Cardiology | Antiarrhythmic Drug Guide | Class IV | Diltiazem

Diltiazem

IV Dose Initial bolus 0.25 mg/kg over 2 min (average 20 mg in adults). Second dose of 0.35 mg/kg over 2 minutes may be given (average 25 mg) Continuous infusion: 5-15 mg/hr (usual 10 mg/hour) in adults. No pediatric dose. (suggest 0.125 mg/kg/hr = 2 ug/kg/min).
Oral dose 30-90 mg QID of short-acting preparation 60-180 mg BID of "SR" preparation 180-360 mg QD of "CD" preparation
Levels Therapeutic range undefined
Kinetics Maximum effect 2-5 minutes after bolus injection. Plasma half-life 3-4.5 hours. Metabolized in lever, excreted in urine.
Cautions Same cautions as with verapamil. May be better tolerated with beta blockers than verapamil. Avoid in young children.
Interactions Increases levels of propranolol, digoxin (20%), cyclosporin, carbamazepine. Levels increased by cimetidine
Preparations Cardizem injectable, vials 25 mg/5 cc or 50 mg/10 cc. Cardizem tablets, 30 mg (non-scored), 60, 90, 120 mg(scored). Cardizem SR capsules, 60, 90, 120 mg Cardizem CD capsules, 120, 180, 240, 300 mg.
FDA approval in children no

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