Diltiazem

Diltiazem
Clinical data
Pronunciation/dɪlˈtaɪəzɛm/
Trade namesCardizem, others
AHFS/Drugs.comMonograph
MedlinePlusa684027
License data
Pregnancy
category
Routes of
administration		By mouth, intravenous
Drug classNondihydropyridine calcium channel blocker
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability40%
MetabolismLiver
Elimination half-life3–4.5 hours
ExcretionKidney
Bile duct
Identifiers
  • cis-(+)-[2-(2-Dimethylaminoethyl)-5-(4-methoxyphenyl)-3-oxo-6-thia-2-azabicyclo[5.4.0]undeca-7,9,11-trien-4-yl]ethanoate
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.050.707 Edit this at Wikidata
Chemical and physical data
FormulaC22H26N2O4S
Molar mass414.52 g·mol−1
3D model (JSmol)
  • O=C2N(c3c(S[C@@H](c1ccc(OC)cc1)[C@H]2OC(=O)C)cccc3)CCN(C)C
  • InChI=1S/C22H26N2O4S/c1-15(25)28-20-21(16-9-11-17(27-4)12-10-16)29-19-8-6-5-7-18(19)24(22(20)26)14-13-23(2)3/h5-12,20-21H,13-14H2,1-4H3/t20-,21+/m1/s1 checkY
  • Key:HSUGRBWQSSZJOP-RTWAWAEBSA-N checkY
  (verify)

Diltiazem, sold under the brand name Cardizem among others, is a nondihydropyridine calcium channel blocker medication used to treat high blood pressure, angina, and certain heart arrhythmias.[9] It may also be used in hyperthyroidism if beta blockers cannot be used.[9] It is taken by mouth or given by injection into a vein.[9] When given by injection, effects typically begin within a few minutes and last a few hours.[9]

Common side effects include swelling, dizziness, headaches, and low blood pressure.[9] Other severe side effects include an overly slow heart beat, heart failure, liver problems, and allergic reactions.[9] Use is not recommended during pregnancy.[9] It is unclear if use when breastfeeding is safe.[1]

Diltiazem works by relaxing the smooth muscle in the walls of arteries, resulting in them opening and allowing blood to flow more easily.[9] Additionally, it acts on the heart to prolong the period until it can beat again.[10] It does this by blocking the entry of calcium into the cells of the heart and blood vessels.[11] It is a class IV antiarrhythmic.[12]

Diltiazem was approved for medical use in the United States in 1982.[9] It is available as a generic medication.[9] In 2022, it was the 100th most commonly prescribed medication in the United States, with more than 6 million prescriptions.[13][14] An extended release formulation is also available.[5][6][9]

  1. ^ a b "Diltiazem Use During Pregnancy". Drugs.com. 4 May 2020. Archived from the original on 31 December 2019. Retrieved 5 May 2020.
  2. ^ "Dilcardia SR 120 mg Prolonged-release hard capsules – Summary of Product Characteristics (SmPC)". emc. 22 March 2018. Archived from the original on 28 August 2021. Retrieved 13 April 2020.
  3. ^ "Angitil SR/XL Capsules – Summary of Product Characteristics (SmPC)". (emc). 7 May 2019. Archived from the original on 28 August 2021. Retrieved 13 April 2020.
  4. ^ "Cardizem–diltiazem hydrochloride tablet, coated". DailyMed. 2 June 2020. Archived from the original on 24 October 2022. Retrieved 23 October 2022.
  5. ^ a b "Cardizem CD–diltiazem hydrochloride capsule, coated, extended release". DailyMed. 30 April 2020. Retrieved 23 October 2022.
  6. ^ a b "Cardizem LA–diltiazem hydrochloride tablet, extended release". DailyMed. 2 May 2019. Archived from the original on 24 October 2022. Retrieved 23 October 2022.
  7. ^ "Cartia XT- diltiazem hydrochloride capsule, extended release". DailyMed. 26 October 2020. Archived from the original on 24 February 2024. Retrieved 30 September 2024.
  8. ^ "Active substance(s): diltiazem" (PDF). European Medicines Agency. 11 January 2018. Archived (PDF) from the original on 24 October 2022. Retrieved 24 October 2022.
  9. ^ a b c d e f g h i j k "Diltiazem Hydrochloride Monograph for Professionals". Drugs.com. AHFS. Archived from the original on 28 December 2018. Retrieved 28 December 2018.
  10. ^ Cardiovascular Pharmacotherapeutics. Cardiotext Publishing. 2011. pp. 251–52. ISBN 978-1-935395-62-1. Retrieved 28 December 2018.
  11. ^ Nurse's Drug Handbook. Jones & Bartlett Learning. 2010. p. 320. ISBN 978-0-7637-7900-9.
  12. ^ Milne GW (2005). Gardner's Commercially Important Chemicals: Synonyms, Trade Names, and Properties. John Wiley & Sons. p. 223. ISBN 978-0-471-73661-5. Retrieved 28 December 2018.
  13. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  14. ^ "Diltiazem Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Archived from the original on 1 September 2024. Retrieved 30 August 2024.