Tablets (on 10 pieces in blister strip packagings, on 3 packagings in a cardboard pack);
Tablets of the prolonged action (on 30 pieces in dark glass bottles, on 1 bottle in a cardboard pack).

The structure of 1 tablet and 1 tablet of the prolonged action includes active agent: diltiazem (in the form of a hydrochloride) – 60 or 90 mg (respectively).

Indications to use

Arterial hypertension;
Stenocardia attacks, including Printsmetal's (prevention) stenocardia;
Supraventricular arrhythmias, including Bouveret's supraventricular disease, trembling and atrial fibrillation, premature ventricular contraction (prevention).

Contraindications

Functional disturbances of kidneys and liver;
The expressed bradycardia;
AV blockade of the II-III degree (except patients with a pacemaker);
Cardiogenic shock;
Sick sinus syndrome;
Ciliary arrhythmia at a syndrome of Launa-Ganoga-Levina and Wolf-Parkinson-Whyte;
Arterial hypotension;
The myocardial infarction which is followed by developments of stagnation in lungs;
Chronic heart failure of the II B-III of a stage;
Hemodynamically significant aortal stenosis;
Acute heart failure;
Pregnancy and period of a lactation;
Hypersensitivity to drug components.

During therapy it is necessary to be careful sick, inclined to arterial hypotension, children (due to the lack of clinical data on safety and efficiency of use of drug for this age group), to patients of advanced age, and also at ventricular tachycardia with expansion of the ORS complex, AV blockade of the I degree, disturbances of intra ventricular conductivity, chronic heart failure, a myocardial infarction with a left ventricular failure, a liver and renal failure.

Route of administration and dosage

Diltiazem should be accepted inside, swallowing tablets entirely and washing down with liquid.

Drug is accepted by 3 times a day on 60 mg or 2 times a day on 90 mg. The optimum dose of Diltiazem makes 180-360 mg a day. Under observation of the doctor in the conditions of a hospital increase in a daily dose up to 480 mg is possible.

Side effects

During therapy development of the following disturbances is possible:

Cardiovascular system: asymptomatic lowering of arterial pressure; seldom – arrhythmia (including blinking and trembling of ventricles), stenocardia, AV blockade of the II-III Art. up to an asystolia, bradycardia (it is less than 50 beats per minute) or tachycardia, aggravation or development of heart failure; at Diltiazem's use in high doses – bradycardia, stenocardia, AV blockade, aggravation of chronic heart failure, the expressed lowering of arterial pressure;
Nervous system and sense bodys: unconscious states, a depression, a headache, drowsiness, dizziness, an adynamy, increased fatigue, sleep disorders, uneasiness, extrapyramidal disturbances (swallowing difficulty, a mask-like face, the ataxy shuffling gait, trembling of fingers of hands and brushes, rigidity of legs or hands); at Diltiazem's use in high doses – a tremor, paresthesias, vision disorders (tranzitorny loss of sight);
System of a hemopoiesis: seldom – an agranulocytosis, thrombocytopenia;
Alimentary system: vomiting, increase in appetite, dryness in a mouth, nausea, diarrhea or locks, a hyperplasia of gums (morbidity, bleeding, puffiness), increase in activity of hepatic transaminases.

Special instructions

Before Diltiazem's use, and also in cases of development of uncharacteristic symptoms it is necessary to consult at the doctor.

Medicinal interaction

Diltiazem's combinations with quinidine and other antiarrhytmic Ia medicines of a class, beta adrenoblockers, cardiac glycosides are potentially dangerous (because of risk of development of excessive bradycardia, delay of AV of conductivity, decrease in contractility of a myocardium).

At simultaneous use of Diltiazem with some medicines there can be undesirable effects:

The procaineamide, quinidine and other drugs causing lengthening of an interval of QT: increase in risk of its considerable lengthening;
Thiazide diuretics and other medicines reducing arterial pressure, means for inhalation anesthesia (derivatives of hydrocarbons): strengthening of hypotensive effect of diltiazem;
Propranolol: increase in its bioavailability is possible;
Diazepam, phenobarbital, rifampicin: decrease in concentration of diltiazem in blood;
Cyclosporine, theophylline, carbamazepine, quinidine, valproic acid and digoxin: increase in their concentration in blood (decrease in a dose can be required);
Cimetidinum: increase in concentration of diltiazem in blood;
Indometacin and other non-steroidal anti-inflammatory drugs, estrogen and glucocorticosteroids, and also sympathomimetic medicines: decrease in hypotensive effect;
Lithium drugs: strengthening of neurotoxic effect of diltiazem is possible (with development of vomiting, nausea, an ataxy, diarrhea, trembling and/or sonitus);
General anesthetics: strengthening of cardiodepressive action.

Co-administration of Diltiazem with nitrates, including the prolonged forms is possible.