Diltiazem 24hr ER (Cd)

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Nov 01, 2023

Warnings

Diltiazem Risks, Warnings, and Complications

Diltiazem can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other medications for chest pain or high blood pressure if you are at an increased risk of adverse reactions from this drug.

HEART RHYTHM ABNORMALITIES: A small number of patients receiving diltiazem develop heart rhythm abnormalities, including an abnormally slow heart rate (particularly in people with sick sinus syndrome) or second or third-degree AV block. The risk of this happening is higher in people who take digitalis or beta blockers along with diltiazem. Tell your doctor without delay if you develop symptoms such as lightheadedness or weakness.
CONGESTIVE HEART FAILURE: Diltiazem should be used with caution in people with congestive heart failure. Tell your doctor if you have a history of heart failure before starting this medicine.
SEVERE HYPOTENSION: Diltiazem can cause low blood pressure. This is more likely to occur if you are taking other blood pressure medications along with diltiazem. Tell your doctor right away if you develop low blood pressure symptoms such as dizziness, weakness, blurred vision, or confusion.
LIVER INJURY: Very rarely, patients receiving diltiazem can develop liver damage. This is most likely to occur in the first two weeks of treatment. The liver damage is usually reversible after stopping diltiazem. Tell your doctor if you have a history of liver disease. Keep all your laboratory appointments while on diltiazem. Your provider may want to monitor your liver function with blood tests.
ALLERGIC REACTION: Diltiazem can cause serious skin reactions in some people. An allergic reaction can also result in swelling and trouble breathing. Stop taking diltiazem and seek emergency medical help if this happens.

Precautions Before Starting Diltiazem

Tell your doctor if you have ever had an allergic reaction to diltiazem, any of the active or inactive ingredients in diltiazem formulations, other calcium channel blockers, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible interactions between diltiazem and your other medicines.

Give your doctor a complete medical history. Diltiazem may not be right for people with certain medical conditions such as a recent myocardial infarction (heart attack), heart disease, ventricular arrhythmias, low blood pressure, kidney failure, kidney disease, hepatic impairment, liver disease, narrowing or blockage of the digestive tract, or conditions that cause slow the movement of food through the digestive tract.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Diltiazem

Keep all your medical and lab appointments while on diltiazem. Your doctor will adjust your dose based on your response to the medicine.

Diltiazem can cause dizziness and weakness as side effects. Alcohol can make these side effects worse. Exercise caution while driving or doing other hazardous activities until you know how the medicine affects you. Arise slowly from a sitting or lying position to avoid lightheadedness due to low blood pressure.

Tell your doctor if you become pregnant while on diltiazem.

Tell all your healthcare providers you are on diltiazem before any surgery, including dental procedures.

Diltiazem Drug Interactions

Concomitant use of certain medicines can affect how diltiazem works. Possible interactions with other medicines can increase the risk of severe adverse events. The following medications can have drug interactions with diltiazem:

Medications used to treat HIV, such as atazanavir (Reyataz)
Anti-anxiety medications (benzodiazepines) such as triazolam (Halcion) and midazolam (Versed)
Medications used to treat anxiety, such as buspirone
Beta blockers such as labetalol, atenolol (Tenormin, in Tenoretic), metoprolol (Toprol XL, Lopressor, in Dutoprol), propranolol (Inderal, Innopran, in Inderide), and nadolol (Corgard, in Corzide)
Anti-seizure drugs such as carbamazepine (Epitol, Carbatrol, Equetro, Tegretol)
H2 blockers such as cimetidine (Tagamet)
Immunosuppressants such as cyclosporine (Neoral, Gengraf, Sandimmune)
Heart medications such as digoxin (Lanoxin)
Cholesterol-lowering drugs such as lovastatin (Mevacor, Altoprev, in Advicor)
Medications used to treat irregular heart rhythms such as quinidine (in Nuedexta)
Antibiotics prescribed for tuberculosis such as rifampin (Rifadin, in Rifater, in Rifamate, Rimactane)

The above list may not include all the potential drug interactions of diltiazem. Give your doctor or pharmacist a complete list of your medications. This includes prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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