Diltiazem

Diltiazem is a calcium channel blocker, a type of pharmaceutical that relaxes blood vessels so the heart does not have to pump as hard and increasing the supply of blood and oxygen to the heart. It is sold under the brand names Cardizem, Cartia XT, Dilacor XR, Dilt-CD, Dilt XR, Diltia XT, Taztia XT, Tiamate, and Tiazac.

Why It's Prescribed
Diltiazem is typically prescribed to treat cardiovascular problems such as high blood pressure and to control angina (chest pain).

Labeled uses include: Chronic Angina Pectoris, Prinzmetal Angina

Additionally, unlabeled uses include: Diastolic Heart Failure, Hypertension, Supraventricular Arrhythmias

Form, Route, and Dosage
Diltiazem is available as a tablet, an extended-release (long-acting) tablet, and an extended-release capsule to take orally. As a tablet, it is available in the strengths 30mg, 60mg, 90mg, and 120mg; extended-release capsules are available in the strengths 120mg, 180mg, 240mg, 300mg, and 360mg; extended-release "coated beads" tablets are available strengths up to 420mg. Adults are generally prescribed between 90mg and 480mg per day.

Side Effects
Some patients taking this medication might experience side effects, including:
 * dizziness or lightheadedness
 * flushing (feeling of warmth)
 * headache
 * weakness
 * slow heartbeat
 * vomiting
 * diarrhea
 * constipation
 * nasal congestion
 * cough
 * swelling of the face, eyes, lips, tongue, hands, arms, feet, ankles, or lower legs
 * difficulty breathing or swallowing
 * fainting
 * rash
 * yellowing of the skin or eyes
 * nausea
 * extreme tiredness
 * unusual bleeding or bruising
 * lack of energy
 * loss of appetite
 * pain in the upper right part of the stomach
 * flu-like symptoms
 * increase in frequency or severity of chest pain (angina)

Overdoses
Patients may overdose on this medication if they take too much of it. Some symptoms of overdose include:
 * slow, fast, or irregular heartbeat
 * fainting
 * difficulty breathing
 * seizures
 * dizziness
 * confusion
 * nausea
 * vomiting
 * increased sweating

As a Pollutant
Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.

In Sewage Sludge
Diltiazem has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found diltiazem in 69 samples (82%) in concentrations ranging from 1.39 to 225 parts per billion. There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

In Drinking Water
An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it. Of those tested, Philadelphia tested positive for diltiazem (as well as 55 other drugs).

Related SourceWatch articles

 * Biosolids
 * Sewage sludge
 * Food Rights Network
 * Pharmaceuticals

External resources

 * Diltiazem: MedlinePlus Drug Information