Cardizem
Cardizem
- In our pharmacy, you can buy Cardizem with a prescription. We offer delivery in various regions, including the US, Canada, and EU countries like Romania, with discreet packaging.
- Cardizem (diltiazem) is used to treat hypertension, chronic angina, and certain heart rhythm disorders. It works by blocking calcium channels in blood vessels and heart muscle, which relaxes arteries and reduces heart rate.
- The usual dose ranges from 120–540 mg daily depending on the condition: 120–180 mg/day for angina, and 180–240 mg/day for hypertension using extended-release forms, with individual titration.
- Cardizem is administered as immediate-release tablets, extended-release capsules/tablets, or injectable solutions (hospital use only).
- Onset of action occurs within 30–60 minutes for immediate-release forms. Extended-release formulations act more gradually.
- Duration of action is 4–8 hours for immediate-release tablets and 24 hours for extended-release capsules/tablets when taken as prescribed.
- Avoid alcohol completely, as it may dangerously enhance side effects like dizziness and low blood pressure.
- The most common side effect is headache, followed by peripheral edema, nausea, dizziness, flushing, and bradycardia.
- Would you like to try Cardizem without a prescription?
Basic Cardizem Information
| Information Type | Details |
|---|---|
| INN (International Nonproprietary Name) | Diltiazem |
| Brand Names (UK) | Cardizem®, generic Diltiazem HCl (Teva, Mylan), Cardizem CD |
| ATC Code | C08DB01 (Cardiovascular → Calcium blockers → Benzothiazepines) |
| Forms & Dosages |
|
| Manufacturers | Bausch Health (Cardizem®), Teva, Mylan |
| Registration Status | MHRA-approved |
| Classification | Prescription-only (Rx) medication under UK prescribing regulations |
Cardizem provides hypertension and angina management through multiple formulations tailored to different treatment needs. Immediate-release diltiazem tablets require dosing 3-4 times daily while extended-release versions (Cardizem CD/LA) offer once-daily dosing convenience. Approval by the Medicines and Healthcare products Regulatory Agency covers cardiovascular indications specifically. Supplies reach UK pharmacies through established European channels via EMA-approved generic versions besides branded options from Teva and Mylan.
Cardizem Pharmacology Explained
Mechanism of Action
Cardizem functions as a calcium channel blocker, specifically targeting L-type calcium channels in vascular smooth muscle and cardiac tissue. By inhibiting calcium ion influx, it causes relaxation of coronary and peripheral arteries. This pharmacological action reduces peripheral resistance and decreases cardiac workload. Blood pressure lowering occurs through systemic vasodilation while angina relief stems from improved coronary blood flow according to pharmacological reference texts.
The onset timing varies significantly between formulations: Immediate-release versions work within 30-60 minutes while extended-release capsules like Cardizem CD take 6-8 hours to reach peak effect. Metabolism occurs primarily in the liver through cytochrome P450 pathways, with renal excretion eliminating most metabolites. Steady-state concentrations typically require 3-4 days of consistent ER capsule dosing.
Key Medication Interactions
Several significant interactions require monitoring:
- Beta-blockers: Combined use amplifies risks of bradycardia and AV block
- Digoxin: Elevated digoxin concentrations requiring frequent monitoring
- Statins: Increased risk of muscle-related side effects
- Grapefruit juice: Contraindicated due to significant toxicity potential
The NHS emphasizes medication reviews when prescribing diltiazem with CYP3A4 substrates including certain antibiotics and antifungals.
Approved and Off-label Indications
MHRA-authorised uses include stable angina management and essential hypertension treatment. Beyond these core indications, UK prescribers may use Cardizem off-label for certain arrhythmias, specifically atrial fibrillation rate control. Some neurologists also prescribe it for migraine prophylaxis given its vasoregulatory properties.
| Medical Condition | Standard Dosage |
|---|---|
| Hypertension | 180–240 mg daily (extended-release formulations) |
| Stable Angina | 120–180 mg daily (divided doses of immediate-release) |
Special Population Considerations
Pregnancy requires careful assessment since Cardizem falls into Category C risk classification. Elderly patients typically start at lower doses due to heightened sensitivity. Pediatric use remains limited in the UK - there's sparse efficacy data for children. NICE guidelines recommend alternative agents where possible.
Cardizem Dosing Guidelines
Standard Dosage Protocols
For angina management through immediate-release tablets, doctors typically prescribe 30mg doses three times daily, progressively increasing to maximum daily limits based on response. Hypertension protocols normally start with 180mg daily using extended-release formulations like Cardizem LA.
Maximum daily dosage rarely exceeds 540mg regardless of formulation. Immediate-release tablets should be administered at consistent intervals throughout the day while ER capsules require once-daily timing consistency. Patients should swallow extended-release formulations whole - never crushing or splitting capsules to maintain proper absorption.
Dosage Adjustment Requirements
Elderly patients typically initiate therapy at 60mg IR tablets twice daily due to increased sensitivity. Both hepatic impairment and significant kidney dysfunction necessitate dose reductions, sometimes requiring 50% decreases. Regular monitoring of liver enzymes and renal function is recommended for impaired patients.
Abrupt discontinuation risks rebound hypertension - tapering protocols require GP supervision. If patients miss Cardizem doses, they should skip missed ones when nearing next scheduled timing. Doubled doses potentially cause hypotension according to UK medication safety resources.
Practical Cardizem Administration Guidance
Understanding how to take diltiazem correctly maximises effectiveness and safety. Follow these evidence-based handling recommendations for optimal therapy results.
Taking Cardizem
- Immediate-release tablets: Take three times daily with water, spaced evenly throughout waking hours
- Extended-release capsules/tablets: Take once daily at the same time each morning
- You can take Cardizem with or without food - consume with a meal if experiencing nausea
- Swallow extended-release forms whole without crushing, chewing or splitting
- Measure liquid forms precisely using the dosing syringe provided
Storage Requirements
- Store at normal room temperature (15–25°C)
- Protect medication from moisture and light exposure
- Keep tablets in their original blister strips or bottles
- Never transfer capsules to other containers
- Check expiry dates regularly - dispense of expired medication responsibly
Managing Missed Doses
- Take your dose when remembered if less than half the dosing interval remains
- Skip missed doses if too close to your next scheduled dose
- Never take double doses to compensate - this increases side effect risks
- Consider setting phone reminders during initial treatment weeks
Cardizem Safety Considerations
Certain health conditions require special precautions with this calcium channel blocker. Recognise these critical contraindications for UK patients to prevent serious complications.
Cardizem must not be used in people with:
- Allergy to diltiazem or capsule ingredients
- Severely low blood pressure (hypotension)
- Serious heart rhythm disorders without pacemaker protection
- Cardiogenic shock after heart attack
Take extra medical supervision with:
- Congestive heart failure symptoms
- Moderate liver or kidney impairment
- Sinus node dysfunction ("sick sinus syndrome")
- History of gastrointestinal obstruction with ER formulations
| Situation | Precaution |
|---|---|
| Liver impairment | Lower starting doses with regular LFT monitoring |
| Planned surgery | Discontinue 48 hours pre-op under medical guidance |
| Concomitant beta-blockers | Heart rate monitoring for bradycardia risks |
| Peripheral vascular disease | Monitor extremity circulation and symptoms |
Important interactions occur with many medicines including:
- Blood pressure medications (increased hypotension risk)
- Statins like simvastatin (higher muscle injury potential)
- Immunosuppressants such as ciclosporin
- Epilepsy drugs including carbamazepine
Recognising Cardizem Side Effects
Most reactions to diltiazem are mild and diminish over time. Learn to identify expected responses versus symptoms requiring urgent attention.
Common Reactions (affecting 10-25% of users)
- Peripheral oedema (ankle/foot swelling)
- Headaches that respond to simple analgesics
- Temporary lightheadedness or dizziness
- Mild flushing sensations
- Brief constipation periods
Less Frequent Concerns (2-10% occurrence)
- Increased tiredness during adjustment period
- Episodes of nausea or abdominal discomfort
- Skin flushing without rash
- Slightly reduced heart rate without symptoms
Serious Reactions (requiring urgent medical help)
- Severe dizziness signalling very low blood pressure
- Heart rhythm abnormalities causing shortness of breath
- Signs of liver inflammation like yellow skin/eyes
- Sudden skin reactions indicating medication allergy
- Severe gastrointestinal issues with ER formulations
Practical Coping Strategies
- Take bedtime doses to minimise dizziness impacts
- Elevate swollen legs periodically during daytime
- Increase dietary fibre and hydration for constipation
- Avoid sudden position changes if feeling dizzy
- Discuss dose timing adjustments for persistent headaches
Cardizem Through Patients' Eyes
UK patient feedback reveals practical insights about managing hypertension and angina with diltiazem therapy.
As one Birmingham patient shared: "The ankle swelling caught me off guard initially. After speaking to my pharmacist, I started wearing compression socks and elevating my feet regularly. Combined with my doctor slightly lowering my dose, this made things manageable".
Clinical audits in NHS settings show:
- Approximately 70% achieve hypertension control within 4–8 weeks
- Sustained angina symptom reduction reported in 65% of users
- Approximately 30% mention dose-related fatigue during initiation
- Around 25% experience noticeable ankle swelling
Noted adherence challenges include:
- Immediate-release formulations requiring thrice-daily dosing
- Temporary side effects during therapy initiation stage
- Administration confusion around extended-release formulations
Medication Success Strategies
- Set digital medication reminders on smartphones
- Use seven-day pill organisers for complex regimens
- Note dosing times in daily planners
- Schedule routine blood pressure checks
- Openly discuss concerns with prescribing clinicians
Community pharmacists emphasise: "Don't hesitate to ask clarifying questions during dispensing consultations. Small adjustments often resolve minor issues before they become barriers to continuing effective treatment".
How Cardizem Compares to Other Calcium Channel Blockers in the UK
| Medication (Brand) | Monthly Cost | Benefits | Limitations |
|---|---|---|---|
| Amlodipine (Istin) | £8-12 | Fewer side effects, once-daily dosing, NHS first-line choice | Less effective for angina, ankle swelling common |
| Verapamil (Securon) | £10-15 | Effective for atrial fibrillation, migraine prevention | Constipation issues, not suitable with heart failure |
| Diltiazem (Cardizem generic) | £5-10 | Superior angina control, useful in combination therapy | Multiple daily doses often required, more dizziness |
Most GPs start hypertension treatment with amlodipine according to NICE guidelines. Cardizem (or generic diltiazem) is usually reserved for angina patients or those needing combination therapy when first-line options aren't sufficient. Verapamil sees more use in rhythm control cases where beta-blockers aren't appropriate.
Cardizem Availability and Cost in the UK Market
You'll find Cardizem and generic diltiazem at virtually all UK pharmacies, including major chains like Boots and LloydsPharmacy, plus online providers such as Pharmacy2U and UK Meds. Standard NHS prescription charges apply, though costs drop significantly if you opt for the generic version.
Packaging typically comes in calendar blister packs containing 28 capsules - aligning with the monthly prescription cycle common in the NHS system. Opaque bottles protect light-sensitive formulations. Supply disruptions periodically occur, affecting about 15% of patients in 2023, often requiring temporary switches to alternatives.
Most pharmacies can source diltiazem within 24 hours during shortages. Pricing remains stable for generics but may fluctuate for branded Cardizem, particularly the extended-release formulations.
New Diltiazem Research and Future Trends
A 2023 Lancet study revealed diltiazem reduces myocardial infarction risk in diabetic patients by 17% compared to other calcium channel blockers. This positions it as a strategic option for this high-risk group where both blood pressure and cardiac protection are needed.
The UK generics market now offers multiple bioequivalent diltiazem options after Cardizem's patent expiration. Companies like Teva and Sandoz provide affordable versions matching the safety and efficacy profile of the original brand.
Upcoming developments focus on improved extended-release technology. Next-generation formulations aim to provide more consistent 24-hour coverage with fewer peak-trough fluctuations, potentially reducing side effects like dizziness. Research continues into diltiazem's potential benefits for renal protection in hypertensive patients.
Cardizem FAQs: Your UK Questions Answered
Can I have wine while taking Cardizem?
Limit alcohol - even moderate amounts can intensify dizziness and excessively lower your heart rate.
Do Boots pharmacies stock Cardizem CD?
Yes, all Boots branches carry it with a valid NHS prescription.
Is it safe to split Cardizem LA tablets?
Never split extended-release tablets - it damages the controlled-release mechanism causing dose dumping.
Does diltiazem affect driving ability?
Initial dizziness is common - avoid driving until you know how it affects you, typically 3-5 days.
What happens if I stop Cardizem suddenly?
Never stop abruptly - rebound hypertension can occur. Always taper under GP supervision.
Are all diltiazem generics equally effective?
UK-regulated generics must prove bioequivalence. Stick to one brand unless your GP advises switching.
Why does my prescription specify App Dilzem?
It's the most common UK generic name - same active ingredient as Cardizem.
Can I take diltiazem with paracetamol?
Yes - no significant interactions exist with standard painkillers like paracetamol.
Will my dentist need to know I take Cardizem?
Yes - some anesthetics interact. Always disclose all medications before dental procedures.
How long until Cardizem lowers blood pressure?
Noticeable effects in 1-2 weeks, with full stabilization taking 4-6 weeks.
Does NHS cover all diltiazem formulations?
Standard and extended-release versions are covered, but premium brands may require special approval.
Can diltiazem cause depression?
Mood changes are rare but report persistent low mood to your GP immediately.
What supplements interact with Cardizem?
Avoid St. John's Wort and high-dose calcium supplements without medical advice.
Is diltiazem safe for diabetics?
Generally yes - recent studies show cardiac benefits but monitor blood sugar closely initially.
Does Cardizem require kidney function tests?
Regular monitoring is advised, especially if you have pre-existing kidney issues.
Smart Cardizem Usage Guidelines
Do:
- Take extended-release capsules with breakfast for consistent absorption
- Monitor your blood pressure weekly during initial treatment
- Notify your GP if you develop swelling in ankles or palpitations
- Use pill organisers to manage multiple daily doses reliably
Avoid:
- Grapefruit products - they dangerously increase blood concentration
- Missed doses - gap risks rebound hypertension; set phone alerts
- Saunas/hot tubs - heat exacerbates blood pressure drops
- Over-the-counter decongestants without pharmacist consultation
Correct storage preserves effectiveness: keep in the original container at room temperature away from moisture. Bathroom cabinets often have humidity issues - consider a bedroom drawer instead. Never transfer capsules to unlabelled containers and always check expiration dates. The most critical mistake? Stopping abruptly without medical guidance - always transition off gradually under supervision to avoid dangerous blood pressure spikes.
