diltiazem

Adult Dosing .

Dosage forms:  ER CAP (12h): 60 mg, 90 mg, 120 mg; ER CAP (24h): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg; TAB: 30 mg, 60 mg, 90 mg, 120 mg; ER TAB (24h): 120 mg, 180 mg, 240 mg, 300 mg, 360 mg, 420 mg; INJ: various

angina, chronic stable

[immediate-release form]

Dose: 180-360 mg/day PO divided q6-8h; Start: 30 mg PO qid, may incr. dose q1-2 days; Max: 360 mg/day

[24h extended-release form]

Dose: 120-480 mg ER PO qd; Start: 120-180 mg ER PO qd, titrate over 7-14 days; Max: 540 mg/day ER; Info: may open ER cap, but do not crush/chew/dissolve contents; do not cut/crush/chew ER tab

angina, vasospastic

[immediate-release form]

Dose: 180-360 mg/day PO divided q6-8h; Start: 30 mg PO qid, may incr. dose q1-2 days; Max: 360 mg/day

[24h extended-release form]

Dose: 120-480 mg ER PO qd; Start: 120-180 mg ER PO qd, titrate over 7-14 days; Max: 540 mg/day ER; Info: may open ER cap, but do not crush/chew/dissolve contents; do not cut/crush/chew ER tab

HTN

[12h extended-release form]

Dose: 120-180 mg ER PO bid; Start: 60-120 mg ER PO bid, may adjust dose q2wk; Max: 360 mg/day ER; Info: do not open/dissolve ER cap

[24h extended-release form]

Dose: 120-480 mg ER PO qd; Start: 120-240 mg ER PO qd, may adjust dose q2wk; Max: 540 mg/day ER; Info: may open ER cap, but do not crush/chew/dissolve contents; do not cut/crush/chew ER tab

atrial fibrillation/flutter

[immediate rate control]

Dose: 5-15 mg/h IV for up to 24h; Start: 0.25 mg/kg/dose IV x1, may give additional 0.35 mg/kg/dose IV x1 after 15min if inadequate response, then 5-15 mg/h IV

[maintenance rate control (off-label)]

Dose: 120-360 mg/day PO divided q6-8h; Start: 60 mg PO tid; Alt: 120-360 mg ER PO qd; Max: 360 mg/day; Info: may open ER cap, but do not crush/chew/dissolve contents; do not cut/crush/chew ER tab

PSVT conversion

[5-15 mg/h IV for up to 24h]

Start: 0.25 mg/kg/dose IV x1, may give additional 0.35 mg/kg/dose IV x1 after 15min if inadequate response, then 5-15 mg/h IV

pulmonary arterial HTN (off-label)

[12h extended-release form]

Dose: 120-360 mg ER PO bid; Start: 60 mg ER PO bid; Info: for pts w/ positive vasoreactivity test; do not open/dissolve ER cap

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[see below]

mild-moderate impairment: no adjustment; severe impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  ER CAP (12h): 60 mg, 90 mg, 120 mg; TAB: 30 mg, 60 mg, 90 mg, 120 mg

HTN (off-label)

[1.5-2 mg/kg/day PO divided tid-qid]

Max: 3.5 mg/kg/day

pulmonary arterial HTN (off-label)

[immediate-release form]

Dose: 3-5 mg/kg/day PO divided tid; Start: 0.5-0.7 mg/kg/dose PO tid; Max: 360 mg/day; Info: for pts w/ positive vasoreactivity test

[12h extended-release form]

Dose: 3-5 mg/kg/day ER PO divided bid; Start: after establishing effective dose w/ IR form; Max: 360 mg/day ER; Info: for pts w/ positive vasoreactivity test; do not open/dissolve ER cap

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[not defined]

hepatic impairment: consider adult hepatic dosing for guidance