Comparative Pharmacology
Head-to-head clinical analysis: CARDIZEM versus SULAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CARDIZEM versus SULAR.
CARDIZEM vs SULAR
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.
Nisoldipine is a dihydropyridine calcium channel blocker that inhibits the influx of calcium ions through L-type calcium channels in vascular smooth muscle and cardiac muscle. This leads to vasodilation, reduced peripheral vascular resistance, and decreased 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.
10-20 mg orally once daily; maximum 60 mg/day.
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 of 24-50 hours, mean ~34 hours; extended in elderly and hepatic impairment, dose adjustment may be needed
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: 50-60% as metabolites, 10% as unchanged drug; Fecal: ~35%; Biliary: <5%
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker