DILTIAZONE CD 90

Diltiazem Hydrochloride Extended Release 90mg is a non-dihydropyridine calcium channel blocker belonging to the benzothiazepine chemical class, distinct from the more commonly known dihydropyridine calcium channel blockers such as amlodipine. This distinction is clinically important, as diltiazem offers a unique combination of vascular and cardiac effects that make it particularly valuable in specific patient populations.

Under the brand name Diltiazone CD 90, manufactured by Steris Healthcare, this extended-release formulation is designed to provide smooth, sustained blood levels of diltiazem over a 24-hour period, supporting consistent blood pressure and heart rate control with convenient once-daily dosing.

Product Information

Why It's Important

Hypertension and coronary artery disease remain two of the most significant cardiovascular health burdens in India, contributing substantially to the national burden of heart attacks, strokes, and heart failure. Calcium channel blockers form one of the core pillars of modern antihypertensive and antianginal therapy, and diltiazem occupies a distinctive place within this class due to its dual mechanism of action.

Unlike dihydropyridine calcium channel blockers, which act almost exclusively on vascular smooth muscle to lower blood pressure, diltiazem also exerts a meaningful effect on the heart's conduction system and contractility. This means it can simultaneously lower blood pressure, reduce heart rate, and decrease myocardial oxygen demand — a combination of effects that is particularly valuable in patients with angina who also need heart rate control, or in patients who experience reflex tachycardia (an unwanted increase in heart rate) with dihydropyridine agents.

The extended-release formulation used in Diltiazone CD 90 is also clinically significant. Immediate-release diltiazem requires multiple daily doses and can produce fluctuating blood levels, which may translate into inconsistent blood pressure control and increased side-effect burden. An extended-release capsule, by contrast, is specifically engineered to release the drug gradually, maintaining more stable plasma concentrations over 24 hours and supporting the simplified, once-daily dosing that is now considered best practice for long-term cardiovascular therapy, given its strong link to improved patient adherence.

Key Benefits 

What Are the Benefits of Diltiazone CD 90?

Diltiazem Hydrochloride Extended Release 90mg, as formulated in Diltiazone CD 90, offers several clinically meaningful advantages:

• Dual mechanism of action: Diltiazem uniquely combines vasodilation with cardiac rate and conduction effects, offering broader hemodynamic benefit than purely vascular-selective calcium channel blockers.
• Effective blood pressure control: By relaxing vascular smooth muscle, diltiazem reduces peripheral vascular resistance, contributing to meaningful and sustained reductions in blood pressure.
• Relief from anginal symptoms: By reducing myocardial oxygen demand and improving coronary blood flow, diltiazem helps reduce the frequency and severity of anginal episodes, including vasospastic angina.
• Heart rate moderation without a beta-blocker: For patients who cannot tolerate or should not use beta-blockers, diltiazem offers an alternative means of achieving heart rate control alongside blood pressure management.
• Reduced reflex tachycardia risk: Unlike dihydropyridine calcium channel blockers, diltiazem's rate-slowing property helps offset the reflex increase in heart rate sometimes seen with pure vasodilators.
• Smooth, sustained drug delivery: The extended-release capsule formulation provides consistent 24-hour blood levels, supporting stable symptom control and reducing peak-and-trough side effects associated with immediate-release formulations.
• Convenient once-daily dosing: This simplifies the treatment regimen for patients on long-term cardiovascular therapy, supporting better adherence over time.
• Trusted manufacturing standards: Diltiazone CD 90 is manufactured by Steris Healthcare, a WHO-GMP and ISO 9001:2018 certified pharmaceutical company, ensuring consistent potency and reliable extended-release performance across every batch.

Side Effects

Common side effects associated with Diltiazem Hydrochloride Extended Release include:

• Headache
• Dizziness or lightheadedness
• Peripheral edema (mild swelling of the ankles or feet)
• Flushing
• Fatigue
• Constipation
• Nausea
• Palpitations in some individuals

Most of these effects are mild to moderate and tend to occur more commonly during the initial weeks of therapy or following dose adjustments, often improving as the body adapts to treatment.

Precautions & Warnings

Before starting Diltiazone CD 90, patients and prescribers should consider the following precautions:

• Cardiac Conduction Disorders: Should be used with caution or avoided in patients with sick sinus syndrome, second- or third-degree AV block, unless a pacemaker is in place.
• Heart Failure: Should be used cautiously in patients with significantly reduced left ventricular function, given diltiazem's negative inotropic (contractility-reducing) effect.
• Hypotension: Caution is required in patients with a tendency toward low blood pressure, particularly when combined with other antihypertensive agents.
• Liver Impairment: Dose adjustment and closer monitoring are advised in patients with hepatic dysfunction, as diltiazem is primarily metabolized by the liver.
• Pregnancy and Lactation: Should only be used if clearly necessary and under medical supervision, with careful risk-benefit assessment.
• Elderly Patients: Increased sensitivity to blood pressure and heart rate effects warrants cautious dose titration.
• Drug Interactions: Caution is required when combining diltiazem with beta-blockers, digoxin, and certain statins, as diltiazem can increase blood levels of some co-administered medications through CYP3A4 enzyme inhibition; grapefruit juice should also be avoided, as it can increase diltiazem blood levels.
• Surgery: Patients undergoing major surgery should inform their anesthesiologist about ongoing diltiazem therapy.

Mechanism of Action 

Diltiazem Hydrochloride Extended Release 90mg exerts its therapeutic effects through selective inhibition of L-type calcium channels:

1. Blockade of L-Type Calcium Channels: Diltiazem selectively inhibits the influx of calcium ions through L-type calcium channels in both vascular smooth muscle and cardiac tissue, distinguishing it from dihydropyridine agents that act almost exclusively on vascular tissue.
2. Vascular Smooth Muscle Relaxation: By reducing calcium influx into vascular smooth muscle cells, diltiazem causes relaxation and widening of peripheral and coronary arteries, reducing systemic vascular resistance and improving coronary blood flow.
3. Reduced Cardiac Contractility (Negative Inotropic Effect): Diltiazem's action on cardiac muscle cells reduces the force of myocardial contraction, decreasing the heart's overall oxygen demand.
4. Slowed AV Nodal Conduction (Negative Dromotropic Effect): Diltiazem slows conduction through the atrioventricular (AV) node, which is the basis for its use in rate control of certain supraventricular arrhythmias.
5. Reduced Heart Rate (Negative Chronotropic Effect): Through its action on the sinoatrial node and cardiac conduction system, diltiazem produces a modest reduction in heart rate, complementing its blood-pressure-lowering effect.
6. Improved Coronary Blood Flow: By relaxing coronary artery smooth muscle, diltiazem is particularly effective in relieving coronary artery spasm, making it valuable in vasospastic (Prinzmetal's) angina.

This combined vascular and cardiac mechanism is what distinguishes diltiazem from other calcium channel blockers and explains its versatile role in the management of hypertension, chronic stable angina, and vasospastic angina.

Frequently Asked Questions (FAQ)

1. Where can I buy Diltiazem Hydrochloride online?
You can purchase Diltiazem Hydrochloride through licensed online pharmacies or authorized pharmaceutical suppliers. Verify the strength, formulation, manufacturer, batch number, expiry date, and packaging before purchasing.

2. What is the price of Diltiazem Hydrochloride?
The price may vary depending on the brand, strength, formulation, pack size, manufacturer, seller, and applicable pharmacy charges. Check the current listed price before ordering.

3. Can I order Diltiazem Hydrochloride online?
Yes, Diltiazem Hydrochloride can be ordered online where legally available. As a prescription cardiovascular medicine, a valid prescription may be required. Purchase only from a licensed pharmacy or authorized supplier.

4. Is Diltiazem Hydrochloride available from Steris Healthcare?
Availability depends on Steris Healthcare's current product range and stock status. Contact Steris Healthcare or an authorized distributor to confirm availability, strength, formulation, pack size, and ordering details.

5. What is Diltiazem Hydrochloride used for?
Diltiazem Hydrochloride is a calcium channel blocker used to treat conditions such as high blood pressure and certain types of angina. Depending on the formulation, it may also be prescribed for controlling certain abnormal heart rhythms.

6. What is the composition of Diltiazem Hydrochloride?
Diltiazem Hydrochloride contains Diltiazem Hydrochloride as the active pharmaceutical ingredient. The exact strength and inactive ingredients depend on the specific formulation.

7. Is a prescription required?
Diltiazem Hydrochloride should be used under the supervision of a qualified healthcare professional, and a prescription is generally required. The appropriate dose depends on the condition and formulation.

8. How should Diltiazem Hydrochloride be taken?
Take Diltiazem Hydrochloride exactly as prescribed by your doctor. Follow the recommended dose and schedule, and follow specific instructions for your formulation. Do not crush or chew modified-release formulations unless specifically instructed.

9. What should I know before buying Diltiazem Hydrochloride?
Before buying, verify the exact strength, formulation, manufacturer, batch number, expiry date, and storage instructions. Inform your doctor about low blood pressure, heart rhythm problems, heart failure, liver or kidney disease, pregnancy, and other medicines you take.

10. How can I order Diltiazem Hydrochloride online?
Order Diltiazem Hydrochloride through a licensed online pharmacy or authorized pharmaceutical supplier. Provide a valid prescription if required, select the prescribed formulation and strength, and verify the product and delivery details before completing your purchase.