Diltiazem is a Medicine belongs to Cardiovascular drugs group whose information about Brand can be referenced from   Book : Martindale    Page : 1395   Edition : 37  

  ►   Brandname : Dilcardia, Dilcontin, Adizem, Angiozem, Angitil, Calcicard, Cardizem, Cartia, Dilacor, Corazem, Diltahexal, Diltiastad, Dilzem, Corazet, Dil-Sanorania, Dilsal, Dilta, Diltabeta, Herbesser
  ►  Strength : Tablet with 30 mg.  Tablet with 60 Mg.  Tablet with 90 mg.  Tablet with 120 mg.  Capsule with 60 mg.  Capsule with 90 mg.  Capsule with 120 mg.  Capsule with 180 mg.  Capsule with 240 mg.  Capsule with 300 mg.  Capsule with 360 mg.  Capsule with 420 mg.  Injection with 5 mg/ml.  Oral solution with .  Oral Suspension with

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 189   Edition : 12   Martindale    Page : 1395   Edition : 37  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral, IV, Topical
Reference :-   Book : Martindale    Page : 1394   Edition : 37  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Angina pectoris Oral 60 mg t.i.d. Dose: (or 30 mg four times daily), increased if necessary to 360 mg daily; up to 480 mg daily has sometimes been given.
2 hypertension Oral 90 120 mg modified-release tablets b.d. Dose: increased as required to a maximum of 360 mg daily.
3 hypertension Oral 90 120 mg modified-release capsules b.d. Dose: increased as required to a maximum of 360 mg daily.
4 Cardiac arrhythmias Bolus IV 250 micrograms/kg Injection Dose: over 2 minutes has been suggested; a further dose of 350 micrograms/kg may be given after 15 minutes if the response is inadequate

Ref :-  Book : Martindale    Page : 1394-1395   Edition : 37  



Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1

Ref :- Book :    Page :    Edition :   
Precaution :- If a Patient is using 'Diltiazem' drug in  DILATED CARDIOMYOPATHY  disease, then Please be used with caution .

Precaution :- If a Patient is using 'Diltiazem' drug in  atrial fibrillation  disease, then Please contraindicated in 2nd and 3rd degree AV block .

Precaution :- If a Patient is using 'Diltiazem' drug in  atrial flutter  disease, then Please use with caution in 2nd and 3rd degree AV block .

►  Side Effect : Headache, Ankle oedema, Hypotension, Dizziness, Flushing, Fatigue, Nausea, Gastrointestinal disturbance, Anorexia, Vomiting, Constipation, Diarrhea, taste disturbances, Weight gain, Gingival hyperplasia, Exfoliative dermatitis, Photosensitivity
Ref :-   Book : Martindale    Page : 1393   Edition : 37.  

►  Drug Interaction : Drug interaction of Diltiazem is with Antihypertensive Agents , Antipsychotic , Beta Blockers , HIV- protease inhibitors, , ,  Amiodarone , Digoxin , Mefloquine , Aldesleukin , Carbamazapine , Phenobarbital , Phenytoin , Rifampicin , Cimetidine
Ref :-   Book : Martindale    Page : 1394   Edition : 37.  


  ►    Mechanism of Drug Drug Interaction :  Increased depression of cardiac conduction with risk of bradycardia and AV block may occur when diltiazem is given with drugs such as amiodarone, beta blockers, digoxin, and mefloquine. Enhanced antihypertensive effect may occur if used with other antihypertensive drugs or drugs that cause hypotension such as aldesleukin and antipsychotics. It is metabolised in the liver by the cytochrome P450 isoenzyme CYP3A4 and may also inhibit the metabolism of drugs sharing the same pathway. Interactions may also be expected with enzyme inducers, such as carbamazepine, phenobarbital, phenytoin, and rifampicin, and with enzyme inhibitors, such as cimetidine and HIV-protease inhibitors.
Ref :-   Book : Martindale    Page : 1394   Edition : 37.  


►  Contraindication : sick-sinus syndrome, Hepatic impairment, Renal impairment, Pre-existing second- or third-degree AV block, Lesser degrees of AV block or bradycardia, Diltiazem has been associated with the development of heart failure and great care is required in patients with impaired left ventricular function
Ref :-   Book : Martindale    Page : 1394   Edition : 37.  
  ►  Mechanism of Action :   Diltiazem is a benzothiazepine calcium-channel blocker and class IV antiarrhythmic. It is a peripheral and coronary vasodilator with limited negative inotropic activity.
Ref :-   Book : Martindale    Page : 1394   Edition : 37.  

Pathway of DIETARY Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- NA Hawthorn fruit with Another pathway.   Ginger (Zingiber officinale) with same pathway.   Quercetin with same pathway.  

  ►  Pathway with its reference as follows :-
  • Cardioprotetive effect --- ( PDR for herbal medicine. (2016) (4th ed.). Thomson Reuters, 2007. )
  • Ca2+ channel-blocking activity --- (Ghayur M. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. Journal of Cardiovascular Pharmacology. 2005;45(1):74-80. )
  • Vasodilator --- (PDR for Herbal medicines. (2000) (4th ed.). U.S. )

  •   ►  URL --
  • http://www.travolekar.ru/arch/Pdr_for_Herbal_Medicines.pdf .
  • https://insights.ovid.com/pubmed?pmid=15613983 .

  • DIETARY Substance Interactions


    ​   ► This Medicine interact with :- NA



    ContraIndication DIETARY Substance


    ​   ► This Medicine contraindicate with :- PLEURISY ROOT with It contains cardiac glycosides , it is best to avoid use of pleurisy root with heart medications such as calcium ..   PLEURISY ROOT with Intensify the blood pressure lowering effect ..  

      ►  Reference :-
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press

  •   ►  URL -- http://www.otto-wipfel.co.uk/otto/supplements-medication/DRUG-HERB-VITAMINS-INTERACTIONS-A-Z_Guide.pdf
    https://books.google.co.in/books?id=WZhj8EO9N3sC&pg=PA49&lpg=PA49&dq=The+New+Age+of+nutritional+and+herbal+remedies.++book&source=bl&ots=UVld-vNZL0&sig=5KwkKUUvW45p0TkfVUCtMZxnbow&hl=en&sa=X&ved=0ahUKEwiajLCNocrOAhVMto8KHfD2D-4Q6AEIMDAE#v=onepage&q=The%20

    ►   Route of Elimination :   Hepatic (Metabolism), Renal
    Ref :-   Book : Martindale    Page : 1394   Edition : 37.  

    ►    Plasma Half-life :   Min value :-   3 hours,    Max value :-   8 hours.  
    Ref :-   Book : Martindale    Page : 1394   Edition : 37.  

    ►    Peak Plasma Concentration :   Min value :-   3 hours,    Max value :-   8 hours.  
    Ref :-   Book : Martindale    Page : 1394   Edition : 37.