From the Guidelines
Cartia, a brand name for diltiazem, is recommended as a calcium channel blocker for managing supraventricular tachycardia (SVT) with an initial daily dose of 120 mg in divided or single dose with long-acting formulations, and a maintenance dose of 360 mg daily in divided or single dose with long-acting formulations, as per the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1. The medication works by relaxing blood vessels and reducing the heart's workload by blocking calcium from entering cells in the heart and blood vessel walls. Key considerations for prescribing Cartia include:
- Potential adverse effects such as hypotension, worsening HF in patients with pre-existing ventricular dysfunction, bradycardia, abnormal liver function studies, and acute hepatic injury (rare) 1.
- Precautions, including AV block greater than first degree or SA node dysfunction (in absence of pacemaker), hypotension, decompensated systolic HF/severe LV dysfunction, WPW with AF/atrial flutter, and drugs with SA and/or AV nodal–blocking properties 1. It is essential for patients to take Cartia consistently, with or without food, and not to crush or chew extended-release capsules. Additionally, patients should inform their doctor about all other medications they're taking, as diltiazem can interact with numerous drugs, particularly those affecting heart rhythm or blood pressure, such as apixaban, itraconazole, bosutinib, ceritinib, cilostazol, cyclosporine, everolimus, ibrutinib, idelalisib, ivabradine, lomitapide, olaparib, ranolazine, rifampin, and simeprevir 1.
From the FDA Drug Label
Diltiazem hydrochloride is a calcium ion cellular influx inhibitor (slow channel blocker or calcium antagonist). The FDA drug label does not answer the question.
From the Research
Cartia Information
- Cartia is not directly mentioned in the provided studies, however, the studies discuss various antihypertensive drugs and their effects on hypertension and coronary artery disease.
- The American Heart Association scientific statement on hypertension and coronary artery disease recommends the use of certain antihypertensive drugs, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and thiazide diuretics 2.
- Beta-blockers are also discussed in the studies as a treatment option for hypertension, with some studies suggesting that they may not be the most effective choice for first-line therapy 3.
- A study on sustained-release diltiazem, a type of calcium channel blocker, found that it was effective in controlling blood pressure and angina pectoris in patients with hypertension and coronary artery disease 4.
Treatment Options
- The studies suggest that the choice of antihypertensive drug depends on various factors, including the patient's medical history and the presence of other health conditions 2.
- ACE inhibitors, ARBs, CCBs, and thiazide diuretics are recommended as first-line therapy for hypertension, with beta-blockers being considered for patients with certain conditions, such as heart failure or coronary artery disease 2, 3.
- The effectiveness of different antihypertensive drugs can vary, with some studies suggesting that CCBs may be more effective than beta-blockers in reducing cardiovascular disease 3.
Study Limitations
- The studies have some limitations, including high risk of bias and limited generalizability to certain populations 3.
- Further research is needed to fully understand the effects of different antihypertensive drugs and to determine the most effective treatment options for patients with hypertension and coronary artery disease 3.