What brand name does Diltiazem Hcl Er carry? – Diltiazem Hcl Er is the generic equivalent of Cartia Xt and is much less expensive. SingleCare’s price for Diltiazem Hcl Er is $30.50 per 100, 60MG Capsule Extended Release 12 Hour, which is much less than the average price for Cartia Xt while containing the same components.
Is diltiazem an extended-release medication?
9. Frequent FAQs – How does diltiazem function? Diltiazem blocks calcium channels. If you have hypertension, it helps by preventing calcium from entering the heart and blood vessel muscles. Calcium is required for muscular contraction, hence inhibiting calcium causes muscle cells to relax.
- This reduces blood pressure and makes it easier for the heart to circulate blood throughout the body.
- Diltiazem treats angina by increasing blood flow to the heart.
- Angina is chest discomfort caused by inadequate blood flow to the heart’s muscles.
- It often occurs when the coronary arteries have stiffened and contracted.
Diltiazem dilates the arteries, allowing more oxygen to reach the heart, so preventing chest discomfort. Diltiazem treats Raynaud’s phenomenon by relaxing and dilating the blood arteries in the fingers and toes. This increases the blood flow to your fingers and toes.
- When diltiazem is used to treat an anal tear, it relaxes the muscle near the anus, making it easier and less painful to defecate.
- It also increases blood flow to the area of the tear, which expedites its recovery.
- How long does it take to work? Diltiazem begins to work the day you begin taking it, but for hypertension and angina, it may take up to two weeks to act completely.
If you are using diltiazem to treat high blood pressure, you may not have previously had any symptoms. In this situation, you may feel no change after taking the medication. This does not indicate that the medication is ineffective, thus it is essential to continue taking it.
- Your doctor will evaluate the effectiveness of the treatment.
- If you are taking diltiazem for angina, you may continue to experience chest discomfort until it fully takes effect.
- Always carry your medication to treat angina episodes, and use it if necessary.
- Consult your physician if your chest pain persists for more than two weeks.
If your condition worsens, contact your doctor immediately. If you apply diltiazem cream or ointment to a tear, it should begin to work on the same day. How long will this process take? If you’re taking diltiazem for high blood pressure or angina, the therapy is often long-term, or even permanent.
- If you are using it to treat an anal fissure, you will apply the cream or ointment until pooing is no longer uncomfortable.
- This indicates the rip has been repaired.
- Typically, this takes around six weeks.
- What will happen if I discontinue use? Stopping diltiazem may elevate blood pressure, which may increase the risk of heart attack or stroke.
If you stop using the cream prior to the fissure’s complete healing, it may reopen. If side effects are bothersome, your doctor may be able to prescribe an alternative medication. Consult your physician if you wish to discontinue diltiazem. How does it compare to other pharmaceuticals? Diltiazem is a calcium channel blocker that treats excessive blood pressure and angina similarly to other calcium channel blockers.
- In addition to diltiazem, various medications are used to treat similar disorders.
- Your physician will be able to determine if you should take additional or alternative medications to address your illness.
- Can I consume alcohol with this? Yes, alcohol can be consumed while taking diltiazem.
- However, alcohol use should be avoided for a few days after starting diltiazem or if your doctor raises your dosage.
Wait until you are aware of the effects of the medication. Consuming alcohol might intensify the hypotensive effects of diltiazem, which can cause dizziness or lightheadedness. Are there meals and beverages I should avoid? You can consume food and liquids regularly while taking diltiazem.
Will this alter my birth control? Diltiazem does not interfere with contraception. However, several hormonal contraceptive options, such as the combination pill and contraceptive patch, are often not indicated for women with hypertension. If you are on combined hormonal contraceptives, consult your physician.
Will my fertility be affected? There is no conclusive evidence that diltiazem reduces fertility in either men or women. If you are attempting to conceive or experiencing difficulty conceiving while taking diltiazem, see your doctor. Can I drive or ride a bike? Diltiazem might make some individuals feel dizzy.
Do not drive a vehicle, ride a bicycle, or operate equipment or machinery until you feel better. Can improvements in lifestyle alleviate angina? You may improve the health of your heart by implementing a few important lifestyle modifications. These are also beneficial if you have hypertension or angina.
Reduce your salt intake, as excessive salt consumption is the leading cause of high blood pressure. The greater the amount of salt consumed, the higher the blood pressure. Aim for less than 6 grams of salt each day. Cessation of smoking is advised as smoking raises your heart rate and blood pressure.
Quitting smoking reduces blood pressure and alleviates symptoms of heart failure. Avoid exposure to secondhand smoking. Reduce your alcohol consumption; excessive alcohol consumption elevates blood pressure over time. It also worsens cardiac failure. Try to adhere to the established standards of not regularly consuming more than 14 units of alcohol each week.
A typical glass of wine (175ml) has two units. A pint of lager or beer typically contains two to three units of alcohol. Regular exercise reduces blood pressure by maintaining the heart and blood arteries in excellent condition, hence lowering blood pressure.
- It does not need to be severe; walking every day can assist.
- Aim to consume a diet rich in fruits and vegetables, whole grains, fat-free or low-fat dairy products, and lean proteins.
- Deal with stress – when you are nervous or disturbed, your heart rate increases, your breathing becomes labored, and your blood pressure often rises.
This can also exacerbate heart failure. Find techniques to minimize your stress levels. Whenever feasible, consider resting or putting your feet up to relax your heart. Spend time with family and friends to be social and reduce stress. Vaccinations – if you have heart failure, it is advised that you have the flu shot annually and the pneumococcal vaccination every five years.
- Consult your physician about these immunizations.
- They are provided for free by the NHS.
- Can changes in lifestyle aid (and/or aid in preventing) anal fissures? An anal fissure is an alternative term for a tear in the anus.
- There are several reasons why anus skin might break.
- Typically, constipation or recurrent diarrhoea are to blame.
You may make modifications to your lifestyle to make using the toilet more convenient. This will help current tears to heal and prevent the likelihood of developing new tears in the future: Include lots of fiber in your diet, such as fruit, vegetables, whole-grain bread, pasta, and rice — adults should try to consume at least 30g of fibre per day.
Diltiazem is used alone or in conjunction with other medications to treat angina (severe chest pain) or excessive blood pressure (high blood pressure). High blood pressure increases the heart and artery strain. If it persists for an extended period of time, the heart and arteries may cease to operate correctly.
- This can cause damage to the blood arteries of the brain, heart, and kidneys, which can lead to a stroke, heart failure, or renal failure.
- Additionally, hypertension may raise the risk of heart attacks.
- These issues may occur less frequently if blood pressure is regulated.
- Diltiazem blocks calcium channels.
It functions by influencing the flow of calcium into the heart and blood vessel cells. This relaxes the blood arteries, reduces blood pressure, and boosts the heart’s blood and oxygen flow while decreasing its strain. This medication is only accessible with a prescription from a doctor.
- Capsule with Prolonged Release
- 24 Hour Extended Release Capsule
- Tablet with Prolonged Release
- 12 Hour Extended Release Capsule
- 24 Hour Extended Release Tablet
When should diltiazem be administered?
Dosage – The dosage of this medication will vary from patient to patient. Follow your doctor’s instructions or the label’s instructions. This information only reflects the typical dosages of this medication. If your dose is different, do not adjust it until your doctor directs you to do so.
- The amount of medication you take depends on the medicine’s potency.
- In addition, the number of daily dosages, the interval between doses, and the duration of medication use are dependent on the ailment being treated.
- For chest discomfort: For oral dose forms (long-acting capsules): Adults—Initially, 120 milligrams (mg) daily in the morning.
Your physician may alter your dosage as necessary. Use and dosage in children must be established by a physician. To administer orally (extended-release tablets): Adults—Initially, 180 milligrams (mg) once day, preferably in the morning. Your physician may alter your dosage as necessary.
- Use and dosage in children must be established by a physician.
- For oral dose form (tablets): Adults—Initially, 30 milligrams (mg) four times a day before meals and before bed.
- Your physician may alter your dosage as necessary.
- Use and dosage in children must be established by a physician.
- Adults—Initially, 30 milligrams (mg) four times a day before meals and before bed.
Your physician may alter your dosage as necessary. Use and dosage in children must be established by a physician. Adults—Initially, 30 milligrams (mg) four times a day before meals and before bed. Your physician may alter your dosage as necessary. Use and dosage in children must be established by a physician.
- For increased blood pressure: For oral dose forms (long-acting capsules): Adults—Initially, 180 to 240 milligrams (mg) in the morning.
- Your physician may alter your dosage as necessary.
- Use and dosage in children must be established by a physician.
- To administer orally (extended-release tablets): Adults—Initially, 180 to 240 milligrams (mg) once day, in the morning or before bed.
Your physician may alter your dosage as necessary. Use and dosage in children must be established by a physician. Adults—Initially, 180 to 240 milligrams (mg) once day, in the morning or before bed. Your physician may alter your dosage as necessary. Use and dosage in children must be established by a physician.
Is diltiazem a costly drug?
Depending on the pharmacy you visit, diltiazem intravenous solution (5 mg/mL) costs around $21 for a supply of 25 milliliters. Prices are only applicable for cash-paying consumers; insurance policies are not accepted. This diltiazem cost guide is based on the use of the Drugs.com discount card, which is accepted at the majority of U.S. pharmacies.
Sleep-disordered breathing (SDB), comprising both Cheyne-Stokes Breathing-Central Sleep Apnea (CSB-CSA) and Obstructive Sleep Apnea Hypoapnea Syndrome (OSAHS), is a common comorbid syndrome in heart failure patients (HF).1 Although both illnesses may be present, it is widely believed that CSB-CSA is a result of HF, whereas OSAHS may be a cause of HF due to its influence on hypertension.
Even if the patient does not have coronary artery disease (CAD), people with OSAHS are more than twice as likely to have a family history of early mortality owing to coronary artery disease (CAD).2 While the relationship between cardiovascular disorders such as CHF and now CAD and their detrimental effects on sleep is well-established, it remains unclear how and to what extent specific cardiovascular drugs may impair sleep quality in patients with other co-morbidities.
This article will discuss the impact of cardiovascular drugs on sleep quality and the measures that doctors may employ to identify and mitigate adverse effects. Alpha Adrenergic Agonists Inconsistent data exist on the effects of centrally acting alpha adrenergic drugs on sleep quality; one research indicated that clonidine decreased total sleep time in hypertensive patients, but another study reported that clonidine enhanced total sleep time in healthy subjects.3,4 However, another research found that clonidine lowered rapid eye movement (REM) sleep and REM apneas, hence reducing nocturnal hypoxemia.5 Despite contradictory results about the effects of alpha adrenergic agonists on sleep quality, it is evident that this class possesses a high degree of CNS effects.
- As a result, it is likely that these agents should not be regarded preferred treatments for hypertension, especially in the elderly population.
- Antiarrhythmics of Type I There are few data and few published research demonstrating adverse effects of Class I antiarrhythmics on the quality of sleep.
- Notably, the labeling for propafenone indicates that insomnia occurs in 1% to 2% of patients, whereas tiredness and sleepiness occur in 2-6% and 1% of patients, respectively.
The adverse effects are believed to be dose-dependent; nonetheless, the blockage of beta adrenergic receptors and rapid inward sodium channels may contribute to the CNS side effects.6 Similarly, the labeling for flecainide states a significant incidence of CNS side effects, such as dizziness (19-30%), visual abnormalities (16%), tiredness (8%) and somnolence and insomnia (1-3%).
Despite the relative scarcity of evidence linking Class I antiarrhythmics and sleep quality, it appears sensible to address these potential detrimental effects with patients, especially perhaps with the subset of older patients who are known to have higher baseline levels of sleep disruption. Class II Beta Blockers There are hydrophilic and lipophilic beta blockers, and their effects on sleep are dependent on their capacity to pass the blood-brain barrier (BBB).
These agents are lipophilic: metoprolol, pindolol, and propranolol. These three drugs quickly cross the BBB and diminish the quality of sleep by increasing the frequency of awakenings and the duration of wakefulness following the beginning of sleep.7 In addition, the lipophilic type has been linked to daytime drowsiness, sleeplessness, night terrors, and hallucinations.
This impact is found even after daytime administration and appears to be unrelated to their influence on sleep at night.8 Both lipophilic and hydrophilic beta blockers may have a deleterious impact on sleep architecture by inhibiting REM sleep.7,8 The 2007 publication of more recent evidence supports the concept that carvedilol, an agent with mixed beta blocker and alpha adrenergic blocker action, may decrease the severity of CSA by regulating the increased brain chemosensitivity to CO 2.9 In the tiny trial, individuals who took carvedilol had a lower apnea-hypopnea index (AHI) and central apnea index (CAI) than those who did not.
In addition, there appeared to be a negative relationship between the indices and the dosage; individuals receiving the greatest doses had the lowest index scores. Uncertainty exists as to whether the results can be generalized to all beta blockers; nonetheless, if a beta blocker is indicated, carvedilol may give an advantage over other medications in patients with concurrent OSAHA or CSA.
Amiodarone class III This substance is known to cause several adverse effects, many of which are severe. Insomnia, exhaustion, and other sleep disorders are indicated as occurring in 3% to 40% of patients on the package label, while 20-40% of patients have been reported to experience neurologic adverse effects.10 Dronedarone This is the most recent drug of its class, and while it has less effectiveness than amiodarone, it also has fewer side effects, including none on sleep quality or structure.
Dofetilide There are no published studies demonstrating a correlation between dofetilide and poor sleep quality; nonetheless, the package insert claims that 4% of treated individuals experience insomnia. Sotalol However, a very short published research evaluating the effects of sotalol 320mg or 960mg on the CNS as measured by sleep, EEG, and psychophysiological parameters found no significant difference between the two treatment groups.11 Although similarly classified, the Class III drugs have radically varied correlations with sleep disruption and sleep quality.
Clinically, based on individual variables, one medication may be selected over another for the treatment of a particular arrhythmia; nevertheless, the physician must be alert for the emergence of CNS effects and their negative impact on sleep quality and architecture. Non-dihydropyridine calcium channel blockers comprise Class IV.
Diltiazem with Verapamil Although sleep disruption is indicated as a potential adverse effect in the product labeling of verapamil, it is not known to be a prevalent side effect, affecting less than 1 percent of individuals treated. Inhibitors of Angiotensin Converting Enzyme (ACE) It is believed that ACE inhibitors have a deleterious effect on sleep in certain people by raising the quantity of circulating bradykinin.
The bradykinin-induced cough and rhinopharyngeal irritation may exacerbate the AHI.12 In addition, potassium levels may be affected by ACE inhibitors, causing leg cramps and joint and muscular discomfort in certain people. Since these adverse effects do not impact all patients, physicians should discuss them with patients and, if required, adapt treatment to prevent sleep problems.
Anti-Angiotensin Receptor Agents (ARBs) Although ARBs do not produce the bradykinin-induced cough observed with ACE inhibitors, they may impact potassium levels, potentially causing sleep disruptions by producing uncomfortable joints and muscles and exacerbating leg cramps.
- As previously said, physicians should enquire about adverse responses and, if necessary, modify therapy to maximize overall results and reduce bad effects.
- HMG Co-A Reductase Blockers These drugs are known to elicit muscular soreness, which may impair sleep quality by preventing patients from falling and becoming asleep.
It has been theorized that the enhanced blood-brain barrier penetration of lipophilic type HMG Co-A reductase inhibitors may disrupt sleep architecture and produce insomnia or nightmares. Comparing simvastatin (a lipophilic agent) with pravastatin (a hydrophilic agent) based on objective and subjective measures of sleep, a research showed no differences between the two drugs.13 It is generally believed that lipophilic agents may cause more adverse reactions than their hydrophilic siblings; therefore, it may be prudent to switch to a hydrophilic agent if the clinician observes that the patient is experiencing side effects such as increased muscle aches or difficulty sleeping.
Numerous cardiovascular drugs have been linked to alterations in sleep quality and sleep architecture. The wide variety of patient-specific factors, including patient age, race, sleep habits or sleep disturbance at baseline, co-morbidities leading to increased sleep disturbance at baseline, variability in clinical dosing, and other unknown factors may contribute to the high variability of the association.
Despite the need for more study to completely clarify the link between cardiovascular drugs and sleep quality, it is evident that doctors should aggressively interview their patients about sleep quality before to initiating pharmacological therapy and occasionally thereafter.
- References Lanfranchi PA, Somers VK.
- Characteristics and consequences of sleep-disordered breathing in heart failure.
- Respir Physiol Neurobiol 2003;136:153-165.
- Gami AS, Olson EJ, Shen WK, et al.
- A Longitudinal Study of 10,710 Adults Examining Obstructive Sleep Apnea and the Risk of Sudden Cardiac Death J Am Coll Cardiol 2013;62:610-616.
Kostis JB, Rosen RC, Holzer BC, et al. CNS adverse effects of centrally-active antihypertensive agents: a prospective, placebo-controlled investigation of sleep, mood, cognitive, and sexual performance in hypertensive males. Psychopharmacology (Berl): 102:163-70 in 1990.
- Anno, O, Clarebach, P.
- Effect of clonidine and yohimbine on human sleep: polygraphic research and EEG analysis using normalized slope descriptors.
- Electroencephalogr Clin Neurophysiol 1985;60:478-84. Issa FG.
- Clonidine’s effect on obstructive sleep apnea.
- Am Rev Respir Dis 1992;145:435-439.
- Stavens CS, McGovern B, Garan H, Ruskin JN.
Intensification of electrically induced ventricular tachycardia with propafenone therapy. American Heart Journal 1985;110:24-9 Rosen RC, Kostis JB. Biobehavioral effects of antihypertensive drugs that block adrenergic receptors: a critical review. Health Psychology, 1985, 4, 579 Schweitzer PK.
- Substances that affect sleep and wakefulness.
- In: Fifth Edition of Principles and Practices of Sleep Medicine.
- Ryger MH, Roth, T, Dement WC.
- Eds), Elsevier Saunders, St.
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- Tamura A, et. al.
- Carvedilol inhibits sleep apnea.
- Chest,2007; 131: 118-121, 130-135.
- Hilleman, D., M.A.
- Miller, R.
Parker, P. Doering, and J.A. Pieper. Effectiveness and adverse effects of optimal amiodarone management.1998’s Pharmacotherapy volume was 18:138S–145S. Bender W, Greil W, Ruther E, Schnelle K. Sotalol’s effects on the central nervous system (CNS): sleep, EEG, and psychophysiological markers.
- Journal of Clinical Pharmacology in 1979;19:505-12.
- Cicolin A, Mangiardi L, Mutani R, Bucca C.
- Inhibitors of the angiotensin-converting enzyme and obstructive sleep apnea.
- Mayo Clinic Proceedings in 2006;81:53-55.
- Eckernas SA, Roos BE, Kvidal P, Eriksson LO, Block GA, Neafus RP, Haigh, JRM.
- A study of the effects of simvastatin and pravastatin on objective and subjective parameters of nocturnal sleep in individuals with primary mild hypercholesterolemia.
Br Journal of Clinical Pharmacology 1993;35:284-289. Cardiovascular Agents, Cheyne-Stokes Respiration, Coronary Artery Disease, Heart Failure, Hypertension, Premature Death are the keywords that best describe the contents of this article. Sleep Apnea Syndromes, Sleep Apnea, Obstructive, Sleep Apnea, Central
Can vitamin D be taken with diltiazem?
Interactions – Examples of possible interactions:
- Aluminum. Taking vitamin D plus aluminum-containing phosphate binders, which may be used to treat high blood phosphate levels in patients with chronic renal disease, might result in dangerous amounts of aluminum in patients with kidney failure over time.
- Anticonvulsants. The anticonvulsants phenobarbital and phenytoin (Dilantin, Phenytek) decrease calcium absorption and promote vitamin D degradation.
- Atorvastatin (Lipitor) (Lipitor). Vitamin D supplementation may impact how your body absorbs this cholesterol-lowering medication.
- Calcipotriene (Dovonex, Sorilux) (Dovonex, Sorilux). Vitamin D is incompatible with this psoriasis medication. The combination may raise the risk of excessive blood calcium levels (hypercalcemia).
- Cholestyramine (Prevalite) (Prevalite). Taking vitamin D with this cholesterol-lowering medication can impair vitamin D absorption.
- Substrates of Cytochrome P-450 3A4 (CYP3A4) Use vitamin D with caution if you are taking medications that are metabolized by these enzymes.
- Digoxin (Lanoxin) (Lanoxin). Avoid consuming vitamin D in large levels while using this cardiac medicine. Vitamin D in high amounts can lead to hypercalcemia, which raises the risk of catastrophic cardiac issues when combined with digoxin.
- Diltiazem (Cardizem, Tiazac, etc) (Cardizem, Tiazac, others). Avoid ingesting vitamin D in large levels when using this blood pressure medication. Vitamin D can produce hypercalcemia, which may impair the efficiency of the medication.
- Orlistat (Xenical, Alli) (Xenical, Alli). This weight loss medication can impair vitamin D absorption.
- Thiazide diuretics. Combining these hypertension medications with vitamin D raises the risk of hypercalcemia.
- Steroids. Steroid medications, such as prednisone, can decrease calcium absorption and impede vitamin D processing in the body.
- Stimulant laxatives. High-dose, long-term usage of stimulant laxatives can inhibit vitamin D and calcium absorption.
- Verapamil (Verelan, Calan SR) (Verelan, Calan SR). Combining this blood pressure medication with excessive dosages of vitamin D may produce hypercalcemia and impair the efficacy of verapamil.