Diltiazem hydrochloride

The main ingredient of this product is diltiazem hydrochloride.

Drugs with antihypertensive effects (antihypertensive drugs, nitrates, etc.) enhance the antihypertensive effect. Measure blood pressure and adjust the dosage. Additive effects (enhanced antihypertensive effect) of beta-blockers (bisoprolol fumarate, propranolol hydrochloride, atenolol, etc.) may cause bradycardia, atrioventricular conduction stagnation, sinoatrial block, etc. Monitor the electrocardiogram and reduce or stop the medication when abnormalities are found. Additive effects (inhibition of sinus rhythm and conduction, negative inotropic effect, antihypertensive effect) are enhanced. Pay special attention to the combined use of these three drugs (diltiazem hydrochloride, beta-blockers and digitalis preparations). Rauwolfia preparations (reserve, etc.) and digitalis preparations (digoxin, methyldigoxin) may cause bradycardia and atrioventricular conduction block. Due to the increase in the blood concentration of digitalis preparations, digitalis poisoning symptoms (nausea, vomiting, headache, dizziness, visual abnormalities, etc.) including arrhythmias may occur. Monitor the electrocardiogram and observe regularly for symptoms of digitalis poisoning. If necessary, measure the blood concentration of digitalis preparations. Reduce the dosage or stop the medication if abnormalities are found. The additive effect (inhibition of sinus rhythm and conduction) is enhanced. Pay special attention to the combined use of these three drugs (diltiazem hydrochloride, β-blockers and digitalis preparations). Diltiazem hydrochloride can increase the blood concentration of digitalis. Antiarrhythmic drugs (amiodarone hydrochloride, mexiletine hydrochloride, etc.) may cause bradycardia, atrioventricular block, sinus arrest, etc. Monitor the electrocardiogram and reduce the dosage or stop the medication if abnormalities are found. The additive effect (inhibition of sinus rhythm and conduction) is enhanced. Symptoms caused by the increase in the blood concentrations of the two drugs may occur with apristinine hydrochloride (bradycardia, atrioventricular block, sinus arrest, tremor, dizziness or mild headache, etc.). Monitor the electrocardiogram, observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. This combination of drugs can affect the common metabolic enzyme (cytochrome P450), resulting in an increase in the blood concentration of both drugs. Dihydropyridine Ca2 antagonists (nifedipine, amlodipine besylate, etc.) sometimes cause symptoms caused by increased blood concentrations of dihydropyridine Ca2 antagonists (enhanced antihypertensive effect, etc.). Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Because diltiazem hydrochloride inhibits the metabolic enzymes (cytochrome P450) of these drugs, the blood concentrations of these drugs increase. Triazolam (sleep induction agent) sometimes causes symptoms caused by increased blood concentrations of triazolam (prolonged sleep time, etc.). Start with a small dose, observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Midazolam (sedative, hypnotic induction agent) sometimes causes symptoms caused by increased blood concentrations of midazolam (enhanced sedative, hypnotic effect, etc.). Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Carbamazepine (anti-epileptic drug, drug for the treatment of manic states) may cause symptoms (drowsiness, nausea, vomiting, dizziness, etc.) caused by increased blood concentrations of carbamazepine. Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Selegiline hydrochloride (a drug for the treatment of Parkinson's disease) The effects and toxicity of selegiline hydrochloride may be enhanced. Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Theophylline (bronchodilator) may cause symptoms (nausea, vomiting, headache, insomnia, etc.) caused by increased blood concentrations of theophylline. Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Cilostazol (antiplatelet drug) may enhance the effects of cilostazol. Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Vinorelbine tartrate (anti-tumor drug) may enhance the effects of vinorelbine tartrate. Observe clinical symptoms regularly, and reduce or stop the medication if abnormalities are found. Cyclosporine (immunosuppressant) may cause symptoms (such as renal dysfunction, etc.) due to increased blood concentration of cyclosporine. Regularly observe clinical symptoms, monitor blood concentration of cyclosporine, and reduce or stop the medication if abnormalities are found. Tacrolimus (immunosuppressant) may cause various symptoms (such as renal dysfunction, etc.) due to increased blood concentration of tacrolimus. Regularly observe clinical symptoms, monitor blood concentration of tacrolimus, and reduce or stop the medication if abnormalities are found. Phenytoin (anti-epileptic drug) may cause various symptoms (such as ataxia, dizziness, nystagmus, etc.) due to increased blood concentration of phenytoin. Regularly observe clinical symptoms, and reduce or stop the use of phenytoin if abnormalities are found. In addition, it may weaken the effect of diltiazem hydrochloride. Diltiazem hydrochloride inhibits the metabolic enzyme (cytochrome P450) of phenytoin, resulting in increased blood concentration of phenytoin. At the same time, phenytoin accelerates the metabolism of diltiazem, resulting in a decrease in the blood concentration of diltiazem. Cimetidine HIV protease inhibitors (ritonavir, saquinavir, etc.) may cause symptoms due to increased blood concentrations of diltiazem (enhanced antihypertensive effect, bradycardia, etc.). Monitor blood pressure and electrocardiogram, and reduce or stop the medication if abnormalities are found. These drugs inhibit the metabolic enzymes (cytochrome P450) of diltiazem, resulting in increased blood concentrations of diltiazem. The effect of rifampicin on diltiazem may be weakened. Observe clinical symptoms regularly, and if possible, monitor the blood concentration of diltiazem. If abnormalities are found, take appropriate measures such as changing the medication or increasing the dosage of this drug. Rifampicin induces the metabolic enzymes (cytochrome P450) of diltiazem, resulting in a decrease in the blood concentration of diltiazem. Anesthetic drugs (isoflurane, enflurane, halothane, etc.) may cause bradycardia, atrioventricular block, sinus arrest, etc. Monitor the electrocardiogram and reduce or stop the medication if abnormalities are found. Additive effects (inhibition of sinus rhythm and cardiac conduction) are enhanced. Muscle relaxants (pancuronium, vecuronium, etc.) enhance the effects of muscle relaxants. Pay attention to the muscle relaxant effect and reduce or stop the medication if abnormalities are found. Diltiazem hydrochloride inhibits the release of acetylcholine from the presynaptic membrane of nerve endings at the neuromuscular junction.

1. β-blockers: Studies have shown that the combination of diltiazem hydrochloride and β-blockers is well tolerated, but there is insufficient data in patients with left ventricular dysfunction and conduction dysfunction. This product can increase the bioavailability of propranolol by nearly 50%, so the dose of propranolol needs to be adjusted when starting or stopping the combination of the two drugs. 2. Cimetidine: Due to the inhibition of cytochrome P450 oxidase, the first-pass metabolism of this product is affected, which can significantly increase the peak blood concentration and the area under the drug-time curve of this product. Ranitidine only slightly increases the blood concentration of this product. 3. Digoxin: There are reports that this product can increase the blood concentration of digoxin by 20%, but there are also reports that it has no effect. Although the results are contradictory, the blood concentration of digoxin should be monitored when starting, adjusting and stopping treatment with this product to avoid digoxin overdose or inappropriate use.