Comparative Pharmacology
Head-to-head clinical analysis: DILT CD versus SULAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILT CD versus SULAR.
DILT-CD vs SULAR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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.
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.
10-20 mg orally once daily; maximum 60 mg/day.
None Documented
None Documented
Terminal elimination half-life 7-10 hours; clinically relevant in hepatic impairment (prolonged to 14-20 hours) and in elderly
Terminal half-life of 24-50 hours, mean ~34 hours; extended in elderly and hepatic impairment, dose adjustment may be needed
Renal 2-4% unchanged; extensive hepatic metabolism; 60-70% fecal, 30-40% renal 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