Cardizem LA

Cardizem LA is available in extended-release tablets with the following strengths:

• 120 mg
• 180 mg
• 240 mg
• 300 mg
• 360 mg
• 420 mg

The dose is individualized based on the patient's condition and response to therapy.

• For off-label uses:
• Pulmonary hypertension: 120-360mg per day.
• Anal fissure: 2% ointment applied topically.

Cardizem LA is contraindicated in patients with:

• Severe hypotension (low blood pressure).
• Second- or third-degree AV block or sick sinus syndrome, unless a pacemaker is present.
• Heart failure with reduced ejection fraction, as it may worsen the condition.
• Hypersensitivity to diltiazem or any of the components of the formulation.

Patients taking Cardizem LA should be advised to:

• Take the medication at the same time every day to maintain consistent blood levels.
• Avoid grapefruit and grapefruit juice, as it can interfere with the metabolism of diltiazem and increase the risk of side effects.
• Monitor blood pressure regularly and report symptoms such as dizziness, lightheadedness, or fainting, which could indicate low blood pressure.
• Do not stop taking the medication suddenly without consulting a healthcare provider, as this could worsen heart conditions.
• Report any unusual swelling (especially in the legs), shortness of breath, or persistent chest pain to their healthcare provider immediately.

• Dizziness or lightheadedness
• Fatigue
• Headache
• Nausea
• Swelling in the hands, ankles, or feet (peripheral edema)

• Bradycardia (Slow Heart Rate): Symptoms may include dizziness, fatigue, or fainting.
• Hypotension (Low Blood Pressure): Can cause dizziness, fainting, or blurred vision.
• Heart Failure: Symptoms include swelling of the legs, rapid weight gain, or shortness of breath.
• Liver Dysfunction: Signs include yellowing of the skin or eyes (jaundice), dark urine, or severe abdominal pain.

Bradycardia and Hypotension: Cardizem LA can cause significant drops in heart rate and blood pressure, particularly when used with other medications that affect heart rate or blood pressure.

Heart Failure: In patients with reduced ejection fraction, Cardizem LA may worsen symptoms of heart failure, such as fluid retention and difficulty breathing.

Liver Function: Diltiazem can cause liver enzyme elevations, and liver function should be monitored during long-term use.

Cardizem LA may interact with other medications, including:

• Beta-Blockers: Such as metoprolol or propranolol, which may increase the risk of low heart rate (bradycardia) and low blood pressure (hypotension).
• Digoxin: Diltiazem can increase digoxin levels, raising the risk of toxicity.
• Statins: Especially simvastatin and atorvastatin, which may increase the risk of muscle damage (rhabdomyolysis) when taken with diltiazem.
• Grapefruit Juice: Grapefruit can increase diltiazem levels in the body, leading to higher risk of side effects.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternative treatments for hypertension, angina, and heart rhythm disorders include:

• Other Calcium Channel Blockers: Such as amlodipine or nifedipine, which work similarly to diltiazem but may have different side effect profiles.
• Beta-Blockers: Such as atenolol or bisoprolol, which lower heart rate and blood pressure.
• ACE Inhibitors: Such as lisinopril or enalapril, used to manage high blood pressure and heart failure.
• Angiotensin II Receptor Blockers (ARBs): Such as losartan or valsartan, which lower blood pressure by relaxing blood vessels.