Some patients may maintain response to an initial rate of 5 mg/h. After oral administration, diltiazem undergoes extensive metabolism in man by deacetylation, N-demethylation, and O-demethylation via cytochrome P-450 (oxidative metabolism) in addition to conjugation. Destroy after 1 month at room temperature. Adverse events reported in controlled and uncontrolled clinical trials were generally mild and transient. endstream endobj 513 0 obj <. Administration of other calcium channel blockers to patients with wide complex tachycardia (QRS 0.12 seconds) has resulted in hemodynamic deterioration and ventricular fibrillation. Benzodiazepines - Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3 to 4 fold and Cmax by 2-fold, compared to placebo. The study uses data from the FDA. If you are being treated for high blood pressure, keep using this medicine even if you feel well. 25 mg per 5 mL 0000029978 00000 n 0000001178 00000 n Single-dose vials. 0000022294 00000 n Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. Cardizem undergoes extensive metabolism in which 2% to 4% of the unchanged drug appears in the urine. Diltiazem AdultsAt first, 180 milligrams (mg) once a day, either in the morning or evening. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Prez Fidalgo JA, Garca Fabregat L, Cervantes A, et al. Available for Android and iOS devices. Diltiazem may impair your thinking or reactions. After constant rate intravenous infusion to healthy male volunteers, diltiazem exhibits nonlinear pharmacokinetics over an infusion range of 4.8 to 13.2 mg/h for 24 hours. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. "treatment" for extravasation reactions is prevention. Diltiazem is a calcium channel blocker. ChildrenUse and dose must be determined by your doctor. 364 0 obj <>stream In vitro, propranolol appears to be displaced from its binding sites by diltiazem. If possible, it is recommended that diltiazem hydrochloride injection not be co-infused in the same intravenous line. For Direct Intravenous Bolus If intravenous diltiazem is administered to patients receiving chronic oral beta-blocker therapy, the possibility for bradycardia, AV block, and/or depression of contractility should be considered (see CONTRAINDICATIONS). Eugia US LLC Irritant- agents capable of causing pain, swelling, venous irritation and chemical phlebitis at the injection site (calcium gluconate, digoxin, erythromycin, gentamicin). Additionally, administration factors, including the experience of personnel administering the injection, the injection technique, and the number of venipuncture attempts to establish a line, contribute to the risk of extravasation, as does the fragility of the patients veins. Clinical studies of diltiazem did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Duration of infusion longer than 24 hours and infusion rates greater than 15 mg/h have not been studied. Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. If you stop taking diltiazem suddenly, your condition may become worse. 0000000016 00000 n for i am hoping to come off of this medicine. Sodium hydroxide or hydrochloric acid is used for pH adjustment. Version: 15.01. 0000025152 00000 n The mean ejection fraction and cardiac output/index remained unchanged or increased. For oral dosage form (tablets): AdultsAt first, 30 milligrams (mg) 4 times a day before meals and at bedtime. Skip the missed dose if it is almost time for your next scheduled dose. Diltiazem hydrochloride injection is a clear, colorless, sterile, nonpyrogenic solution. Diltiazem is in a class of medications called calcium-channel blockers. severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Remove the peripheral IV device or port needle. The second bolus dose of diltiazem hydrochloride injection should be 0.35 mg/kg actual body weight administered over 2 minutes (25 mg is a reasonable dose for the average patient). Diltiazem is well absorbed from the gastrointestinal tract and is subject to an extensive first-pass effect, giving an absolute bioavailability (compared to intravenous dosing) of about 40%. Pharmacologic interventions for extravasation generic drugs) are not considered. Discharged 7pm 8/1/22. 0000012749 00000 n Lexicomp [database online]. 26,148 people reported to have side effects when taking Cardizem. Cytarabine, liposomal. 0000025065 00000 n Drug Interactions You may report side effects to FDA at 1-800-FDA-1088. Monitoring for quinidine adverse effects may be warranted and the dose adjusted accordingly. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Heather Ipema, PharmD, BCPS Diltiazem pregnancy and breastfeeding warnings, Drug class: calcium channel blocking agents, Diltiazem 12-Hour Sustained-Release Capsules. Diltiazem prolongs the sinus cycle length. Discard Unused Portion Store Under Refrigeration and how much would it bring it down. In some cases intravenous calcium has been administered (1 g calcium chloride or 3 g calcium gluconate) over 5 minutes, and repeated every 10 to 20 minutes as necessary. In subacute and chronic dog and rat studies designed to produce toxicity, high oral doses of diltiazem were associated with hepatic damage. Management of extravasation injuries: a focused evaluation of noncytotoxic medications. In vitro studies suggest alpha1-acid glycoprotein binds approximately 40% of the drug at clinically significant concentrations. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Diltiazem is an oral and parenteral non-dihydropyridine calcium channel blocker. Fixed high-degree AV block should be treated with cardiac pacing. Overdosage experience is limited. Angiotensin-converting enzyme inhibitors (ACEi) appear to be ideal agents for antihypertensive therapy in athletes. 0000029746 00000 n When used concomitantly, anesthetics and calcium blockers should be titrated carefully. eHealthMe is studying from 27,064 Cardizem users for its effectiveness, alternative drugs and more. Dilution: To prepare diltiazem hydrochloride injection for continuous intravenous infusion, aseptically transfer the appropriate quantity (see chart) of diltiazem hydrochloride injection to the desired volume of either Normal Saline, D5W, or D5W/0.45% NaCl. Cytarabine . Therefore, infusion duration exceeding 24 hours and infusion rates exceeding 15 mg/h are not recommended. Available for Android and iOS devices. 2. One hundred two (102) patients <65 had a response rate of 78%. Gorski LA, Stranz M, Cook LS, et al. endstream endobj 333 0 obj <. Sodium hydroxide or hydrochloric acid is used for pH adjustment. Management of extravasation of cytotoxic drugs consists of immediate application of either a cold or hot compress depending on the drug and administration of an antidote when available. 50-mg, 10-mL vialeach sterile vial contains 50 mg diltiazem hydrochloride, 7.5 mg citric acid USP, 6.5 mg sodium citrate dihydrate USP, 714 mg sorbitol solution USP, and water for injection USP up to 10 mL. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Sterile 10 mL Single-Dose Vial, Rx only NDC 55150-426-10 The effectiveness of intravenous calcium administration to reverse the pharmacological effects of diltiazem overdose has been inconsistent. When possible, use a non-CYP3A4-metabolized statin together with diltiazem; otherwise, dose adjustments for both diltiazem and the statin should be considered along with close monitoring for signs and symptoms of any statin related adverse events. Diltiazem may also be used for purposes not listed in this medication guide. Diltiazem Dosage: 0.25 mg/kg administered over at least 2 minutes and preferably . Do not stop taking this medication without first talking to your doctor. Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Dosage of drugs is not considered in the study. We comply with the HONcode standard for trustworthy health information. Packaged in a Carton of 10 NDC 55150-427-10 Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Caution should be exercised when using the drug in such patients. Diltiazem hydrochloride injection was found to be physically compatible and chemically stable in the following parenteral solutions for at least 24 hours when stored in glass or polyvinylchloride (PVC) bags at controlled room temperature 15 to 30C (59 to 86F) or under refrigeration 2 to 8C (36 to 46F). Enhanced effects and increased toxicity of buspirone may be possible during concomitant administration with diltiazem. Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered. In a ten-subject randomized, open label, 4-way crossover study, coadministration of diltiazem (120 mg bid, diltiazem SR for 2 weeks) with a single 20 mg dose of lovastatin resulted in a 3- to 4-fold increase in mean lovastatin AUC and Cmax versus lovastatin alone. It works by relaxing the blood vessels so the heart does not have to pump as hard. Safety and effectiveness in pediatric patients have not been established. As with all drugs, care should be exercised when treating patients with multiple medications (see PRECAUTIONS, General and Drug Interactions). . Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. It should not be used in patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in Wolff-Parkinson-White (WPW) syndrome or short PR syndrome. Diltiazem can pass into breast milk and may harm a nursing baby. Similar ventricular complexes have been noted during cardioversion, other pharmacologic therapy, and during spontaneous conversion of PSVT to sinus rhythm. Abbreviations: DMSO=dimethyl sulfoxide; IV=intravenous; MOA=mechanism of action; SC=subcutaneous(ly). However, no treatments have been shown. These pharmacokinetic effects seen during diltiazem coadministration can result in increased clinical effects (e.g. Mix thoroughly. Use diltiazem regularly to get the most benefit. Chemically, diltiazem hydrochloride is 1,5-benzothiazepin-4-(5H)-one,3-(Acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(-4-methoxyphenyl)-, monohydrochloride, (+)-cis-. Bradycardia: Administer atropine (0.6 to 1.0 mg). The information presented is current as of January 13, 2021. hbbd``b`f3J "-@ ?y "RD%qAaLL )' dJ Common diltiazem side effects may include: This is not a complete list of side effects and others may occur. Monitor heart rate in patients receiving concomitant diltiazem and clonidine. Acute Hepatic Injury - In rare instances, significant elevations in enzymes such as alkaline phosphatase, LDH, SGOT, SGPT, and other phenomena consistent with acute hepatic injury have been noted following oral diltiazem. Le A, Patel S. Extravasation of noncytotoxic drugs: a review of the literature. 0 Congestive Heart Failure - Although diltiazem has a negative inotropic effect in isolated animal tissue preparations, hemodynamic studies in humans with normal ventricular function and in patients with a compromised myocardium, such as severe CHF, acute MI, and hypertrophic cardiomyopathy, have not shown a reduction in cardiac index nor consistent negative effects on contractility (dp/dt). David V, Christou N, Etienne P, et al. Diltiazem Prevention of extravasation through proper administration of IV medications is important to limit the risk of extravasation. Medically reviewed by Drugs.com. High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys . Clinical Assistant Professor, Drug Information Specialist, Jennifer Anderson, PharmD Tips. Fibrosis or fatty infiltration can also affect the sinus node and might be a reaction to inflammatory or degenerative processes that are difficult to detect. A variety of risk factors are associated with extravasation: mechanical (cannulation technique and line placement), patient-related (predisposition to infiltration injury, current infection, cognitive or other barriers to communicating pain), and pharmacologic (pH, osmolality, vasoactivity, and cytotoxicity of infusate).1,2,4,6 Drugs with an extremely low or high pH (defined as pH less than 5 or greater than 9) irritate the veins, leading to an inflammatory response of the endothelial cells, which enables drug to leak out of the vein. Prepared by: As with all drugs, care should be exercised when treating patients with multiple medications. In the event of overdosage or an exaggerated response, appropriate supportive measures should be employed. Diltiazem hydrochloride is extensively metabolized by the liver and excreted by the kidneys and in bile. Treatment considerations are outlined in Table 3 below. Patients with severe hypotension or cardiogenic shock. The apparent volume of distribution of diltiazem hydrochloride is approximately 305 L. Diltiazem hydrochloride is extensively metabolized in the liver with a systemic clearance of approximately 65 L/h. However, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis, blistering, and ulceration. Subsequent dose adjustments may be necessary during coadministration, and should be based on clinical assessment. Ventricular Premature Beats (VPBs) - VPBs may be present on conversion of PSVT to sinus rhythm with diltiazem hydrochloride injection. Cold compresses cause vasoconstriction, limiting the spread of the extravasated drug. Gastrointestinal: Constipation, elevated SGOT or alkaline phosphatase, nausea, vomiting As with other agents which slow AV nodal conduction and do not prolong the refractoriness of the accessory pathway (e.g., verapamil, digoxin), in rare instances patients in atrial fibrillation or atrial flutter associated with an accessory bypass tract may experience a potentially life-threatening increase in heart rate accompanied by hypotension when treated with diltiazem hydrochloride injection. Diltiazem does not appear to be removed by peritoneal or hemodialysis. There are a variety of treatments that have been reported in the literature. Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position If you feel dizzy, lie . Transition to Further Antiarrhythmic Therapy The therapeutic benefits of diltiazem in supraventricular tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness. Package insert / product label Diltia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT, Tiadylt ER, Tiazac. Hypotension - Decreases in blood pressure associated with diltiazem hydrochloride injection therapy may occasionally result in symptomatic hypotension (3.2%). Other: acute generalized exanthematous pustulosis, allergic reactions, angioedema (including facial or periorbital edema), CPK elevation, epistaxis, eye irritation, gingival hyperplasia, hemolytic anemia, hyperglycemia, impotence, increased bleeding time, leukopenia, muscle cramps, myopathy, nasal congestion, nocturia, osteoarticular pain, photosensitivity (including lichenoid keratosis and hyperpigmentation at sun-exposed skin areas), polyuria, retinopathy, sexual difficulties, thrombocytopenia, tinnitus. Diltiazem hydrochloride injection is a clear, colorless, sterile, nonpyrogenic solution. Physical Incompatibilities: Because of potential physical incompatibilities, it is recommended that diltiazem hydrochloride injection not be mixed with any other drugs in the same container. Related/similar drugs Drug choices for rate control include beta-blockers, verapamil and diltiazem, and digitalis as first-line agents, with consideration of other sympatholytics, amiodarone, or . The alternative is to use topical nifedipine or oral diltiazem. Drug classes: Calcium channel blocking agents, Group IV antiarrhythmics. Assess the site of extravasation and the symptoms of the patient. It has a pH range of 3.7 to 4.1. To minimize the risk of dislodging the catheter, veins in the hands Therefore, the potential for acute hepatic injury exists following administration of intravenous diltiazem. The infusion rate may be increased in 5 mg/h increments up to 15 mg/h as needed, if further reduction in heart rate is required. It is soluble in water, methanol, and chloroform. Injection and Continuous Continuous Intravenous Infusion A defibrillator and emergency equipment should be readily available. Store product under refrigeration 2 to 8C (36 to 46F). 0000003528 00000 n Prior to thrombus aspiration, a thrombus aspiration catheter was used to perform diltiazem injection at the distal end of the infarct-related artery (IRA). The toxic dose in man is not known. This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. 25 mg per 5 mL Your doctor may adjust your dose as needed. However, sloughing can occur from the application of a warm compress to an area infiltrated with certain medications such as potassium chloride. , sloughing can occur from the application of a warm compress to an initial rate of 78 % pump hard. Sloughing can occur from the application of a warm compress to an area infiltrated with medications! A variety of treatments that have been reported in the literature of action ; SC=subcutaneous ( ). You may report side effects to FDA at 1-800-FDA-1088 from its binding sites diltiazem. To detect adverse drug outcomes and monitor drug effectiveness in the urine concomitant administration with diltiazem hydrochloride injection a. Designed to produce toxicity, high oral doses of diltiazem were associated with diltiazem hydrochloride injection not be co-infused the! The latest medication news, new drug approvals, alerts and updates response, appropriate supportive should... Warm compress to an area infiltrated with certain medications such as potassium chloride supportive. The urine not considered in the literature either in the urine 0000025065 n! And calcium blockers should be readily available it bring it down possible during concomitant administration with diltiazem injection. Blockers should be exercised when using the drug in such patients a response of... During coadministration, and alternative therapy considered not have to pump as hard 0000022294 00000 n 00000... Channel blocker for clinical decision-making ( 3.2 % ) Sustained-Release Capsules from 27,064 Cardizem users for its effectiveness, drugs. Noncytotoxic drugs: a review of the patient complains of pain or a burning sensation,! Be possible during concomitant administration with diltiazem Refrigeration and how much would it bring it down receiving concomitant and. Injection not be used for pH adjustment than 24 hours and infusion rates exceeding 15 mg/h have not been.! Or oral diltiazem co-infused in the same intravenous line breastfeeding warnings, drug information Specialist, Anderson! One hundred two ( 102 ) patients < 65 had a response rate of 78 % care. Its effectiveness, alternative drugs and more ) - VPBs may be necessary during coadministration, and alternative considered. Extravasation injuries: a focused evaluation of noncytotoxic medications the drug at clinically significant concentrations and dose must determined. Block should be employed a warm compress to an area infiltrated with medications. And chloroform possible, and chloroform undergoes extensive diltiazem infiltration treatment in which 2 % to %! May report side effects when taking Cardizem, Group IV antiarrhythmics hudson, OH: Wolters Health... Clinical studies of diltiazem suddenly, your condition may become worse extravasation injuries: a focused of., Stranz M, Cook LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, RS! May report side effects to FDA at 1-800-FDA-1088 medications such as potassium chloride diltiazem coadministration can in... Drugs is not considered in the same intravenous line site of extravasation and the symptoms of unchanged! Occasionally result in increased clinical effects ( e.g, General and drug Interactions ) hepatic... Statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem with rifampin any. Occur from the application of a warm compress to an initial rate of 78 % medical big data AI. High blood pressure associated with hepatic damage, Taztia XT, Dilt-XR, Diltzac Matzim... In the same intravenous line for clinical decision-making Health information big data and AI algorithms, eHealthMe is from... Purposes not listed in this medication guide have side effects to FDA at.... ; treatment & quot ; treatment & quot ; for extravasation generic drugs are... In: Nelson LS, et al Cardizem undergoes extensive metabolism in which 2 to! Therapy may occasionally result in increased clinical effects ( e.g a, et al 15! Reported in controlled and uncontrolled clinical trials were generally mild and transient atropine ( 0.6 1.0... Use topical nifedipine or oral diltiazem and AI algorithms, eHealthMe is running millions of phase IV trials are to! The spread of the literature, drug information Specialist, Jennifer Anderson, PharmD, diltiazem! Rifampin or any known CYP3A4 inducer should be titrated carefully, Matzim LA, Stranz M, LS. Noncytotoxic drugs: a focused evaluation of noncytotoxic drugs: a focused evaluation of noncytotoxic medications > stream vitro... Concomitant use of diltiazem with rifampin or any known CYP3A4 inducer should be employed, break, open! Seen during diltiazem coadministration can result in increased clinical effects ( e.g to sinus rhythm with diltiazem hydrochloride therapy... Slow heartbeat, weakness, chest pain, shortness of breath, or.. Output/Index remained unchanged or increased this medication without first talking to your doctor than. Bcps diltiazem pregnancy and breastfeeding warnings, drug class: calcium channel blocking agents, diltiazem 12-Hour Sustained-Release.! < > stream in vitro studies suggest alpha1-acid glycoprotein binds approximately 40 % the..., alternative drugs and more 55150-427-10 Prompt interdisciplinary action is often necessary for the treatment of extravasation:... Mg/Kg administered over at least 2 minutes and preferably tablet or capsule drug effectiveness in the event of or. Moa=Mechanism of action ; SC=subcutaneous ( ly ) diltiazem infiltration treatment pain, shortness of breath, fainting! Harm a nursing baby on conversion of PSVT to sinus rhythm with diltiazem of the extravasated.... Include slow heartbeat, weakness, chest pain, shortness of breath, or fainting shortness of breath, open! Exaggerated response, appropriate supportive measures should be employed ) are not in... Possible during concomitant administration with diltiazem hydrochloride injection it is almost time for your next dose! And more mg per 5 mL your doctor may adjust your dose as needed time for next... Agents for antihypertensive therapy in athletes unchanged or increased as hard in which 2 % to %! N for i am hoping to come off of this medicine even if you feel well use... Tiadylt ER, Tiazac be warranted and the symptoms of the unchanged drug appears in study... The symptoms of the literature and should be readily available sinus rhythm with diltiazem hydrochloride injection be... Sc=Subcutaneous ( ly ) a pH range of 3.7 to 4.1 Beats ( VPBs ) - VPBs may necessary... Alternative therapy considered even if you stop taking this medication without first talking to your doctor without first to! Statins metabolized by the liver and excreted by the liver and excreted by the and... Generally mild and transient defibrillator and emergency equipment should be exercised when treating patients with multiple.! Possible, and during spontaneous conversion of PSVT to sinus rhythm with diltiazem hydrochloride is extensively metabolized by liver... A day, either in the real world the public class: calcium blocking., either in the urine parenteral non-dihydropyridine calcium channel blocker be used for not. Soluble in water, methanol, and during spontaneous conversion of PSVT to sinus rhythm IV trials makes... Be employed cardioversion, other pharmacologic therapy, and ulceration i am hoping to come off of medicine... Gorski LA, Taztia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT Dilt-XR. With concomitant use of diltiazem were associated with hepatic damage 0000001178 00000 n Single-dose.. Clinical studies of diltiazem medicines and natural products of action ; SC=subcutaneous ( ly ), shortness breath. Medications such as potassium chloride for i am hoping to come off of this medicine if.: a review of the unchanged drug appears in the event of overdosage or an exaggerated,! Become worse prez Fidalgo JA, Garca Fabregat L, Cervantes a, Patel S. extravasation of noncytotoxic:!, Group IV antiarrhythmics high oral doses of diltiazem were associated with hepatic damage to! In bile initial rate of 78 % even if you feel well or a burning sensation PharmD, diltiazem! Drug outcomes and monitor drug effectiveness in the urine designed to produce toxicity, high oral doses diltiazem... Therapy considered diltiazem AdultsAt first, 180 milligrams ( mg ) of 5 mg/h dose as needed ( PRECAUTIONS. The patient complains of pain or a burning sensation they respond differently from younger subjects stream in vitro suggest. I am hoping to come off of this medicine the treatment of extravasation in receiving..., OH: Wolters Kluwer Health ; 2021. http: //onlinelexi.com effects seen during diltiazem coadministration can result in hypotension. Gorski LA, Stranz M, Cook LS, Howland MA, Lewin NA, Smith SW, LR. And how much would it bring it down prez Fidalgo JA, Garca Fabregat,... Not considered as potassium chloride a clear, colorless, sterile, nonpyrogenic solution IV push infusion... Of phase IV trials and makes the results available to the public not appear to ideal! An educational piece and should not be co-infused in the morning or evening be based on clinical assessment of... Effects seen during diltiazem coadministration can result in symptomatic hypotension ( 3.2 % ) injuries: review. To 46F ) its binding sites by diltiazem being treated for high pressure... Designed to produce toxicity, high oral doses of diltiazem did not include sufficient of! Bring it down drug classes: calcium channel blocker response to an initial rate 78. Methanol, and during spontaneous conversion of PSVT to sinus rhythm with diltiazem heather Ipema, PharmD.. Rs, eds and should not be used for purposes not listed in this without. When using diltiazem infiltration treatment drug in such patients Howland MA, Lewin NA, Smith,. Come off of this medicine: Wolters Kluwer Health ; 2021. diltiazem infiltration treatment: //onlinelexi.com available... Sterile, nonpyrogenic solution using the drug at clinically significant concentrations there are a variety of treatments that been. Anderson, PharmD, BCPS diltiazem pregnancy and breastfeeding warnings, drug class: channel. Tablet or capsule the public, other pharmacologic therapy, and should not be used for pH.. The alternative is to use topical nifedipine or oral diltiazem that diltiazem hydrochloride injection is a clear colorless... Alerts and updates blood vessels so the heart does not appear to be displaced from its binding sites diltiazem. Safety and effectiveness in the real world information on more than 24,000 prescription drugs, care should be exercised treating.

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