Flexible once-daily AM or PM dosing
The once-daily dose can be taken in the PM or AM, without regard to meals.1
- Recommended starting doses for hypertension: 180 mg or 240 mg.1
- Titrate as needed after 14 days to 300, 360, 420, or up to 540 mg for maximum effect.1
* There is limited general clinical experience with doses above 360 mg, but the safety and efficacy of doses as high as 540 mg have been studied in clinical trials. The incidence of side effects increases as the dose increases, with first-degree AV block, dizziness, and sinus bradycardia bearing the strongest relationship to dose.
- Recommended starting dose for angina: 180 mg.1
- Titrate as needed after 7 days to 240, 300, or up to 360 mg for maximum effect.1
INDICATIONS
CARDIZEM LA is indicated for the treatment of hypertension and management of chronic stable angina.
IMPORTANT SAFETY INFORMATION
CARDIZEM LA is contraindicated in patients with sick sinus syndrome or 2° or 3° AV block (except in the presence of a functioning ventricular pacemaker), hypotension (<90 mm Hg systolic), demonstrated hypersensitivity to the drug, and acute myocardial infarction and pulmonary congestion documented by x-ray on admission.
Worsening of congestive heart failure has been reported in patients with pre-existing impairment of ventricular function. Caution should be exercised in these patients when diltiazem is used in combination with β-blockers. In rare instances, elevations in LFT enzymes have been noted.
Concomitant use of diltiazem with ß-blockers or digitalis may result in additive effects on cardiac conduction. Patients taking buspirone, quinidine and drugs that are substrates or inhibitors of CYP450 3A4 (i.e. cimetidine, midazolam, triazolam, cyclosporine, carbamazepine, lovastatin, rifampin), or patients with renal and/or hepatic impairment should be monitored and may require dosage adjustment when starting or stopping concomitantly administered diltiazem.
In hypertension, the most common adverse events (greater than placebo) reported for the 120 mg to 360 mg dose were lower-limb edema (5%), sinus congestion (1%), and rash (1%).
In chronic stable angina, the most common adverse events (>2% and greater than placebo) were lower-limb edema (6.8%), dizziness (6.4%), fatigue (4.8%), bradycardia (3.6%), and 1° AV block (3.2%).
References:
1. CARDIZEM LA Prescribing Information. Abbott Laboratories.
