Comparative Pharmacology
Head-to-head clinical analysis: CARDIZEM versus DILACOR XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CARDIZEM versus DILACOR XR.
CARDIZEM vs DILACOR XR
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.
Diltiazem inhibits calcium ion influx across cardiac and vascular smooth muscle cells, resulting in dilation of coronary and systemic arteries, decreased myocardial contractility, and reduced sinoatrial and atrioventricular conduction velocity.
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.
180 to 240 mg orally once daily, administered on an empty stomach; maximum dose 480 mg once daily.
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 half-life: 6-12 hours (prolonged in elderly, hepatic impairment, or with CYP3A4 inhibitors)
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.
Renal (70% as metabolites, 3-4% as unchanged drug); biliary/fecal (25-30%)
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker