Felis ISSN 2398-2950

Diltiazem

Contributor(s): Mark Rishniw

Introduction

Name

  • Diltiazem.

Class of drug

  • Class IV antidysrhythmic agent.
  • Calcium channel blocker.

Description

Chemical name

  • 1,5-benzothiazepim-4(5H)one,3-(acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(4-methoxyphenyl)-monohydrochloride,(+)-cis-.

Molecular weight

  • 451.

Uses

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Indications

Primary uses
  • To control supraventricular tachycardias.
  • Sustained and paroxysmal ventricular tachycardias   Ventricular premature contraction  particularly in cases of hypertrophic cardiomyopathy.
  • To slow heart rate in dogs with atrial fibrillation as an adjunct to digoxin   Digoxin  .
  • Management of hypertrophic cardiomyopathy.

Other conditions

  • Management of hypertension   Hypertension  .
  • To limit CNS damage following trauma.

Miscellaneous

  • Preferred to verapamil by many because it has effective anti-arrhythmic properties with minimal negative inotropy.
  • Diltiazem is preferred to B-blockers for the management of feline hypertrophic cardiomyopathy by some authors because it improves myocardial relaxation, increases ventricular filling and dilates coronary vasculature.

Administration

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Pharmocokinetics

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Precautions

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Interactions

with other drugs

Beta-adrenergic blockers, eg propranolol
  • If administered concurrently with propranolol   Propranolol  there may be additive negative inotropic and chronotropic effects.

Calcium salts, Vitamin D

Cimetidine

  • Cimetidine   Cimetidine  inhibits the metabolism of diltiazem thereby increasing plasma concentrations.

Theophylline

  • Theophylline   Theophylline  diltiazem enhances the effect, which may lead to toxicity.

Protein bound agents, eg warfarin

  • Diltiazem may displace warfarin   Warfarin  .

Further Reading

Publications

Other sources of information

  • Based onSmall Animal Formulary.Tennant, Bryn (1999) 3rd edn. Cheltenham: BSAVA.

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