Before taking this medication, tell your doctor if you have

· ever had an allergic reaction to any form of diltiazem in the past;
· kidney disease;
· liver disease; or
· other diseases of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, congestive heart failure, heart block, low blood pressure, or coronary artery disease.

You may not be able to take diltiazem, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Diltiazem is in the FDA pregnancy category C. This means that it is not known whether diltiazem will be harmful to an unborn baby. Do not take diltiazem without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Diltiazem passes into breast milk and may affect a nursing infant. Do not take diltiazem without first talking to your doctor if you are breast-feeding a baby.

How should I take diltiazem?

Take diltiazem exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Do not open, break, crush, or chew any extended-release forms of diltiazem such as Cardizem CD, Cardizem LA, Cardizem SR, Diltia XT, or Dilacor XR. Swallow them whole.

If swallowing is difficult, the Tiazac capsules may be opened and the contents sprinkled onto a spoonful of applesauce. The applesauce should be swallowed immediately, without chewing, and followed with a glass of water to ensure complete swallowing of the capsule contents. The applesauce should not be hot and should be soft enough to enable swallowing without chewing. The mixture must be consumed immediately and not stored for later use.

Dilacor XR and Diltia XT should be taken in the morning on an empty stomach.

It is important to take diltiazem regularly to get the most benefit.

Do not stop taking this medication without first talking to your doctor. If you stop taking the medication, your condition could become worse.

Your doctor may want you to have blood tests, blood pressure monitoring, or other medical evaluations during treatment with diltiazem to monitor progress and side effects.

Store diltiazem at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a diltiazem overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

What should I avoid while taking diltiazem?

Use caution when driving, operating machinery, or performing other hazardous activities. Diltiazem may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while taking diltiazem.

Follow any recommendations your doctor makes about diet or exercise.

What are the possible side effects of diltiazem?

If you experience any of the following serious side effects, stop taking diltiazem and contact your doctor immediately or seek emergency medical treatment:

· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
· unusually fast or slow heartbeats;
· severe dizziness or fainting;
· abnormal behavior or psychosis;
· jaundice (yellowing of the skin or eyes); or
· swelling of the legs or ankles.

Other, less serious side effects may be more likely to occur. Continue to take diltiazem and talk to your doctor if you experience

· fatigue or tiredness;
· headache;
· flushing (redness);
· insomnia and vivid dreams;
· nausea, diarrhea, or constipation;
· difficulty urinating;
· numbness; or
· a rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diltiazem?

Before taking this medication, tell your doctor if you are taking any of the following medicines:

· other medicines to treat the same or another heart condition;
· cyclosporine (Sandimmune, Neoral);
· cimetidine (Tagamet, Tagamet HB);
· carbamazepine (Tegretol);
· digoxin (Lanoxin);
· midazolam (Versed) or triazolam (Halcion); or
· rifampin (Rifadin, Rimactane) or rifabutin (Mycobutin).

You may not be able to take diltiazem, or you may require a dosage adjustment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with diltiazem or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.