Diltiazem 60mg Administration
Yes, you can safely administer Cardizem (diltiazem) 60mg, as this dose falls within the FDA-approved dosing range and is commonly used in clinical practice. 1
FDA-Approved Dosing Parameters
- Diltiazem 60mg tablets are FDA-approved and may be swallowed whole, crushed, or chewed (though extended-release formulations should never be split or crushed). 1
- The FDA-approved starting dose for angina is 30mg four times daily, with gradual titration in divided doses (3-4 times daily) at 1-2 day intervals until optimal response is achieved. 1
- The average therapeutic dosage range is 180-360mg daily for most cardiovascular indications. 1
Clinical Context for 60mg Dosing
- For immediate-release formulations, 60mg represents a standard single-dose increment that can be administered 3-4 times daily as part of the therapeutic regimen. 1, 2
- Diltiazem has demonstrated efficacy and excellent tolerability across multiple cardiovascular conditions including stable angina, variant angina, hypertension, and supraventricular arrhythmias. 2, 3
Critical Contraindications to Verify Before Administration
Absolute contraindications where diltiazem 60mg should NOT be given:
- Second or third-degree AV block without a functioning pacemaker 4, 5
- Sick sinus syndrome without a pacemaker 4, 5
- Wolff-Parkinson-White syndrome with atrial fibrillation/flutter 4, 5
- Decompensated systolic heart failure or severe left ventricular dysfunction 4, 5
- Cardiogenic shock 4, 5
- Hypotension 4, 5
Important Drug Interactions
- Exercise extreme caution when combining with beta-blockers due to increased risk of significant bradyarrhythmias and heart failure. 4
- Diltiazem is a CYP3A4 substrate and moderate CYP3A4 inhibitor—use caution with medications like apixaban, cyclosporine, simvastatin, and rifampin. 4
Monitoring Requirements After Administration
- Monitor blood pressure and heart rate regularly. 4
- Watch for hypotension (most common adverse effect), bradycardia, peripheral edema, and constipation. 4
- In patients with conduction system disease, ECG monitoring is recommended. 4
- Monitor for signs of worsening heart failure in at-risk patients. 4
Special Populations Requiring Caution
- Hepatic dysfunction: Titrate with particular caution as diltiazem is metabolized by the liver. 4, 1
- Renal dysfunction: May require dose adjustment and careful titration. 4, 1
- Elderly patients: Generally well-tolerated but monitor closely for hypotension and bradycardia. 4