Comparative Pharmacology
Head-to-head clinical analysis: DILT CD versus VASCOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILT CD versus VASCOR.
DILT-CD vs VASCOR
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.
VASCOR (bepridil) is a calcium channel blocker that inhibits calcium ion influx across cardiac and smooth muscle cells, reducing contractility and oxygen demand. It also has class I and IV antiarrhythmic properties.
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.
Bepridil hydrochloride (Vascor) is typically dosed as 200 mg to 400 mg orally once daily.
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 elimination half-life: 6-8 hours (normal renal/hepatic function). May be prolonged in hepatic impairment; unchanged in renal impairment.
Renal 2-4% unchanged; extensive hepatic metabolism; 60-70% fecal, 30-40% renal as metabolites
Primarily hepatic metabolism; ~70% excreted in feces as metabolites, ~30% in urine (largely as metabolites). <2% excreted unchanged in urine.
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker