Comparative Pharmacology
Head-to-head clinical analysis: DILTZAC versus VASCOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILTZAC versus VASCOR.
DILTZAC vs VASCOR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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.
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.
Bepridil hydrochloride (Vascor) is typically dosed as 200 mg to 400 mg orally once daily.
None Documented
None Documented
Terminal elimination half-life: 3.5-5.0 hours (healthy adults). Prolonged in elderly (6-8 hours) and in hepatic impairment (10-12 hours).
Terminal elimination half-life: 6-8 hours (normal renal/hepatic function). May be prolonged in hepatic impairment; unchanged in renal impairment.
Renal: 60-70% as metabolites, 2-4% unchanged; Biliary/Fecal: 20-30% 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