From the Guidelines
Cardizem ER (diltiazem extended-release) should be initiated at a dose of 120-180 mg once daily for hypertension or angina, with gradual increases every 7-14 days as needed and tolerated, up to a maximum of 540 mg daily, as supported by the most recent guidelines 1.
Key Considerations for Dosing
- The dose can be adjusted based on patient response, with most patients requiring 240-360 mg once daily.
- For elderly patients or those with liver or kidney impairment, starting at a lower dose (120 mg) is advisable.
- Cardizem ER should be taken consistently with respect to meals, either always with or always without food.
Mechanism of Action and Efficacy
- The medication works by blocking calcium channels in the heart and blood vessels, which relaxes blood vessels, reduces heart rate, and decreases the heart's workload.
- This mechanism makes it effective for treating high blood pressure and chest pain.
Administration and Monitoring
- Patients should swallow the capsules whole without crushing or chewing them, as this would disrupt the extended-release mechanism and potentially cause side effects or overdose.
- Blood pressure monitoring is essential when starting or adjusting doses to ensure proper therapeutic effect, as indicated in guidelines such as those from the American College of Cardiology Foundation/American Heart Association 1.
Side Effects and Precautions
- Major side effects include hypotension, worsening HF, bradycardia, and AV block, as noted in the guidelines 1.
- Verapamil and diltiazem should be avoided in patients with pulmonary edema or evidence of severe LV dysfunction, highlighting the need for careful patient selection and monitoring 1.
From the Research
Dosing for Cardizem ER
- The dosing for Cardizem ER (diltiazem) is not explicitly stated in the provided studies, but we can gather information about its usage and effects from the given texts.
- According to the study 2, diltiazem CD 180 mg and diltiazem SR 90 mg bid were compared in patients with mild to moderate systemic hypertension, with total daily doses titrated from 180 mg to 360 mg to achieve a goal of seated diastolic blood pressure < 90 mmHg.
- The study 3 compared the efficacy of diltiazem in a slow-release formulation administered once daily with its twice daily administration as monotherapy in patients with mild to moderate essential hypertension, with doses of 120 mg or 180 mg twice daily.
- It is essential to note that the dosing of diltiazem may vary depending on the patient's condition, such as hypertension or coronary heart disease, and the combination therapy with other medications, such as beta-blockers 4, 5.
- The studies suggest that diltiazem can be effective in treating hypertension and angina pectoris, but the optimal dosing regimen may depend on individual patient factors and the specific formulation of the medication 2, 6, 3.