Diltiazem retard 90mg №20

Mechanism of action

Selective Calcium channel blocker class III. It has antianginal, hypotensive and antiarrhythmic effects. Reduces myocardial contractility, slows AV conductivity, reduces heart rate, reduces myocardial oxygen demand, dilates coronary arteries, increases coronary blood flow. Reduces the tone of the smooth muscles of peripheral arteries and round neck.

Indications and usage

Prevention of angina attacks (including Prinzmetal stenocardia). Arterial hypertension. Prevention of supraventricular arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, extrasystole).
For IV injection: relief of acute angina attacks, prevention of coronary artery spasm during coronary angiography or coronary artery bypass surgery, paroxysmal ventricular tachycardia, for relief of frequent ventricular rhythm during atrial fibrillation or flutter (except for WPW syndrome).

When ingestion, the initial dose is 60 mg 3 times / day or 90 mg 2 times / day. With insufficient effectiveness, the dose is increased to 180 mg 2 times / day. Prolonged form used 1-2 times / day, depending on the dose. The maximum daily dose of 360 mg.
With the / in the introduction of a single dose of 300 mg / kg.For intravenous drip administration, 2.8-14 mg / kg / min, the maximum dose is 300 mg / day.

Adverse reactions

Possible - headache, dizziness, fatigue, facial flushing, skin rash. In rare cases, nausea, vomiting, constipation, transient increase in liver transaminase activity, sleep disorders, nervousness, edema of the lower extremities. With the use of diltiazem in high doses, as well as with a / in the introduction of possible severe bradycardia, conduction disorders, arterial hypotension, the appearance of symptoms of heart failure. With prolonged use, isolated cases of gingival hyperplasia have been noted.

Contraindications

Severe bradycardia, SSSU, cardiogenic shock, AV block II-III degree (except for patients with a pacemaker), WPW syndrome, arterial hypotension, chronic heart failure II B-III stage, acute heart failure, marked impaired liver and kidney function, pregnancy, lactation, childhood, hypersensitivity to benzothiazepine derivatives.

Special notes

With caution used for AV blockade of I degree, violation of intraventricular conduction, patients prone to arterial hypotension.
In / in apply only to emergency treatment, but if necessary, may be administered within a few days. With the introduction of diltiazem requires careful monitoring of the function of the cardiovascular system.Against the background of regular beta-blockers, the indications for IV diltiazem injection should be strictly clarified and should be used only after ECG monitoring in the intensive care unit, and the possible need to use a pacemaker should be taken into account.
The simultaneous use of beta-blockers and diltiazem for parenteral administration is not recommended.