Analogues
Diacordin , Diltiazem Lannacher retard , Diltiazem ‑retard , Kardil .
pharmachologic effect
It has antianginal, hypotensive and antiarrhythmic effects. Reduces myocardial contractility, slows down AV ‑conduction, reduces heart rate, reduces myocardial oxygen demand, dilates coronary arteries, increases coronary blood flow. Reduces the tone of the smooth muscles of the peripheral arteries and the total peripheral vascular resistance.
Indications for use
Prevention of angina attacks. AG. Prevention of supraventricular arrhythmias.
For intravenous administration: relief of acute attacks of angina pectoris, prevention of spasm of the coronary arteries during coronary angiography or coronary artery bypass surgery, paroxysmal ventricular tachycardia, for the relief of frequent ventricular rhythm with atrial fibrillation or flutter.
Dosage and administration
When taken orally, the initial dose is 60 mg 3 times a day or 90 mg 2 times a day.
With insufficient effectiveness, the dose is increased to 180 mg 2 times a day.
Prolonged forms are used 1-2 times a day, depending on the dose.
The maximum daily dose for oral administration is 360 mg. With a / in the introduction of a single dose – 300 mcg / kg.
For intravenous drip, the dose is 2.8–14 µg/kg per minute. The maximum daily dose is 300 mg.
Side effects
Headache, dizziness, fainting, fatigue, asthenia, sleep disturbances, drowsiness, anxiety, extrapyramidal disorders, depression; when used in high doses – paresthesia, tremor, visual impairment, pregnancy and lactation.
Contraindications
Severe bradycardia, AV ‑block II and III degree, SSS, cardiogenic shock, atrial fibrillation in WPW and Lown – Ganoga -Levin syndrome, myocardial infarction with congestion in the lungs, arterial hypotension, chronic heart failure stage II B – III, acute heart failure , hemodynamically significant aortic stenosis, impaired liver and kidney function, pregnancy, lactation, hypersensitivity to benzothiazepine derivatives .
Overdose
Symptoms. Severe bradycardia, pronounced decrease in blood pressure, turning into collapse, impaired atrioventricular and sinoatrial conduction, confusion, stupor, nausea, vomiting, metabolic acidosis, hyperglycemia, heart failure, cardiogenic shock, asystole.
Treatment. Depending on the severity of overdose manifestations. It is necessary to wash the stomach, take activated charcoal, further treatment is symptomatic. Hemodialysis and peritoneal dialysis are ineffective.