CHF and arrhythmias:
Indications for Diltiazem HCl Injection:
Temporary control of rapid ventricular rate in atrial fibrillation or flutter. Rapid conversion of paroxysmal supraventricular tachycardias (PSVT) to sinus rhythm.
Adult:
Direct IV single injections (bolus): initially 0.25mg/kg over 2 minutes; if needed, may give second dose (0.35mg/kg) after 15 minutes; subsequent bolus doses should be individualized. If continuous IV infusion is needed, begin immediately after bolus administration. Initial infusion rate: 10mg/h; may increase in 5mg/h increments up to 15mg/h. May be maintained for up to 24 hours.
Children:
Not recommended.
Contraindications:
Sick sinus syndrome or 2nd- or 3rd-degree AV block (unless paced). Severe hypotension. Cardiogenic shock. Concomitant IV β-blockers. Atrial fibrillation or flutter associated with an accessory bypass tract such as in Wolff-Parkinson-White syndrome or short PR syndrome. Ventricular tachycardia.
Warnings/Precautions:
Have resuscitative equipment readily available. CHF. Renal or hepatic impairment. Hemodynamically compromised. Continuously monitor ECG and blood pressure. Pregnancy (Cat.C). Nursing mothers: not recommended.
Pharmacologic Class:
Calcium channel blocker (CCB) (benzothiazepine).
Interactions:
See Contraindications. Possible bradycardia, AV block, and/or depression of contractility with concomitant oral β-blockers. Additive effects with agents known to affect cardiac conduction. Avoid concomitant CYP3A4 inducers (eg, rifampin). Potentiated by cimetidine; may need to adjust diltiazem dose. May potentiate anesthetics, benzodiazepines, buspirone, carbamazepine, cyclosporine, quinidine; monitor.
Adverse Reactions:
Hypotension, inj site reactions (eg, itching, burning), vasodilation, arrhythmia; dermatological events (eg, erythema multiforme, exfoliative dermatitis; discontinue if occurs), hepatotoxicity, ventricular premature beats.
Note:
Formerly known under the brand name Cardizem.
How Supplied:
Contact supplier.
