Diltiazem is a nondihydropyridine, benzothiazepine-derived calcium channel blocker that is primarily used to treat hypertension, angina, and arrhythmia. By blocking the influx of extracellular calcium ions into myocardial and vascular smooth muscle cells, the drug causes vasodilation of the coronary and peripheral systemic arteries. This lowers blood pressure by reducing peripheral resistance and allowing blood to flow more easily. It also decreases heart contractility by slowing conduction through the atrioventricular node and the sinoatrial node.1
Patients should contact a physician immediately if they experience the following serious side effects:
Swelling of the face, lips, tongue, eyes, hands, arms, feet, lower legs, or ankles
Difficulty breathing or swallowing
Bleeding or bruising easily
Loss of appetite
Upper right stomach pain
Increased chest pain
Patients who have a history of congestive heart failure, sick sinus syndrome, atrioventricular block, low heart rate, low blood pressure, liver disease, or kidney disease should talk to a doctor before taking diltiazem. Patients who are pregnant or breastfeeding should only take diltiazem if it is absolutely necessary.5
Diltiazem is both an inhibitor and a substrate of the enzyme CYP3A4, so taking it in conjunction with other drugs that act on the enzyme could alter its efficacy or side effects. These drugs include benzodiazepines, beta blockers, carbamazepine, cimetidine, HIV protease inhibitors, tricyclic antidepressants, quinidine, rifampin, and certain statins.6 Patients are also advised against taking diltiazem alongside grapefruit juice, which contains bergamottin, another inhibitor of CYP3A4.7
Latest News and Research
Recent research probes the relationship between diltiazem and diabetes. One study found that type II diabetes patients who took blood pressure medications, including diltiazem, were less likely to die prematurely or suffer from a heart attack or stroke, even if they had not been specifically diagnosed with hypertension.8 Diltiazem may also provide effective treatment for diabetes mellitus.9 Investigations into how the drug works to treat these conditions are ongoing.
Scientists are also exploring other alternative uses for diltiazem. Recent research indicates that diltiazem can decrease cocaine cravings in rats, most likely because of the effects of calcium channel blockers on dopaminergic and glutaminergic signaling, and some scientists hope to use the drug to treat cocaine addiction in the future.10 Studies also show that diltiazem can be taken orally or applied topically to heal chronic anal fissures.11 Diltiazem may also facilitate kidney stone passage.12
Many compound pharmacists elect Verapamil and Nifedipine, which are calcium channel blockers that treat many of the same conditions as diltiazem but interact with fewer medications. Please find more information aboutour Bulk APIs here.