治療心律不整、心絞痛、高血壓 (CCB) Atrial arrhythmia; Hypertension; Paroxysmal supraventricular tachycardia; Chronic Stable angina

Diltiazem hydrochloride is a slow calcium channel blocker that blocks calcium ion influx during depolarization of cardiac and vascular smooth muscle. It decreases peripheral vascular resistance and causes relaxation of the vascular smooth muscle resulting in a decrease of both systolic and diastolic blood pressure.

Bioavailability: approximately 93% to greater than 95%
Vd: 305 L to 391 L
Metabolism: Hepatic; cytochrome P450, extensive, deacetylation, N-demethylation, O-demethylation, and conjugation
Excretion: Renal; 2% to 4% unchanged; not dialyzable
Elimination Half Life: 4 h to 9.5 h

1. Acute MI with pulmonary congestion on x-ray
2. Administration of IV beta-blockers within a few hours of IV diltiazem
3. Atrial fibrillation or flutter associated with an accessory bypass tract (Wolff-Parkinson-White or short PR syndromes); risk of potentially fatal heart rate fluctuations
4. Cardiogenic shock
5. Heart block, second or third-degree atrioventricular without a functioning ventricular pacemaker
6. Hypersensitivity to diltiazem
7. Newborns; some IV injections contain benzyl alcohol
8. Sick sinus syndrome without a functioning ventricular pacemaker
9. Symptomatic hypotension, systolic blood pressure 90 mmHg or less
10. Ventricular tachycardia; may lead to hemodynamic deterioration and ventricular fibrillation

C(FDA) (AUS)

Common:
Cardiovascular: Bradyarrhythmia, Peripheral edema
Neurologic: Dizziness, Headache
Respiratory: Cough
Other: Fatigue
Serious:
Cardiovascular: Congestive heart failure, Heart block, Myocardial infarction
Hepatic: Hepatotoxicity

Hypertension:
Initial, 120 to 240 mg orally once daily; usual dose, 240 to 360 mg orally once daily, up to 480 mg/day
Chronic stable angina:
Initial, 120 to 180 mg orally once daily up to 480 mg once daily

Safety and effectiveness not established in children