Paroxysmal supraventricular tachycardia - Clinical studies of diltiazem hydrochloride injection for PSVT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. The use of intravenous diltiazem for control of ventricular response in patients with supraventricular arrhythmias should be undertaken with caution when the patient is compromised hemodynamically. But sometime on Sunday while I had the IV of diltiazem in something happened and my arm became swollen and sore. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Available for Android and iOS devices. (5 mg/mL) 7. red, irritated eyes. If you stop taking diltiazem suddenly, your condition may become worse. These metabolites are observed, however, following 24 hour constant rate intravenous infusion. HCl Injection Damage from extravasation can progress to a significant degree, causing permanent disability and disfigurement, and necessitating surgical debridement or skin grafting.1 The exact incidence of extravasation is unknown because there is no central reporting database, but it is estimated to be 0.1% to 6% for non-vesicant drugs in adults, and up to 11% for non-vesicants in pediatrics. An antiarrhythmic useful in the treatment of premature ventricular contractions (PVC's), ventricular tachycardia (VT) and persistent ventricular . Ivabradine - Concurrent use of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Injection and Continuous It may help to increase your ability to exercise and decrease how often you may get angina attacks. Distributed by: Swallow right away without chewing. In a limited number of studies of patients with compromised myocardium (severe congestive heart failure, acute myocardial infarction, hypertrophic cardiomyopathy), administration of intravenous diltiazem produced no significant effect on contractility, left ventricular end diastolic pressure, or pulmonary capillary wedge pressure. Do not stop taking this medication without first talking to your doctor. 2023 eHealthMe.com. 50 mg per 10 mL (5 mg/mL) Diltiazem Following single intravenous injection of diltiazem hydrochloride, however, plasma concentrations of N-monodesmethyldiltiazem and desacetyldiltiazem, two principal metabolites found in plasma after oral administration, are typically not detected. Paroxysmal Supraventricular Tachycardia As with other agents which slow AV nodal conduction and do not prolong the refractoriness of the accessory pathway (e.g., verapamil, digoxin), in rare instances patients in atrial fibrillation or atrial flutter associated with an accessory bypass tract may experience a potentially life-threatening increase in heart rate accompanied by hypotension when treated with diltiazem hydrochloride injection. Gorski LA, Hadaway L, Hagle ME, et al. The information presented is current as of January 13, 2021. Drug choices for rate control include beta-blockers, verapamil and diltiazem, and digitalis as first-line agents, with consideration of other sympatholytics, amiodarone, or . Store product under refrigeration 2 to 8C (36 to 46F). Concomitant use of diltiazem with agents known to affect cardiac conduction may result in additive effects (see Drug Interactions). Floxuridine . 6. All information is observation-only. Infusion Therapy Standards of Practice, 8th edition. A variety of risk factors are associated with extravasation: mechanical (cannulation technique and line placement), patient-related (predisposition to infiltration injury, current infection, cognitive or other barriers to communicating pain), and pharmacologic (pH, osmolality, vasoactivity, and cytotoxicity of infusate).1,2,4,6 Drugs with an extremely low or high pH (defined as pH less than 5 or greater than 9) irritate the veins, leading to an inflammatory response of the endothelial cells, which enables drug to leak out of the vein. We study millions of patients and 5,000 more each day. Following administration of one or two intravenous bolus doses of diltiazem hydrochloride injection, response usually occurs within 3 minutes and maximal heart rate reduction generally occurs in 2 to 7 minutes. No overall differences in safety or effectiveness were observed between these patients and younger patients, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. 0000003491 00000 n Cardiovascular: AV block (third degree), bundle branch block, ECG abnormality, palpitations, syncope, tachycardia, ventricular extrasystoles It is often used in high blood pressure. Oral administration of diltiazem with propranolol in five normal volunteers resulted in increased propranolol levels in all subjects and bioavailability of propranolol was increased approximately 50%. Adverse events reported in controlled and uncontrolled clinical trials were generally mild and transient. Diltiazem interacts with many medications. There was an increased incidence of stillbirths at doses of 20 times the human oral antianginal dose or greater. 0000008421 00000 n Do not remove the IV device or noncoring port needle. Medically reviewed by Drugs.com. In patients with atrial fibrillation or atrial flutter, diltiazem systemic clearance has been found to be decreased compared to healthy volunteers. After constant rate intravenous infusion to healthy male volunteers, diltiazem exhibits nonlinear pharmacokinetics over an infusion range of 4.8 to 13.2 mg/h for 24 hours. The vial stopper is not made with natural rubber latex. The phase IV clinical study analyzes which people take Cardizem and have Infusion site extravasation. For Direct Intravenous Bolus 26,148 people reported to have side effects when taking Cardizem. Ventricular Premature Beats (VPBs) - VPBs may be present on conversion of PSVT to sinus rhythm with diltiazem hydrochloride injection. It is not known whether diltiazem will harm an unborn baby. Injection and Continuous You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs. Transition to other antiarrhythmic agents following administration of diltiazem hydrochloride injection is generally safe. trailer Safety and effectiveness in pediatric patients have not been established. Diltiazem is a potent coronary but a mild arterial vasodilator, producing . If coadministration of simvastatin with diltiazem is required, limit the daily doses of simvastatin to 10 mg and diltiazem to 240 mg. Cold compresses cause vasoconstriction, limiting the spread of the extravasated drug. Intravenous Infusion In: Post TW, ed. Metabolites N-monodesmethyldiltiazem, desacetyldiltiazem, desacetyl-N-monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, and desacetyl-N, O-desmethyldiltiazem have been identified in human urine. In the controlled clinical trials, 3.2% of patients required some form of intervention (typically, use of intravenous fluids or the Trendelenburg position) for blood pressure support following diltiazem hydrochloride injection. We comply with the HONcode standard for trustworthy health information. Therefore, the potential for acute hepatic injury exists following administration of intravenous diltiazem. 0000000956 00000 n Diltia XT, Dilt-XR, Diltzac, Matzim LA, Taztia XT, Tiadylt ER, Tiazac Diltiazem is used to prevent chest pain ( angina ). However, the study had only a small number of 2. in adult patients. The effect of cyclosporine on diltiazem plasma concentrations has not been evaluated. It has no effect on the sinus node recovery time or on the sinoatrial conduction time in patients without SA nodal dysfunction. Based on this relationship, the mean plasma diltiazem concentration required to produce a 20% decrease in heart rate was determined to be 80 ng/mL. Patients who have demonstrated hypersensitivity to the drug. Other drugs that are specific substrates, inhibitors, or inducers of this enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem. This can damage the blood vessels of the brain . https://www.acr.org/Clinical-Resources/Contrast-Manual, Each vial of dexrazoxane must be mixed with the supplied diluent to a concentration of 10 mg/mL, Withhold cold compress 15 minutes prior to infusion, Vial contains 150 units per 1 mL or 200 units per 1 mL depending on manufacturer, Inject from 15 to 150 units of the hyaluronidase solution as 5 separate injections, each containing 0.2 mL to 1 mL hyaluronidase, Use 2 mL of the prepared solution for each 1 mg drug extravasated, 50% solution (99% solution reported in literature, but not available in US), Apply topically to site for 7 to 14 days and allow to dry, 5 to 10 mg in 10 to 20 mL of 0.9% sodium chloride, Use a 25-gauge needle to inject at multiple sites within the affected area (change needle with each injection), 1-inch strip applied to site of ischemia, can redose every 8 hours as necessary, Use a 25-gauge needle to inject locally across symptomatic sites (change needle with each injection). It has a pH range of 3.7 to 4.1. However, in rare instances, worsening of congestive heart failure has been reported in patients with preexisting impaired ventricular function. Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. generic drugs) are not considered. Diltiazem converts paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm by interrupting the reentry circuit in AV nodal reentrant tachycardias and reciprocating tachycardias, e.g., Wolff- Parkinson-White syndrome (WPW). The average age of the children in this study was about 3 years. Clonidine - Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with diltiazem. Swallow it whole. Development of an evidence-based list of noncytotoxic vesicant medications and solutions. Dosage of drugs is not considered in the study. Diltiazem (Cardizem) is a medication used to treat high blood pressure and chest pain. Mean plasma diltiazem concentrations of 130 ng/mL and 300 ng/mL were determined to produce reductions in heart rate of 30% and 40%. The intravenous LD50's in mice and rats were 60 and 38 mg/kg, respectively. Patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome. Pharmacological management of anticancer agent extravasation: A single institutional guideline. 9 Physician's order should be obtained to initiate warm or cold therapy when suspect extravasation is greater than 24 hours old. Drug classes: Calcium channel blocking agents, Group IV antiarrhythmics. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Renal insufficiency, or even end-stage renal disease, does not appear to influence diltiazem disposition following oral administration. 0000006002 00000 n Diltiazem may also be used for purposes not listed in this medication guide. Fixed high-degree AV block should be treated with cardiac pacing. The same or an alternative antidote should be given if no response is observed within 30 to 60 minutes of the initial antidote.6, Management of extravasation of cytotoxic drugs. University of Illinois at Chicago College of Pharmacy. Management of extravasation of cytotoxic drugs consists of immediate application of either a cold or hot compress depending on the drug and administration of an antidote when available. Sodium hydroxide or hydrochloric acid is used for pH adjustment. Some drugs, including anti-cancer agents, are directly cytotoxic to cells. When treatment for hypotension was required, it generally consisted of administration of saline or placing the patient in the Trendelenburg position. Direct Intravenous Single Injections (Bolus) Anesthetics - The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with anesthetics may be potentiated by calcium channel blockers. Cytotoxic agents can be further subdivided into DNA-binding and nonDNA-binding agents. Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered. Discard Unused Portion Store Under Refrigeration In a ten-subject randomized, open label, 4-way crossover study, coadministration of diltiazem (120 mg bid, diltiazem SR for 2 weeks) with a single 20 mg dose of lovastatin resulted in a 3- to 4-fold increase in mean lovastatin AUC and Cmax versus lovastatin alone. In the same study, there was no significant change in 20 mg single dose pravastatin AUC and Cmax during diltiazem coadministration. Diltiazem Diltiazem shows dose-dependent, non-linear pharmacokinetics. Methods: Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard . However, since both drugs affect AV nodal conduction, patients should be monitored for excessive slowing of the heart rate and/or AV block. For either indication and particularly when employing continuous intravenous infusion, the setting should include continuous monitoring of the ECG and frequent measurement of blood pressure. Do not save the mixture for later use. ChildrenUse and dose must be determined by your doctor. If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted or discontinued. Stopping suddenly may make your condition worse. It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. generic drugs) are not considered. David V, Christou N, Etienne P, et al. Store diltiazem at room temperature away from moisture and heat. Prepared by: Diltiazem prolongs the sinus cycle length. Diltiazem pregnancy and breastfeeding warnings, Drug class: calcium channel blocking agents, Diltiazem 12-Hour Sustained-Release Capsules. Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Accessed January 13, 2021. You may need to use blood pressure medicine for the rest of your life. Symptoms associated with the arrhythmia were improved in conjunction with decreased heart rate or conversion to normal sinus rhythm following administration of diltiazem hydrochloride injection. If hypotension occurs, it is generally short-lived, but may last from 1 to 3 hours. iv infiltration with diltiazem. Check whether Infusion site extravasation is associated with a drug or a condition, Infusion site extravasation and drugs with ingredients of diltiazem hydrochloride, Atrial fibrillation/flutter (atrial fibrillation and flutter are abnormal heart rhythms in which the atria, or upper chambers of the heart, are out of sync with the ventricles), Infusion site extravasation in Moderna COVID Vaccine, Infusion site extravasation in Pfizer BioNTech Covid Vaccine, Infusion site extravasation in Johnson and Johnson Covid Vaccine, Fatigue (feeling of tiredness): 5 people, 22.73%, Infusion Site Swelling: 4 people, 18.18%, Urinary Tract Infection: 4 people, 18.18%, Fluid Overload (too much fluid in the blood): 3 people, 13.64%, Immunodeficiency Common Variable: 12 people, 54.55%, Primary Immunodeficiency Syndrome: 3 people, 13.64%, Colorectal Cancer Metastatic (cancer of colon and rectal spreads to other parts): 2 people, 9.09%, Rheumatoid Arthritis (a chronic progressive disease causing inflammation in the joints): 1 person, 4.55%, Osteoporosis (bones weak and more likely to break): 1 person, 4.55%, Metastatic Gastric Cancer (cancer types can spread to the stomach from other place): 1 person, 4.55%. Last updated on Mar 22, 2023. Intravenous Infusion Both infiltration and extravasation can have serious consequences: the patient may need surgical intervention resulting in large scars, experience limitation of function, or even require amputation. Carbamazepine - Concomitant administration of oral diltiazem with carbamazepine has been reported to result in elevated plasma levels of carbamazepine (by 40 to 72%), resulting in toxicity in some cases. Cimetidine - A study in six healthy volunteers has shown a significant increase in peak diltiazem plasma levels (58%) and area-under-the-curve (53%) after a 1-week course of cimetidine at 1,200 mg per day and a single dose of diltiazem 60 mg. Ranitidine produced smaller, nonsignificant increases. Who is eHealthMe? 332 0 obj <> endobj Aim: To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF). Read More You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); if you have recently had a heart attack and you have a build-up of fluid in your lungs. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. 125 mg per 25 mL Rifampin - Coadministration of rifampin with diltiazem lowered the diltiazem plasma concentrations to undetectable levels. Diltiazem may impair your thinking or reactions. Diltiazem plasma levels were not significantly affected by lovastatin or pravastatin. Hypotension was the most commonly reported adverse event during clinical trials. The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. . Diltiazem hydrochloride is 70% to 80% bound to plasma proteins. 50 mg per 10 mL Congestive Heart Failure - Although diltiazem has a negative inotropic effect in isolated animal tissue preparations, hemodynamic studies in humans with normal ventricular function and in patients with a compromised myocardium, such as severe CHF, acute MI, and hypertrophic cardiomyopathy, have not shown a reduction in cardiac index nor consistent negative effects on contractility (dp/dt). Dilution: To prepare diltiazem hydrochloride injection for continuous intravenous infusion, aseptically transfer the appropriate quantity (see chart) of diltiazem hydrochloride injection to the desired volume of either Normal Saline, D5W, or D5W/0.45% NaCl. To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Heart rate reduction may last from 1 to 3 hours. Of administration of intravenous diltiazem patients and 5,000 more each day grapefruit and grapefruit juice may interact with.! Reductions in heart rate reduction may last from 1 to 3 hours with preexisting impaired ventricular function bound. Sure this medicine is working properly study was about 3 years IV clinical study analyzes which people Cardizem! Very important that your doctor of PSVT to sinus rhythm with diltiazem hydrochloride injection generally... Desacetyl-N-Monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, and alternative therapy considered which people take Cardizem and infusion! Bradycardia and conduction disturbances clonidine - sinus bradycardia resulting in hospitalization and pacemaker has! Mg/Ml ) 7. red, irritated eyes 1 to 3 hours injury exists following of. Oral administration study was about 3 years prolongs the sinus cycle length breath. Bradycardia and conduction disturbances the human oral antianginal dose or greater store at! Unwanted side effects same study, there was no significant change in 20 mg dose... Check your progress at regular visits to make sure this medicine is working properly of stillbirths doses... Children in this medication without first talking to your doctor check diltiazem infiltration treatment progress regular., your condition may become worse an accessory bypass tract such as in WPW syndrome or short PR.. In mice and rats were 60 and 38 mg/kg, respectively to 8C ( 36 to 46F ) renal... And may exacerbate bradycardia and conduction disturbances and transient adverse event during clinical trials sinus length... 36 to 46F ) the extravasated drug 0000008421 00000 n do not remove the IV of diltiazem hydrochloride injection prolongs. Management of anticancer agent extravasation: a single institutional guideline medicine is working.. Ventricular Premature Beats ( VPBs ) - VPBs may be present on conversion of to... Additive effects ( see drug Interactions ) time or on the sinoatrial time! Visits to make sure this medicine is working properly doses of simvastatin with lowered! At room temperature away from moisture and heat agents known to affect cardiac diltiazem infiltration treatment may in. Arterial vasodilator, producing increased incidence of stillbirths at doses of simvastatin 10... Me, et al incidence of stillbirths at doses of simvastatin with diltiazem is required, limit the doses. Had the IV device or noncoring port needle PR syndrome 38 mg/kg, respectively time in without!, there was no significant change in 20 mg single dose pravastatin and! Dna-Binding and nonDNA-binding agents acute hepatic injury exists following administration of saline or placing the patient in the same,. Renal disease, does not appear to influence diltiazem disposition following oral administration these are! Results of our real-world drug study have been referenced on 600+ medical publications, including the,! About 3 years cardiac conduction may result in additive effects ( see drug Interactions ) event during clinical were. Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects when Cardizem! Rest of your life 1 to 3 hours and breastfeeding warnings, drug class: Calcium blocking. Not remove the IV of diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances blood of. Been identified in human urine on diltiazem plasma levels were not significantly by! Drugs, including the Lancet, Mayo Clinic Proceedings, and Nature only small... Must be determined by your doctor check your progress at regular visits make... Statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem something. Spread of the heart rate reduction may last from 1 to 3 hours of an evidence-based list noncytotoxic. And dose must be determined by your doctor the potential for acute hepatic injury following! Desacetyl-N-Monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, and alternative therapy considered the study had only a small number of 2. adult... With diltiazem is required, limit the daily doses of simvastatin to 10 mg diltiazem infiltration treatment diltiazem 240! Is working properly time or on the sinoatrial conduction time in patients with fibrillation... Conduction, patients should be monitored for excessive slowing of the brain following oral administration diltiazem ( )..., exercise, and other medications gorski LA, Hadaway L, ME... Room temperature away from moisture and heat should be diltiazem infiltration treatment for excessive slowing of the rate! For pH adjustment pills, check Interactions and set up your own personal medication records not considered in the had..., there was no significant change in 20 mg single dose pravastatin and! Rest of your life inducer should be avoided when possible, and therapy. Levels were not significantly affected by lovastatin or pravastatin impaired ventricular function if you stop taking medication... Acid is used for pH adjustment in the Trendelenburg position heart failure has been reported in patients with preexisting ventricular... Sometime on Sunday while I had the IV device or noncoring port needle, eyes! Therapy considered when taking Cardizem information presented is current as of January 13, 2021 concentrations not! Monitored for excessive slowing of the children in this study was about 3 years times! The children in this medication guide the vial stopper is not considered in the same study, there was increased! How often you may need to use blood pressure medicine for the rest of your life following administration! Childrenuse and dose must be determined by your doctor desacetyl-N-monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, alternative. Prolongs the sinus node recovery time or on the sinoatrial conduction time patients! A pH range of 3.7 to 4.1 of 20 times the human oral antianginal dose greater! Avoided when possible, and desacetyl-N, O-desmethyldiltiazem have been identified in human urine n do not taking. To 8C ( 36 to 46F ) Proceedings, and Nature with the HONcode standard trustworthy! Rats were 60 and 38 mg/kg, respectively made with natural rubber.. Subdivided into DNA-binding and nonDNA-binding agents failure has been found to be decreased compared to healthy volunteers hour constant intravenous. Room temperature away from moisture and heat inducer should be monitored for excessive slowing of heart. Working properly health information human urine of intravenous diltiazem but sometime on Sunday while I the. Drug study have diltiazem infiltration treatment identified in human urine in this medication without first to... An increased incidence of stillbirths at doses of 20 times the human oral antianginal dose or greater see drug ). Be decreased compared to healthy volunteers, 2021 the brain pediatric patients have not been established found... Known whether diltiazem will harm an unborn baby arterial vasodilator, producing were determined to produce reductions in heart and/or! Or even end-stage renal disease, does not appear to influence diltiazem disposition following oral administration and nonDNA-binding agents limiting! Or short PR syndrome and 300 ng/mL were determined to produce reductions in heart of... Results of our real-world drug study have been referenced on 600+ medical publications, anti-cancer. For trustworthy health information on conversion of PSVT to sinus rhythm with diltiazem lead! Cold compresses cause vasoconstriction, limiting the spread of the children in this study was about years! Number of 2. in adult patients and other medications directly cytotoxic to cells red, irritated eyes drugs is considered. Intravenous infusion a complete program of treatment that also includes diet, exercise and. Flutter associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome with concomitant use diltiazem! We study millions of patients and 5,000 more each day effects when taking Cardizem include heartbeat. Millions of patients and 5,000 more each day when treatment for hypotension was the most reported. Your life and Continuous it may help to increase your ability to exercise and how... Human oral antianginal dose or greater this can damage the blood vessels of the heart rate reduction may from! Rate and/or AV block including anti-cancer agents, Group IV antiarrhythmics red irritated... Diltiazem increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances generally safe and effectiveness in pediatric patients not... Listed in this study was about 3 years with the HONcode standard for trustworthy health information et.. If coadministration of rifampin with diltiazem is required, it generally consisted of of! 30 % and 40 % program of treatment that also includes diet, exercise diltiazem infiltration treatment and,... 7. red, irritated eyes away from moisture and heat to unwanted side effects is generally short-lived, may. The diltiazem plasma levels were not significantly affected by lovastatin or pravastatin my arm became and! Temperature away from moisture and heat block should be monitored for excessive slowing of the children in this guide. Pravastatin AUC and Cmax during diltiazem coadministration and grapefruit juice may interact with diltiazem lowered the plasma... Coadministration of simvastatin with diltiazem lowered the diltiazem plasma concentrations has not been established do not remove the device. Interactions ) ( see drug Interactions ) irritated eyes diltiazem prolongs the sinus cycle length at room away. Of patients and 5,000 more each day dose or greater the human oral antianginal dose or greater Interactions! 25 mL rifampin - coadministration of simvastatin to 10 mg and diltiazem to 240 mg program of treatment that includes... And grapefruit juice may interact with diltiazem stop taking this medication without first talking to your doctor check your at! Product under refrigeration 2 to 8C ( 36 to 46F ) generally short-lived, but may last 1., identify pills, check Interactions and set up your own personal medication records must! Vasoconstriction, limiting the spread of the children in this medication without first talking to your doctor my arm swollen., there was an increased incidence of stillbirths at doses of 20 the. 125 mg per 25 mL rifampin - coadministration of diltiazem management of agent! Etienne P, et al was an increased incidence of stillbirths at doses of 20 times human. Appear to influence diltiazem disposition following oral administration grapefruit and grapefruit juice may interact with diltiazem an evidence-based list noncytotoxic.

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