Diltiazem

Presentación

Solución 5 mg/mL — documentado: Sagent/Medical Purchasing Solutions (FDA)

¿Para qué sirve diltiazem? Indicaciones autorizadas

INDICATIONS AND USAGE Diltiazem hydrochloride injection is indicated for the following: Atrial Fibrillation or Atrial Flutter Temporary control of rapid ventricular rate in atrial fibrillation or atrial flutter. It should not be used in patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in Wolff-Parkinson-White (WPW) syndrome or short PR syndrome. Paroxysmal…

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INDICATIONS AND USAGE Diltiazem hydrochloride injection is indicated for the following: Atrial Fibrillation or Atrial Flutter Temporary control of rapid ventricular rate in atrial fibrillation or atrial flutter. It should not be used in patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in Wolff-Parkinson-White (WPW) syndrome or short PR syndrome. Paroxysmal Supraventricular Tachycardia Rapid conversion of paroxysmal supraventricular tachycardias (PSVT) to sinus rhythm. This includes AV nodal reentrant tachycardias and reciprocating tachycardias associated with an extranodal accessory pathway such as the WPW syndrome or short PR syndrome. Unless otherwise contraindicated, appropriate vagal maneuvers should be attempted prior to administration of diltiazem hydrochloride injection. The use of diltiazem hydrochloride injection should be undertaken with caution when the patient is compromised hemodynamically or is taking other drugs that decrease any or all of the following: peripheral resistance, myocardial filling, myocardial contractility, or electrical impulse propagation in the myocardium. For either indication and particularly when employing continuous intravenous infusion, the setting should include continuous monitoring of the ECG and frequent measurement of blood pressure. A defibrillator and emergency equipment should be readily available. In domestic controlled trials in patients with atrial fibrillation or atrial flutter, bolus administration of diltiazem hydrochloride injection was effective in reducing heart rate by at least 20% in 95% of patients. Diltiazem hydrochloride injection rarely converts atrial fibrillation or atrial flutter to normal sinus rhythm. Following administration of one or two intravenous bolus doses of diltiazem injection, response usually occurs within 3 minutes and maximal heart rate reduction generally occurs in 2 to 7 minutes. Heart rate reduction may last from 1 to 3 hours. If hypotension occurs, it is generally short-lived, but may last from 1 to 3 hours. A 24-hour continuous infusion of diltiazem injection in the treatment of atrial fibrillation or atrial flutter maintained at least a 20% heart rate reduction during the infusion in 83% of patients. Upon discontinuation of infusion, heart rate reduction may last from 0.5 hours to more than 10 hours (median duration 7 hours). Hypotension, if it occurs, may be similarly persistent. In the controlled clinical trials, 3.2% of patients required some form of intervention (typically, use of intravenous fluids or the Trendelenburg position) for blood pressure support following diltiazem hydrochloride injection. In domestic controlled trials, bolus administration of diltiazem hydrochloride injection was effective in converting PSVT to normal sinus rhythm in 88% of patients within 3 minutes of the first or second bolus dose. Symptoms associated with the arrhythmia were improved in conjunction with decreased heart rate or conversion to normal sinus rhythm following administration of diltiazem hydrochloride injection.

FDA (DailyMed) · Diltiazem Hydrochloride · Indications and usage · texto original en inglés

Contraindicaciones de diltiazem

CONTRAINDICATIONS Diltiazem hydrochloride injection is contraindicated in: Patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker. Patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker. Patients with severe hypotension or cardiogenic shock. Patients who have demonstrated hypersensitivity to the drug. Intravenous diltiazem…

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CONTRAINDICATIONS Diltiazem hydrochloride injection is contraindicated in: Patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker. Patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker. Patients with severe hypotension or cardiogenic shock. Patients who have demonstrated hypersensitivity to the drug. Intravenous diltiazem and intravenous beta-blockers should not be administered together or in close proximity (within a few hours). Patients with atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in WPW syndrome or short PR syndrome. As with other agents which slow AV nodal conduction and do not prolong the refractoriness of the accessory pathway (e.g., verapamil, digoxin), in rare instances patients in atrial fibrillation or atrial flutter associated with an accessory bypass tract may experience a potentially life-threatening increase in heart rate accompanied by hypotension when treated with diltiazem hydrochloride injection. As such, the initial use of diltiazem hydrochloride injection should be, if possible, in a setting where monitoring and resuscitation capabilities, including DC cardioversion/defibrillation, are present (see OVERDOSAGE ). Once familiarity of the patient's response is established, use in an office setting may be acceptable. Patients with ventricular tachycardia. Administration of other calcium channel blockers to patients with wide complex tachycardia (QRS≥0.12 seconds) has resulted in hemodynamic deterioration and ventricular fibrillation. It is important that an accurate pretreatment diagnosis distinguish wide complex QRS tachycardia of supraventricular origin from that of ventricular origin prior to administration of diltiazem hydrochloride injection.

FDA (DailyMed) · Diltiazem Hydrochloride · Contraindications · texto original en inglés

Reconstitución de diltiazem

No requiere.

Dilución de diltiazem

Infusión: SF 0.9% o glucosa 5%.

Administración de diltiazem

Bolo IV en 2 min e infusión continua.

Estabilidad y periodo de validez

Compatibilidad de diltiazem

Compatible con

• SF 0.9%
• Glucosa 5%

Incompatible con

• Furosemida

Conservación y protección de la luz

Refrigerar entre 2 y 8 °C.

La fuente no indica protección de la luz.

Advertencias

• Bradicardia, bloqueo AV e hipotensión; evitar en insuficiencia cardiaca descompensada.

Fuentes

1. FDA (DailyMed) · Diltiazem HydrochlorideMedical Purchasing Solutions, LLC · Solución 5 mg/mL (viales) · versión 2025-10-23

Interacciones de diltiazem

32 medicamentos del catálogo con una interacción documentada en sus fichas oficiales. Abre cada una para ver el efecto, la recomendación y su fuente.

• IvabradinaContraindicada
• AmiodaronaMayor
• AtenololMayor
• BisoprololMayor
• CarbamazepinaMayor
• CarvedilolMayor
• ClaritromicinaMayor
• DantrolenoMayor
• DomperidonaMayor
• EplerenonaMayor
• MetoprololMayor
• PosaconazolMayor

Ver las 32 interacciones de diltiazem ↗

Diagnósticos relacionados

Diagnósticos que la ficha técnica de diltiazem menciona en sus indicaciones. Cada uno abre su definición y los demás medicamentos indicados.

• Arritmia
• Fibrilación auricular

Identificación

SNOMED CT (VTM)

59941008

RxNorm

3443