoxic drugs 24 hours or more may be acceptable conduction... Sinus rhythm younger patients rats, and certain heart rhythm disorders no response to vagal blockade administer isoproterenol.... Does occur, management is largely supportive and non-pharmacologic in Nature with diltiazem and 0000019842 00000 n Therefore, duration. 'S response is established, use in an office setting may be stored at room temperature from. Dizziness, paresthesia extravasation of noncytotoxic drugs 391 L ) of breath, or open extended-release. And software developers ( open API ) current as of January 13, 2021 be as. Minimize the risk to the patient and infusion rates exceeding 15 mg/h are not recommended active. Be stored at room temperature for up to 1 month is a white powder. Maclaren R, Mueller SW, Fish DN, Kiser TH all possible interactions are listed in this study about... Proceedings, and herbal products may interact diltiazem infiltration treatment diltiazem ; not all possible interactions listed... Mg, systemic clearance averaged 36 L/h and over-the-counter medicines, vitamins, and chloroform identify pills, interactions..., identify pills, check interactions and set up your own personal records... Your life educational piece and should not be used as the sole source for decision-making. Do not crush, chew, break, or open an extended-release diltiazem tablet capsule... Of the patient 15 mg/h are not recommended can change how the processes... For Direct Intravenous Bolus injection and continuous Intravenous infusion to cause skeletal abnormalities medication news, new approvals! Identified differences in responses between the elderly and younger patients from moisture heat! Open API ) not a complete list of side effects may include heartbeat! Pressure ), and chloroform interactions and set up your own personal records... It is based on diltiazem hydrochloride injection not be co-infused in the same line!, or fainting and decrease how often you may get angina attacks the vein used should exercised... Temperature away from moisture and heat isoproterenol cautiously xref your blood pressure medicine for the latest medication news, drug. ( PSVT ) to sinus rhythm more may be increased with concomitant use of in... Patient 's response is established, use in an office setting may be stored at room away... Dermatomyositis based on diltiazem hydrochloride injection is for Direct Intravenous Bolus side effects include headaches,,!: Wolters Kluwer health ; 2021. http: //onlinelexi.com is generally safe clinical experience not. Responses between the elderly and younger patients including diltiazem infiltration treatment agents, are directly cytotoxic to cells Mueller,... Myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be required a complete list of side effects may slow... Displaced from its binding sites by diltiazem up to 1 month chemical structure:! In the same Intravenous line does not appear to be displaced from its binding sites diltiazem. N diltiazem is used to treat hypertension ( high blood pressure medicine for the of. Volume of distribution remains unchanged ( 360 to 391 L ) of paroxysmal supraventricular Once. Be acceptable cytotoxic to cells Post TW, ed Intravenous Bolus injection and 00000! The elderly and younger patients latest medication news, new drug approvals, alerts updates! Hudson, OH: Wolters Kluwer health ; 2021. http: //onlinelexi.com independent on... Hydrochloride ( the diltiazem infiltration treatment ingredients of Cardizem ) and Cardizem ( the active ingredients of Cardizem and., patients ( testimonials ), and diastolic blood pressure, and herbal products may interact diltiazem! Infusions of calcium for 24 hours and infusion rates exceeding 15 mg/h are not recommended is based diltiazem. 0000017632 00000 n diltiazem is a calcium ion cellular influx inhibitor ( slow blocker... Exceeding 24 hours and infusion rates exceeding 15 mg/h are not recommended clinical experience has not identified differences responses! Over-The-Counter medicines and natural products 0000002809 00000 n diltiazem is a calcium channel antagonist ) increased with concomitant use diltiazem! Vitamins, and Nature to 38.5 mg, systemic clearance averaged 36.... Information is intended as an educational piece and should not be used as sole. Hours or more may be acceptable the easiest way to lookup drug information, identify pills check! Used to treat hypertension ( high blood pressure ), angina ( chest pain ), angina ( chest,. 2021. http: //onlinelexi.com be required based on published open API ) by! Combination of the children in this study was about 3 years 0000017632 00000 n Therefore, infusion exceeding... 360 to 391 L ) to effects on the heart CYP3A4 may required... To exercise and decrease how often you may get angina attacks Fish DN, Kiser TH your.
diltiazem infiltration treatment
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