Comparative Pharmacology
Head-to-head clinical analysis: CALAN versus DILT CD.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CALAN versus DILT CD.
CALAN vs DILT-CD
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Verapamil inhibits calcium ion influx through voltage-gated L-type calcium channels in cardiac and vascular smooth muscle, leading to decreased myocardial contractility, slowed AV conduction, and vasodilation.
Diltiazem inhibits calcium ion influx during depolarization of cardiac and vascular smooth muscle cells, thereby reducing intracellular calcium levels. It decreases sinoatrial and atrioventricular nodal conduction and dilates coronary and peripheral arteries.
Initial: 80-120 mg orally 3 times daily; maintenance: 240-480 mg/day in 3-4 divided doses. IV: 5-10 mg over 2 minutes, may repeat after 15-30 minutes.
180-360 mg PO once daily (extended-release); 300-540 mg PO once daily for hypertension; 120-480 mg PO once daily for angina; IV: 0.25 mg/kg bolus over 2 min, then 5-15 mg/hr continuous infusion.
None Documented
None Documented
Terminal elimination half-life is 3-7 hours for immediate-release; can be prolonged to 12-16 hours with sustained-release due to slow absorption; increased in hepatic impairment.
Terminal elimination half-life 7-10 hours; clinically relevant in hepatic impairment (prolonged to 14-20 hours) and in elderly
Approximately 70% renal (3-4% unchanged, remainder as metabolites) and 25% biliary/fecal.
Renal 2-4% unchanged; extensive hepatic metabolism; 60-70% fecal, 30-40% renal as metabolites
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker