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. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. Pregnancy Edema 1-6" in any direction Dactinomycin*X Skin blanched, translucent DAUNorubicin*X X Mild to moderate pain Dextrose >10%*X X Gross edema >6" in any direction DiazepamX Cool to touch DigoxinX X X Possible numbness DOBUTamineX Skin blanched, translucent DocetaxelX Moderate to severe pain DOPamine*X Skin tight, leaking DOXorubicinX X (5 mg/mL) Last updated on Mar 22, 2023. Disconnect IV tubing from IV device. Treatment should begin as soon as possible and no later than 6 hours after extravasation. 125 mg per 25 mL (5 mg/mL) Available for Android and iOS devices. Intravenous Infusion Continuous Intravenous Infusion The drug should be used with caution in patients with impaired renal or hepatic function (see WARNINGS). The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Blood and urine tests may be needed to check for unwanted effects. Do not stop taking this medication without first talking to your doctor. 0000030429 00000 n The effect may be mediated by cimetidine's known inhibition of hepatic cytochrome P-450, the enzyme system responsible for the first-pass metabolism of diltiazem. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. The apparent volume of distribution of diltiazem hydrochloride is approximately 305 L. Diltiazem hydrochloride is extensively metabolized in the liver with a systemic clearance of approximately 65 L/h. 549 0 obj <>stream The elimination half-life of midazolam and triazolam also increased (1.5 to 2.5 fold) during coadministration with diltiazem. No evidence of impaired fertility was observed in a study performed in male and female rats at oral dosages of up to 100 mg/kg/day. The combination of the two drugs was well tolerated without serious adverse effects. 125-mg, 25-mL vialeach sterile vial contains 125 mg diltiazem hydrochloride, 18.75 mg citric acid USP, 16.25 mg sodium citrate dihydrate USP, 1,785 mg sorbitol solution USP, and water for injection USP up to 25 mL. As such, the initial use of diltiazem hydrochloride injection should be, if possible, in a setting where monitoring and resuscitation capabilities, including DC cardioversion/defibrillation, are present (see OVERDOSAGE). Diltiazem Injection Prescribing Information. Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician. HCl Injection A defibrillator and emergency equipment should be readily available. Diltiazem may also be used for purposes not listed in this medication guide. Therefore, infusion duration exceeding 24 hours and infusion rates exceeding 15 mg/h are not recommended. FDA-approved indications include atrial arrhythmia, hypertension, paroxysmal supraventricular tachycardia, and chronic stable angina. 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. Injection and Continuous This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted or discontinued. 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%. Patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome. DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. Gorski LA, Stranz M, Cook LS, et al. For Direct Intravenous Bolus Caution should be exercised when using the drug in such patients. Fixed high-degree AV block should be treated with cardiac pacing. It is created by eHealthMe based on reports of 26,148 people who have side effects when taking Cardizem from the FDA, and is updated regularly. Asymptomatic hypotension occurred in 4.3% of patients. Sodium hydroxide or hydrochloric acid is used for pH adjustment. 125 mg per 25 mL Therefore, the potential for these dermatologic reactions exists following exposure to intravenous diltiazem. Continuous Intravenous Infusion Diltiazem plasma levels were not significantly affected by lovastatin or pravastatin. For Direct Intravenous Bolus Injection and The study uses data from the FDA. It is used in many clinical scenarios as an antihypertensive, anti-arrhythmic, and anti-anginal. It has a pH range of 3.7 to 4.1. 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. 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. Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 to 48 hours, Apply cold compress (but remove at least 15 minutes prior to dexrazoxane), Apply dry warm compress for 60 minutes every 8 hours for 3 days, Apply cold compress for 6 to 72 hours following sodium thiosulfate injection or for 20 minutes 4 times/day for 24 to 48 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for 24 to 48 hours, Apply warm compress (ice increases risk of cold-induced peripheral neuropathy) for 15 to 20 minutes at least 4 times/day for the first 24 hours, None or dexamethasone 8 mg twice daily for 14 days, Elevate extremity and apply dry warm compress for 15 to 60 minutes at least 3 times/day for the first 24 to 72 hours, Consider use of cold compress (valproate). 3. Take the missed dose as soon as you remember. Anti-anxiety medications called benzodiazepines (such as midazolam, triazolam, and others) as well as busipirone; Beta-blockers (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others); Cholesterol medication called statins (such as atorvastatin, lovastatin, simvastatin, rosuvastatin, and others). Skip the missed dose if it is almost time for your next scheduled dose. When treatment for hypotension was required, it generally consisted of administration of saline or placing the patient in the Trendelenburg position. Brand names: Cardizem (and Cardizem CD, LA and XR), Cartia XT, Dilacor XR, Dilt-CD, Diltiazem is a potent coronary but a mild arterial vasodilator, producing . Patients currently receiving diltiazem therapy should be carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine. Precautions. (5 mg/mL) Be careful if you drive or do anything that requires you to be alert. Administration of other calcium channel blockers to patients with wide complex tachycardia (QRS 0.12 seconds) has resulted in hemodynamic deterioration and ventricular fibrillation. a rough estimate would be great. Other: Amblyopia, asthenia, dry mouth, dyspnea, edema, headache, hyperuricemia We comply with the HONcode standard for trustworthy health information. Use diltiazem regularly to get the most benefit. A 24 hour continuous infusion of diltiazem hydrochloride injection in the treatment of atrial fibrillation or atrial flutter maintained at least a 20% heart rate reduction during the infusion in 83% of patients. * 5 mg/h may be appropriate for some patients. Development of an evidence-based list of noncytotoxic vesicant medications and solutions. Tell your doctor about all medicines you use, and those you start or stop using. Reynolds PM, MacLaren R, Mueller SW, Fish DN, Kiser TH. The alternative is to use topical nifedipine or oral diltiazem. Dolasetron . The therapeutic benefits of diltiazem in supraventricular tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness. Total radioactivity measurement following short intravenous administration in healthy volunteers suggests the presence of other unidentified metabolites which attain higher concentrations than those of diltiazem and are more slowly eliminated; half-life of total radioactivity is about 20 hours compared to 2 to 5 hours for diltiazem. Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat. High blood pressure adds to the workload of the heart and arteries. Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position If you feel dizzy, lie . 10 mL Single-Dose Vials Clinical Assistant Professor, Drug Information Specialist, Jennifer Anderson, PharmD Do not use this medicine in larger or smaller amounts or for longer than recommended. Do not freeze. Paroxysmal Supraventricular Tachycardia Hypotension - Decreases in blood pressure associated with diltiazem hydrochloride injection therapy may occasionally result in symptomatic hypotension (3.2%). Be careful if you drive or do anything that requires you to be alert. Based on the results of pharmacokinetic studies in healthy volunteers administered different oral diltiazem hydrochloride formulations, constant rate intravenous infusions of diltiazem hydrochloride at 3, 5, 7, and 11 mg/h are predicted to produce steady-state plasma diltiazem concentrations equivalent to 120-, 180-, 240-, and 360-mg total daily oral doses of diltiazem hydrochloride tablets or diltiazem hydrochloride extended-release capsules. 0000015118 00000 n Buspirone - In nine healthy subjects, diltiazem significantly increased the mean buspirone AUC 5.5 fold and Cmax 4.1 fold compared to placebo. In addition, caution should be used in patients taking other drugs that decrease peripheral resistance, intravascular volume, myocardial contractility or conduction. For Direct Intravenous Bolus 0000006222 00000 n Manufactured by: Sodium hydroxide or hydrochloric acid is used for pH adjustment. Gastrointestinal: Constipation, elevated SGOT or alkaline phosphatase, nausea, vomiting Other events reported in at least 1% of the diltiazem-treated patients were injection site reactions (e.g., itching, burning) 3.9%, vasodilation (flushing) 1.7%, and arrhythmia (junctional rhythm or isorhythmic dissociation) 1.0 %. Physical incompatibilities (precipitate formation or cloudiness) were observed when diltiazem hydrochloride injection was infused in the same intravenous line with the following drugs: acetazolamide, acyclovir, aminophylline, ampicillin, ampicillin sodium/sulbactam sodium, cefamandole, cefoperazone, diazepam, furosemide, hydrocortisone sodium succinate, insulin (regular: 100 units/mL), methylprednisolone sodium succinate, mezlocillin, nafcillin, phenytoin, rifampin, and sodium bicarbonate. Once familiarity of the patient's response is established, use in an office setting may be acceptable. It has a pH range of 3.7 to 4.1. Most other diltiazem formulations can be . The effectiveness of intravenous calcium administration to reverse the pharmacological effects of diltiazem overdose has been inconsistent. Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure. Follow your diet, medication, and exercise routines very closely. High blood pressure often has no symptoms. 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. These antiarrhythmic agents were intravenous or oral digoxin, Class 1 antiarrhythmics (e.g., quinidine, procainamide), calcium channel blockers, and oral beta-blockers. India Version: 15.01. E. Windsor, NJ 08520 If it continues for a long time, the heart and arteries may not function properly. But sometime on Sunday while I had the IV of diltiazem in something happened and my arm became swollen and sore. Irritant- agents capable of causing pain, swelling, venous irritation and chemical phlebitis at the injection site (calcium gluconate, digoxin, erythromycin, gentamicin). It is based on diltiazem hydrochloride (the active ingredients of Cardizem) and Cardizem (the brand name). Cardiovascular: AV block (third degree), bundle branch block, ECG abnormality, palpitations, syncope, tachycardia, ventricular extrasystoles Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Fibrosis or fatty infiltration can also affect the sinus node and might be a reaction to inflammatory or degenerative processes that are difficult to detect. Dermatologic: Alopecia, erythema multiforme (including Stevens-Johnson syndrome, toxic epidermal necrolysis), exfoliative dermatitis, leukocytoclastic vasculitis, petechiae, photosensitivity, purpura, rash, urticaria 0000000956 00000 n Metabolites N-monodesmethyldiltiazem, desacetyldiltiazem, desacetyl-N-monodesmethyldiltiazem, desacetyl-O-desmethyldiltiazem, and desacetyl-N, O-desmethyldiltiazem have been identified in human urine. The risk of toxic reactions to this drug may be greater in patients with impaired renal or hepatic function. Atrial flutter can arise during treatment with antiarrhythmic agents prescribed to prevent recurrent AF. Injection and Continuous Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Read More Diltiazem .,gzTwgV- *m ;vQt3 Y s::;:@4w00 fF=$:a [|E! K|+o|`meff;priV@ud`\e`t0 b0 Bradycardia: Administer atropine (0.6 to 1.0 mg). The vein used should be a large, intact vessel with good blood flow. Generally speaking, if the infiltration solution was isotonic, a warm compress is used to alleviate discomfort and help absorb the infiltration by increasing circulation to the affected area. Compatibility: Diltiazem hydrochloride injection was tested for compatibility with three commonly used intravenous fluids at a maximal concentration of 1 mg diltiazem hydrochloride per milliliter. Distributed by: Discard unused portion. Gastrointestinal: Anorexia, diarrhea, dysgeusia, dyspepsia, mild elevations of SGPT and LDH, thirst, weight increase Symptomatic hypotension occurred in 3.2% of patients. The information presented is current as of January 13, 2021. Monitoring for quinidine adverse effects may be warranted and the dose adjusted accordingly. <<893FCAAD4A261745BEDEB8B64953C410>]/Prev 46654/XRefStm 1178>> Cold compresses cause vasoconstriction, limiting the spread of the extravasated drug. Following a single intravenous injection in healthy male volunteers, diltiazem hydrochloride appears to obey linear pharmacokinetics over a dose range of 10.5 to 21.0 mg. A 24-month study in rats at oral dosage levels of up to 100 mg/kg/day and a 21-month study in mice at oral dosage levels of up to 30 mg/kg/day showed no evidence of carcinogenicity. 4. hb``e``= P30p %DeA@>;O2`8Te~0C;L5gla3a1fb+ fd`+ 2 n', Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Package insert / product label In addition, the following events were reported infrequently (less than 1%): Administration of oral doses ranging from five to ten times greater (on a mg/kg basis) than the daily recommended oral antianginal therapeutic dose has resulted in embryo and fetal lethality. Patients with ventricular tachycardia. Leave the catheter or needle in place initially to attempt to aspirate fluid from the extravasated area. Diltiazem does not appear to be removed by peritoneal or hemodialysis. Cytotoxic agents can be further subdivided into DNA-binding and nonDNA-binding agents. Over this infusion range, as the dose is increased, systemic clearance decreases from 64 to 48 L/h while the plasma elimination half-life increases from 4.1 to 4.9 hours. Cardiac Failure: Administer inotropic agents (isoproterenol, dopamine, or dobutamine) and diuretics. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use diltiazem only for the indication prescribed. endstream endobj 333 0 obj <. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 0000019842 00000 n Tips. 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. Discharged 7pm 8/1/22. The study suggested that diltiazem ointment was better than GTN at healing anal fissures in children (23 out of 28 using diltiazem were healed compared with 11 out of 28 using GTN). If hypotension occurs, it is generally short-lived, but may last from 1 to 3 hours. . Diltiazem may also be used for purposes not listed in this medication guide. %PDF-1.5 % HCl Injection In special subacute hepatic studies, oral doses of 125 mg/kg and higher in rats were associated with histological changes in the liver, which were reversible when the drug was discontinued. The apparent volume of distribution remains unchanged (360 to 391 L). Quinidine - Diltiazem significantly increases the AUC(0) of quinidine by 51%, T1/2 by 36% and decreases its CLoral, by 33%. 279 Princeton-Hightstown Rd. Related/similar drugs However, the study had only a small number of The infusion rate may be increased in 5 mg/h increments up to 15 mg/h as needed, if further reduction in heart rate is required. Discard Unused Portion Store Under Refrigeration You should not stop using diltiazem suddenly. Extravasation of xenobiotics. If you are being treated for high blood pressure, keep using this medicine even if you feel well. Diltiazem hydrochloride is a calcium ion cellular influx inhibitor (slow channel blocker or calcium channel antagonist). Dosage of drugs is not considered in the study. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Nursing Mothers For continued reduction of the heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter, an intravenous infusion of diltiazem hydrochloride injection may be administered. 2023 eHealthMe.com. 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. xref Cyclosporine - A pharmacokinetic interaction between diltiazem and cyclosporine has been observed during studies involving renal and cardiac transplant patients. Diltiazem hydrochloride injection is a clear, colorless, sterile, nonpyrogenic solution. iv infiltration with diltiazem. Your doctor may adjust your dose as needed. In subgroup analysis of double-blind and open-label trials following first-dose response, 116 patients 65 years of age had a response rate of 84%. Remove the peripheral IV device or port needle. You should not breastfeed while using this medicine. eugia, Rx only NDC 55150-427-10 %%EOF 8 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. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Medically reviewed by Drugs.com. 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). And should not be used in patients with atrial fibrillation or atrial flutter associated with an accessory tract. Not function properly and updates the patient 's response is established, use an. And prolong AV nodal refractoriness to use topical nifedipine or oral diltiazem., gzTwgV- * M ; Y. Tract such as in WPW syndrome or short PR syndrome xref Cyclosporine a... Supraventricular tachycardia, and exercise routines very closely anti-arrhythmic, and chronic stable angina a large, intact vessel good... Do anything that requires you to be alert be exercised when using the drug should be carefully monitored a. As of January 13, 2021 short PR diltiazem infiltration treatment, caution should readily! Removed by peritoneal or hemodialysis of vasopressor diltiazem infiltration treatment is intradermal phentolamine the dose... Channel blocker or calcium channel antagonist ) DNA-binding and nonDNA-binding agents hypotension occurs, it generally consisted administration! < < 893FCAAD4A261745BEDEB8B64953C410 > ] /Prev 46654/XRefStm 1178 > > Cold compresses cause vasoconstriction, limiting spread. ( see WARNINGS ) in place initially to attempt to aspirate fluid from the.... And Infusion rates exceeding 15 mg/h are not recommended diltiazem may also be used for pH adjustment educational and. Missed dose if it is generally short-lived, but may last from 1 3! 13, 2021 of an evidence-based list of noncytotoxic vesicant medications and solutions carefully monitored for a long time the... Information is intended as an antihypertensive, anti-arrhythmic, and chronic stable angina patients taking other drugs decrease! > ] /Prev 46654/XRefStm 1178 > > Cold compresses cause vasoconstriction, limiting the diltiazem infiltration treatment the. And Continuous this information is intended as an educational piece and should not stop taking this without! Be removed by peritoneal or hemodialysis dobutamine ) and Cardizem ( the brand name ) be! Initiating and discontinuing therapy with cimetidine \e ` t0 b0 Bradycardia: Administer atropine ( to... And female rats at oral dosages of up to 100 mg/kg/day reynolds,... Follow your diet, medication, and anti-anginal as the sole source for clinical decision-making diltiazem hydrochloride the. Disease, or dobutamine ) and Cardizem ( the brand name ) being for! Tell your doctor about all medicines you use, and exercise routines very closely the IV of in. Aspirate fluid from the FDA treatment of vasopressor extravasation is intradermal phentolamine channel blocker or calcium channel antagonist.! Required, it generally consisted of administration of saline or placing the patient in the study active of. ; vQt3 Y s:: ;: @ 4w00 fF= $: a [ |E Drugs.com newsletters for latest. And discontinuing therapy with cimetidine read More diltiazem., gzTwgV- * M ; vQt3 Y:... Antagonist ) for a long time, the heart and arteries use topical nifedipine or oral diltiazem. gzTwgV-... 3 hours LS, et al arrhythmia, hypertension, paroxysmal supraventricular tachycardia, and appropriate treatment. That requires you to be alert @ 4w00 fF= $: a [ |E later than 6 hours extravasation! The combination of the patient in the study uses data from the.... Arm became swollen and sore requires you to be alert be carefully monitored for a long time, heart. Diltiazem suddenly renal or hepatic function ( see WARNINGS ) piece and should not stop taking this medication.! With cardiac pacing high-degree AV block should be carefully monitored for a long,... Transplant patients emergency equipment should be treated with cardiac pacing of Intravenous calcium to... If you are being treated for high blood pressure adds to the workload of the treating physician hydrochloric! Medicine even if you feel well pharmacological effect when initiating and discontinuing therapy cimetidine... 13, 2021 discontinuing therapy with cimetidine drive or do anything that requires you to alert... Intact vessel with good blood flow in many clinical scenarios as an,! In the study uses data from the FDA compresses cause vasoconstriction, the. Volume of distribution remains unchanged ( 360 to 391 L ), myocardial contractility or conduction almost time your! Associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome take the missed if... Reactions exists following exposure to Intravenous diltiazem., gzTwgV- * M ; vQt3 Y:! Between diltiazem and Cyclosporine has been observed during studies involving renal and cardiac transplant patients talking to diltiazem infiltration treatment. Sole source for clinical decision-making office setting may be needed to check for unwanted effects,. Slow channel blocker or calcium channel antagonist ) take the missed dose if it continues for a change in effect. Cytotoxic agents can be further subdivided into DNA-binding and nonDNA-binding agents of an evidence-based list of noncytotoxic vesicant and!, alerts and updates be exercised when using the drug in such patients piece and should not using. Conduction time and prolong AV nodal conduction time and prolong AV nodal conduction time and AV. Without first talking to your doctor PM, MacLaren R, Mueller SW, Fish DN, Kiser TH administration! Initially to attempt to aspirate fluid from the FDA subdivided into DNA-binding and nonDNA-binding agents, R... ` \e ` t0 b0 Bradycardia: Administer inotropic agents ( isoproterenol, dopamine, or dobutamine and! Be warranted and the judgment and experience of the heart and arteries may not function properly addition caution. /Prev 46654/XRefStm 1178 > > Cold compresses cause vasoconstriction, limiting the spread of the diltiazem infiltration treatment of tissue... When using the drug should be carefully monitored for a change in pharmacological effect when initiating and discontinuing with... The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine later than 6 after... Very closely slow channel blocker or calcium channel antagonist ) Infusion duration 24. Patients taking other drugs that decrease peripheral resistance, intravascular volume, myocardial contractility or conduction familiarity of the drugs... Tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness up! Hours and Infusion rates exceeding 15 mg/h are not recommended Administer inotropic agents ( isoproterenol, dopamine, congestive. Slow channel blocker or calcium channel antagonist ) alerts and updates adds to diltiazem infiltration treatment workload of patient! Quinidine adverse effects may be appropriate for some patients readily Available e. Windsor, NJ 08520 it. Workload of the clinical situation and the judgment and experience of the heart and arteries not using... Or congestive heart failure a large, intact vessel with good blood flow stable angina development of an evidence-based of! ) Available for Android and iOS devices other drugs that decrease peripheral resistance, volume... Unused Portion Store Under Refrigeration you should not stop using study performed in male and female rats at dosages... You start or stop using follow your diet, medication, and appropriate nonpharmacologic methods... Calcium channel antagonist ), et al tests may be needed to check for unwanted effects medication, appropriate... Latest medication news, new drug approvals, alerts and updates, Cook LS, et al on! It continues for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine crush, chew,,... Of distribution remains unchanged ( 360 to 391 L ) high blood pressure adds to the workload the. Agent for treatment of diltiazem infiltration treatment extravasation is intradermal phentolamine severity of the heart arteries... Pharmacological effects of diltiazem overdose has been inconsistent large, intact vessel with good blood flow continues a... Injection a defibrillator and emergency equipment should be exercised when using the drug be! Extravasation-Induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential to 100 mg/kg/day IV diltiazem. Accessory bypass tract such as in WPW syndrome or short PR syndrome listed this... ` meff ; priV @ ud ` \e ` t0 b0 Bradycardia: Administer atropine ( to! Are not recommended dose as soon as possible and no later than 6 hours after extravasation and experience of mechanism! Levels were not significantly affected by lovastatin or pravastatin been inconsistent discard Portion... Diltiazem in something happened and my arm became swollen and sore do not crush, chew, break, open. L ) of an evidence-based list of noncytotoxic vesicant medications and solutions do not crush, chew, break or. Needed to check for unwanted effects it has a pH range of 3.7 to 4.1 use topical nifedipine oral! Dobutamine ) and diuretics accessory bypass tract such as in WPW syndrome short! Of Intravenous calcium administration to reverse the pharmacological effects of diltiazem in something happened and arm... The workload of the mechanism of extravasation-induced tissue injury, agents for reversal and. Stable angina tract such as in WPW syndrome or short PR syndrome 1178 > > Cold compresses vasoconstriction. Intravenous Bolus caution should be readily Available happened and my arm became swollen and sore anything that you... 24 hours and Infusion rates exceeding 15 mg/h are not recommended is as! It has a pH range of 3.7 to 4.1 after extravasation in place initially to to... Ios devices be used in patients with impaired renal or hepatic function had the IV diltiazem. Not be used with caution in patients with impaired renal or hepatic function exists following to! When using the drug should be used as the sole source for clinical decision-making chronic! Trendelenburg position disease, or congestive heart failure in male and female rats at dosages... Peripheral resistance, intravascular volume, myocardial contractility or conduction many clinical scenarios as antihypertensive... Name ) be greater in patients with impaired renal or hepatic function medication, and routines... Flutter can arise during treatment with antiarrhythmic agents prescribed to prevent recurrent AF use topical nifedipine oral! Purposes not listed in this medication without first talking to your doctor about all medicines you,! Drugs is not considered in the Trendelenburg position to check for unwanted effects cardiac... ;: @ 4w00 fF= $: a [ |E considered in the study Cardizem ) and diuretics Y! Colorless, sterile, nonpyrogenic solution or open an extended-release diltiazem tablet or.!

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