📋 Indications & Clinical Dosage
*Prophylaxis and treatment of angina:*
Adult: Initially 60 mg 3 times a day, adjusted according to response; max. 360 mg per day. Alternately, 90 mg SR Tab/Cap twice daily; increased if necessary to 180 mg twice daily
Elderly: Initially 60 mg twice daily, adjusted according to response; max. 360 mg per day. Alternately, 90 mg SR Tab/Cap twice daily.
*Mild to moderate hypertension:*
Adult: 120 mg SR Tab/Cap twice daily, dose form not appropriate for initial dose titration.
⛔ Contraindications
Acute porphyria, left ventricular failure with pulmonary congestion, severe bradycardia, sick sinus syndrome, 2nd or 3rd degree AV block, uncontrolled cardiac failure
⚠️ Precautions & Warnings
Observe patients with mild bradycardia, 1st degree AV block or a prolonged PR interval, significantly impaired left ventricular function. Impaired renal or hepatic function; reduced dose. In overdose, diltiazem has a profound cardiac depressant effect causing hypotension and arrhythmias, including complete heart block and asystole.
🔄 Drug Interactions
Other anti hypertensives, cardiac depressants, beta-blockers, digitalis, carbamazepine, cyclosporin, theophylline, H2 antagonists, dantrolene infusion.
⚠️ Adverse Reactions / Side Effects
Asthenia, AV block, bradycardia, dizziness, GI disturbances, headache, hot flushes, hypotension, malaise, oedema (notably of ankles), palpitation, sino-atrial block, fatigue, gum hyperplasia, changes in liver function, depression, extrapyramidal symptoms, gum hyperplasia, gynaecomastia, hepatitis. Rare: Erythema multiforme, exfoliative dermatitis, photosensitivity, rashes
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.