Comparative Pharmacology
Head-to-head clinical analysis: CARDIZEM versus DILTZAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CARDIZEM versus DILTZAC.
CARDIZEM vs DILTZAC
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 is a calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cells, resulting in dilation of coronary and systemic arteries and decreased myocardial contractility and 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.
Oral: 30-120 mg 3-4 times daily; maximum 480 mg/day. IV: 0.25 mg/kg over 2 min, then 0.35 mg/kg after 15 min if needed; continuous infusion 5-15 mg/hour.
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: 3.5-5.0 hours (healthy adults). Prolonged in elderly (6-8 hours) and in hepatic impairment (10-12 hours).
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: 60-70% as metabolites, 2-4% unchanged; Biliary/Fecal: 20-30% as metabolites.
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker