Dilzem Dosage/Direction for Use

ORAL: Ischemic Heart Disease (Exertional Angina Pectoris Due to Atherosclerotic Coronary Artery Disease or Angina Pectoris at Rest Due to Coronary Artery Spasm): The initial dose is 120 mg/day in equally divided doses, administered preferably before meals, and at bedtime; dosage should be increased gradually in equally divided doses (two to four times daily) at 1- to 2-day intervals until optimum response is obtained. The optimum dosage range appears to be 180 mg/day to 360 mg/day. Doses up to 480 mg/day may be administered in some cases.
Hypertension: Dosages must be adjusted to each patient's needs.
The initial dose is 120 mg/day to 240 mg/day in equally divided doses, administered preferably before meals, and at bedtime. Maximum antihypertensive effect is usually observed at 14 days of chronic therapy; therefore, dosage adjustments should be scheduled accordingly. The usual dosage range is 240 mg/day to 360 mg/day.
There is an additive antihypertensive effect when diltiazem is used with other antihypertensive agents. Therefore, the dosage of diltiazem or the concomitant antihypertensive(s) may need to be adjusted when adding one to the other.
Kidney Transplantation: The initial dose is 120 mg/day in two equally divided doses. Depending on the patient's blood pressure, dosage may be increased up to a maximum of 360 mg/day given in three equally divided doses. The optimum dosage range appears to be 180 mg/day to 360 mg/day.
Concomitant Use With Other Cardiovascular Agents: Nitroglycerin Therapy: Sublingual nitroglycerin (NTG) may be taken as required to abort acute anginal attacks during diltiazem therapy.
Prophylactic Nitrate Therapy: Although there have been no controlled studies to evaluate the antianginal effectiveness of this combination, diltiazem may be co-administered with short- and long-acting nitrates.
SPECIAL POPULATIONS: Use in Renal Impairment: There are no available data concerning dosage requirements in patients with impaired renal function. If the drug must be used in such patients, titration should be done cautiously.
Use in Hepatic Impairment: There are no available data concerning dosage requirements in patients with impaired hepatic function. If the drug must be used in such patients, titration should be done cautiously.
Use in Children: Safety and effectiveness in children have not been established.