Comparative Pharmacology
Head-to-head clinical analysis: CARDIZEM versus CARDIZEM LA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CARDIZEM versus CARDIZEM LA.
CARDIZEM vs CARDIZEM LA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Diltiazem inhibits calcium influx into cardiac and vascular smooth muscle cells during depolarization by binding to L-type calcium channels. This results in coronary vasodilation, decreased myocardial oxygen demand, and negative chronotropic and inotropic effects.
Cardizem LA (diltiazem) is a calcium channel blocker that inhibits calcium ion influx across cardiac and smooth muscle cells during depolarization, leading to negative inotropic, chronotropic, and dromotropic effects. It dilates coronary and peripheral arteries, reducing systemic vascular resistance and myocardial oxygen demand.
Oral: 30-120 mg three to four times daily; extended-release: 120-360 mg once daily. IV: Initial 0.25 mg/kg (max 25 mg) bolus over 2 minutes, may repeat in 15 minutes (0.35 mg/kg); maintenance: 5-15 mg/hour continuous infusion.
Oral, 180-360 mg once daily; initiate at 180 mg once daily, titrate to 240 mg, then 300 mg, then 360 mg once daily as needed.
None Documented
None Documented
Terminal elimination half-life is 3.0-4.5 hours in healthy adults; may be prolonged to 7-9 hours in elderly, hepatic impairment, or renal impairment; clinically relevant for dosing frequency.
Terminal elimination half-life: 5-8 hours after oral administration. For extended-release formulations, the half-life is similar but the prolonged absorption phase results in sustained plasma concentrations.
Primarily hepatic metabolism with extensive first-pass effect; approximately 2-4% excreted unchanged in urine; fecal excretion accounts for about 65% of dose as metabolites; renal excretion accounts for about 35% of dose as metabolites.
Urine (2-4% unchanged, ~40% as metabolites); bile/feces (major route, ~60% as metabolites).
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker