Comparative Pharmacology
Head-to-head clinical analysis: DILT CD versus VERELAN PM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILT CD versus VERELAN PM.
DILT-CD vs VERELAN PM
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.
Verapamil is a calcium channel blocker that inhibits the influx of calcium ions across the cardiac and vascular smooth muscle cells, thereby reducing myocardial contractility, sinoatrial and atrioventricular node conduction, and vascular tone.
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.
Verelan PM (verapamil hydrochloride) is an extended-release oral capsule administered once daily at bedtime. Typical adult dose for hypertension is 200 mg to 400 mg once daily at bedtime. Initial dose is 200 mg, titrated upward as needed. Maximum recommended dose is 400 mg 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 7.2 ± 1.5 hours after oral administration, prolonged in hepatic impairment (up to 14-16 hours) and elderly; steady-state achieved after 3-4 days.
Renal 2-4% unchanged; extensive hepatic metabolism; 60-70% fecal, 30-40% renal as metabolites
Primarily hepatic metabolism (>95%), with 3-4% excreted unchanged in urine; biliary/fecal excretion accounts for <1% of unchanged drug.
Category C
Category C
Calcium Channel Blocker
Calcium Channel Blocker