Cartia XT

Cartia XT is available in extended-release capsules with the following strengths:

• 120 mg
• 180 mg
• 240 mg
• 300 mg

The appropriate dose is individualized based on the patient’s condition and response to treatment.

It has also been used off-label for conditions such as pulmonary hypertension and anal fissures.

• Pulmonary hypertension: 120360mg per day.
• Anal fissure: 2% ointment applied topically.

Cartia XT is contraindicated in patients with:

• Severe hypotension (low blood pressure).
• Sick sinus syndrome or second- or third-degree AV block (unless the patient has a pacemaker).
• Severe heart failure, particularly with reduced ejection fraction, as it may worsen the condition.
• Hypersensitivity to diltiazem or any components of the formulation.

Patients using Cartia XT should be advised to:

• Take the medication at the same time each day to maintain consistent blood levels.
• Avoid grapefruit and grapefruit juice, as it can interfere with the metabolism of diltiazem, leading to higher drug levels and an increased risk of side effects.
• Monitor their blood pressure regularly and report any symptoms of low blood pressure, such as dizziness or fainting.
• Be cautious when standing up quickly, as Cartia XT can cause dizziness or lightheadedness, especially during the first few days of treatment.
• Contact their healthcare provider if they experience worsening chest pain, swelling in the legs, or shortness of breath.

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

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

Bradycardia and Hypotension: Cartia XT can significantly lower heart rate and blood pressure, especially when used with other heart rate-lowering medications like beta-blockers.

Heart Failure: Cartia XT may worsen symptoms in patients with heart failure, particularly those with reduced ejection fraction.

Liver Function: Diltiazem may elevate liver enzymes, so liver function should be monitored regularly during long-term use.

Cartia XT may interact with other medications, including:

• Beta-Blockers: Such as metoprolol or atenolol, which can 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: Particularly simvastatin and atorvastatin, which may have increased risk of muscle damage (rhabdomyolysis) when used with diltiazem.
• Grapefruit Juice: Grapefruit can inhibit the metabolism of diltiazem, increasing drug levels and the 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 and angina 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 propranolol or carvedilol, which lower heart rate and blood pressure.
• ACE Inhibitors: Such as lisinopril or enalapril, which reduce blood pressure and protect heart function.
• Angiotensin II Receptor Blockers (ARBs): Such as losartan or valsartan, which are used to treat high blood pressure and heart failure.