Drug Interaction:
Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercanidipine
Refer Verapramil-
Elevates digoxin,cyclosporin,hence dose must be reduced.
Potentiates action of propanolol (bradycardia and conduction disturbances).
Decreases serum theophyline levels. H-2 recepector blockrs increase plasma concentration of diltiazem.
Indication:
Approved by FDA in 1982
LIST OF DRUGS DURING 2007
Sr.No- 9
Name of the Drug- Diltiazem Hcl 2% gel
Pharmacological Classification- For anal fissure
Date of Approval- 07-02-07
Approved by U.S.FDA on 30-12-2007 (Ref- FDA approved List- 2007)
Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Diltiazem Hcl For Anal Fissure 07-02-2007
Angina pectoris,Chronic stable angina,chronic stable angina,essential hypertension,atrial fibrillation and flutter,paraoxymal supraventricular tachycardia.
Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Flunarizine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Clevidipine butyrate, Lercanidipine
Refer Verapramil-
Adverse Reaction:
DILTIAZEM-
Generally not serious, rarely requires discontinuation or dosage adjustment
CNS-
Dizziness/lightheadedness 7 %,Headache 2 % ,Asthenia 1.7 %,Nervousness,
Sleep disturbances, Psychiatric disturbances,Depression, amnesia, Weakness/shakiness < 1 %
GASTROINTESTINAL -
Nausea 2 %,Constipation 7 %,Diarrhea < 1%, Abdominal discomfort / cramps/dyspepspa, Dry mouth/ Thirst < 1 %
CARDIOVASCULAR -
Periph.edema 2 %, Bradycardia 1.5%, Hypotension 1% , Abnormal ECG 4%
Palpitation < 1%,Syncope, 1Congestive Heart failure , Arrhythmias ,Tachycardia ,
Ventricular extrasystole < 1 %
DERMATOLOGIC -
Dermatitis/rash 1 %, Pruritis/urticaria Photosensitivity < 1%
HEMATOLOGIC-
Leukopenia 1%, Petechiae/pupura/ < 1%
OTHER -
Flushing 3% ,Mituration disorders,dysuria/frequency 1%,Nasal or chest congestion/sinusitis, Sexual difficulties, Shortness of breath,dyspepsia, wheezing < 1%
Effects associated with depression of cardiac conduction (atrioventricular block,tachycardia etc).
Patients with sick sinus syndrome,preexisting atrioventricular block, bradycardia.
Those taking beta-blckrs or digitalis are particularly at risk of developing these reactions.
Ankle oedema, headache, hypotension,flushing,nausea,
GI discomfort,Gynaecomastia.
Hyperactivity(sometimes associated with psychiatric symptoms).
Contra-Indications:
Sick sinus syndrome,
2nd or 3rd AV shock.Severe CCF.
Marked bradycardia.
Pregnancy.
Special precations:
Measure heart rate regularly in elderly or those with hepatic or renal impairment.prolonged AV peroids.
Diabetes,hypotension,abrupt withdrawal long term use.
Dosages/ Overdosage Etc:
Approved by FDA in 1982
Indications:
Angina pectoris,Chronic stable angina,chronic stable angina,essential hypertension,atrial fibrillation and flutter,paraoxymal supraventricular tachycardia
. Dosage:
Individualise dose. 30mg 4 times a day before meals and bed time..
Gradually increase dosage to 180 to 360mg, given in divided doses of 3 to 4 times a day, at 1 or 2 days interval until optimum response is obtained.
Missed dose-
1. If you miss a dose of this medicine, take it as soon as possible.
2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.
3. Do not double doses.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
Patient Information:
Calcium channel blockers-
1.Take the medicine exactly as directed by the physician.
2.Swallow the tablet whole,without crushing or chewing it. However if advosed by the doctor, you may break into half.
3.Take the medicine with food or milk.
Pharmacology/ Pharmacokinetics:
Refer - Verapramil- Calcium channel blockers
Interaction with Food:
Refer- Verapramil- Calcium channel blockers
Pregnancy and lactation:
Refer - Verapramil - Calcium channel blockers