Diltiazem
Class IV
| IV Dose | Initial bolus 0.25 mg/kg over 2 min (average 20 mg in adults). Second dose of 0.35 mg/kg over 2 minutes may be given (average 25 mg) Continuous infusion: 5-15 mg/hr (usual 10 mg/hour) in adults. No pediatric dose. (suggest 0.125 mg/kg/hr = 2 ug/kg/min). |
| Oral dose | 30-90 mg QID of short-acting preparation 60-180 mg BID of “SR” preparation 180-360 mg QD of “CD” preparation |
| Levels | Therapeutic range undefined |
| Kinetics | Maximum effect 2-5 minutes after bolus injection. Plasma half-life 3-4.5 hours. Metabolized in lever, excreted in urine. |
| Cautions | Same cautions as with verapamil. May be better tolerated with beta blockers than verapamil. Avoid in young children. |
| Interactions | Increases levels of propranolol, digoxin (20%), cyclosporin, carbamazepine. Levels increased by cimetidine |
| Preparations | Cardizem injectable, vials 25 mg/5 cc or 50 mg/10 cc. Cardizem tablets, 30 mg (non-scored), 60, 90, 120 mg(scored). Cardizem SR capsules, 60, 90, 120 mg Cardizem CD capsules, 120, 180, 240, 300 mg. |
| FDA approval in children | no |