Cardizem

What Cardizem tablets are for

Cardizem tablets contain diltiazem and come in 30mg, 60mg, 90mg, 120mg and 180mg strengths. They are used for two things: high blood pressure and angina — the chest tightness or pain that appears when the heart muscle is not getting enough blood. It does not cure either problem: pressure and chest pain stay under control only while the tablets are taken, and the full effect builds over the first couple of weeks. An attack of angina that is already under way is not what these tablets are for.

How diltiazem works, and why the doses are spread out

Take the first tablet of the day and, within hours, the cells in your artery walls are getting less calcium. Calcium is what tells that muscle to tighten, so with some of it kept out the walls slacken and the channel inside widens. The heart then has less to push against and pressure falls. The arteries that feed the heart muscle itself open up too, which makes chest pain less likely, and impulses move more slowly through the heart's electrical tissue, which is how diltiazem settles some fast or uneven rhythms.

By evening that tablet has largely cleared from the body, so Cardizem is taken three or four times across the day at fairly even gaps, each with water and with or without food. Let the gaps stretch and symptoms drift back; stopping all at once may bring a flare.

Side effects you may notice

In the first days, a headache, a flushed face or a dizzy spell is what people mention, and the pulse can run slower than usual. Puffy ankles, nausea, constipation, diarrhoea, a blocked nose and a cough turn up for some. Most of this eases as the body gets used to the tablets. Swelling of the face, lips or tongue is different and needs urgent treatment.

Grapefruit and other medicines

Grapefruit juice interferes with the enzyme that clears diltiazem, so levels rise and the side effects above become more likely; skip it while on these tablets. Beta-blockers and diltiazem together slow the heart more than either alone. Diltiazem also lifts the level of some statins, which can bring on muscle aches, and it interacts with ciclosporin and certain heart-rhythm drugs. Keep the tablets in their pack, in a cool, dry spot.