Diltiazem

Dosage forms available

• Diltiazem is available in several oral forms, including tablets and extended-release capsules and injectable formulation.

Age and dose restrictions

• Diltiazem is not typically recommended for children below 18 years. Dosage in adults is determined by the condition being treated, and adjustments may be needed in elderly patients or those with liver or kidney impairment.

Contraindications

• Diltiazem is contraindicated in individuals with severe hypotension (low blood pressure), certain types of heart block (without a pacemaker), recent heart attack with left ventricular failure, and known allergy to diltiazem or other calcium channel blockers.

Other medications to avoid

• Avoid using diltiazem with beta-blockers (e.g., atenolol), digoxin, amiodarone, certain statins (e.g., simvastatin), antifungals (e.g., itraconazole), macrolide antibiotics (e.g., erythromycin), and benzodiazepines (e.g., midazolam). These may increase the risk of adverse effects or reduce diltiazem’s effectiveness.

Overdose and missed dose

• Overdose of diltiazem can lead to severe hypotension, bradycardia (slow heart rate), and even cardiac arrest. Immediate medical attention is required in such cases. 
• If you miss a dose, take it as soon as possible. If it’s nearly time for the next dose, skip the missed dose—do not double the dose to catch up.

Management of side effects

• If dizziness or fatigue occurs, lie down until symptoms pass, and avoid sudden position changes. Constipation can be managed by increasing dietary fiber and fluid intake. If side effects persist or worsen, consult your doctor for evaluation and possible dose adjustment.

Use in driving and operating machinery

• Diltiazem may cause dizziness or drowsiness, especially at the beginning of treatment. Refrain from driving or operating heavy machinery until you are sure how the medication affects you.

Use in pregnancy and lactation

• Diltiazem should be used during pregnancy only if clearly needed and prescribed by a doctor. It passes into breast milk, so breastfeeding while using diltiazem is not recommended unless deemed essential by a physician.

Caution in other conditions

• Use caution in patients with liver or kidney disease, congestive heart failure, bradycardia, atrioventricular block, and low blood pressure. Diltiazem may also interact with conditions affecting heart conduction and muscle function.

Special dietary and lifestyle recommendations

• Limit sodium intake to help manage blood pressure effectively. Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. 
• Avoid excessive caffeine and alcohol, as these can affect blood pressure and heart rhythm. 
• Regular physical activity and stress management techniques can further support heart health.