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Cardizem

Cardizem
Cardizem is used for High blood pressure, Chest pain, Heart rhythm disorders and other conditions.

Brand: Diltiazem

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: September 2023
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Package Price Per pill Save Order
Cardizem 180 mg
270 pills - 180 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$241.97 $0.90 $351.94 Add to cart
180 pills - 180 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$177.93 $0.99 $218.01 Add to cart
120 pills - 180 mg
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$134.91 $1.12 $129.05 Add to cart
90 pills - 180 mg
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$113.91 $1.27 $84.06 Add to cart
60 pills - 180 mg $91.95 $1.53 $40.03 Add to cart
30 pills - 180 mg $65.99 $2.20 No Add to cart
Cardizem 120 mg
270 pills - 120 mg
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$231.55 $0.86 $146.18 Add to cart
180 pills - 120 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$162.95 $0.91 $88.87 Add to cart
120 pills - 120 mg
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$114.91 $0.96 $52.97 Add to cart
90 pills - 120 mg $91.93 $1.02 $33.98 Add to cart
60 pills - 120 mg $67.91 $1.13 $16.03 Add to cart
30 pills - 120 mg $41.97 $1.40 No Add to cart
Cardizem 60 mg
270 pills - 60 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$129.59 $0.48 $86.19 Add to cart
180 pills - 60 mg $94.67 $0.53 $49.18 Add to cart
120 pills - 60 mg $70.91 $0.59 $24.99 Add to cart
90 pills - 60 mg $59.97 $0.67 $11.96 Add to cart
60 pills - 60 mg $47.95 $0.80 No Add to cart

Product description

Therapeutic indications

Buy Cardizem in Canada

Tablets and retard tablets: prevention of angina attacks (including Prinzmetal) and supraventricular arrhythmias (paroxysmal, atrial fibrillation and atrial flutter, extrasystole), arterial hypertension.

Lyophilized powder for injection: treatment of angina attacks, prevention of spasm of coronary arteries during coronary angiography or coronary artery bypass grafting, paroxysmal ventricular tachycardia, arresting rapid ventricular rhythm with atrial fibrillation or flutter (except WPW syndrome).

Prevention of angina attacks (including Prinzmetal's angina), arterial hypertension.

Angina pectoris, hypertension, supraventricular arrhythmias.

Prevention and treatment of ischemic heart disease: angina pectoris (including spontaneous, mixed), postinfarction state, primary arterial hypertension.

Arterial hypertension, prevention of angina attacks and supraventricular arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, extrasystole).

What is Cardizem?

Drug Cardizem for the treatment of heart problems

Cardizem (diltiazem) is a calcium channel blocker. It works by relaxing the muscles in your heart and blood vessels.

Cardizem is used to treat hypertension (high blood pressure). It can be used alone or in combination with other high blood pressure medications.

Cardizem is also used to treat chronic stable angina (chest pain) and angina due to coronary artery spasm.

Dosage and administration

Tablets: inside, 3 times a day before meals and at night, 1 tab. If necessary, the daily dose is gradually (with an interval of 1-2 days) increased to 240 mg.

Retard tablets: inside, 1 tab. 2-3 times a day or 2 tables. 2 times a day.

Lyophilized powder for injection: IV slowly (within 2-3 minutes) at a dose of 300 mcg / kg body weight (possibly repeated after 30 minutes). Intravenous drip at a dose of 0.2–1 mg / min (2.8–14 μg / kg / min), but not more than 300 mg per day.

Inside, without chewing, tablets - 180 mg per day in 3 divided doses before meals. The maximum daily dose is 360 mg. Retard capsules - 1 capsule 1 time per day (200 or 300 mg, depending on the severity of angina pectoris or hypertension, as well as depending on tolerance). The timing of the capsule intake does not matter, but should remain the same.

Inside, 0.5–2 tab. 3 times a day (table. 60 mg) or 1-2 times a day (table. 120 mg). With supraventricular arrhythmias - 240-360 mg / day in 2 divided doses.

Inside, before meals, without chewing, with a little water. The dose is set individually. 1 table. 3 times a day. With insufficient severity of the therapeutic effect - up to 2 tablets. 3 times a day. The maximum daily dose is 360 mg.

Inside, with mild arterial hypertension: 1 caps. 1 time per day, with moderate arterial hypertension and angina pectoris: 1 caps. 2 times a day.

Inside, before meals, without chewing, with a little water. Tablets 60 mg - 1–2 table. 3 times a day.

Retard tablets - 1 tab. 2 times a day. The maximum daily dose is 360 mg.

In old age and with severe violations of liver and kidney function, the dose is reduced.

Inside, after eating, without chewing, drinking a sufficient amount of liquid, 60 mg 3 times a day; if necessary, the dose is increased to a maximum daily dose of 360 mg, divided into 2-3 doses. With long-term therapy (not less than 3-4 months) and provided that a good therapeutic effect is obtained, it is possible to reduce the dose under the supervision of the attending physician. Reduce the dose gradually before discontinuing Cardizem.


Contraindications for use

Severe bradycardia, AV block II and III degree (except for patients with a pacemaker), SSSU, cardiogenic shock, atrial fibrillation in WPW and Laun-Ganogh-Levin syndrome, myocardial infarction with congestion in the lungs, arterial hypotension, chronic heart failure stage IIB-III, acute heart failure, hemodynamically significant aortic stenosis, impaired liver and kidney function, pregnancy, lactation, hypersensitivity to benzothiazepine derivatives.

Application during pregnancy and lactation

Contraindicated for use during pregnancy and lactation (breastfeeding).

In experimental studies , the teratogenic effect of diltiazem has been established.

Application for violations of liver function

Contraindicated in violation of liver function. Use with caution in liver failure.

Application for impaired renal function

Contraindicated in impaired renal function. Use with caution in renal failure.

Use in children

Use with caution in children (efficacy and safety have not been studied).

Use in elderly patients

Use with caution in elderly patients.

Special instructions

Use with caution in AV blockade of the 1st degree, intraventricular conduction disorders, in patients prone to arterial hypotension, chronic heart failure, myocardial infarction with left ventricular failure, ventricular tachycardia with expansion of the QRS complex, liver failure, renal failure, in elderly patients age, in children (efficacy and safety of use have not been studied).

IV is used only for emergency treatment, but if necessary, it can be administered over several days. With the introduction of diltiazem, careful monitoring of the function of the cardiovascular system is necessary. Against the background of regular intake of beta-blockers, the indications for intravenous administration of diltiazem should be strictly clarified and used only after ECG monitoring in the intensive care unit, while taking into account the possible need to use a pacemaker.

The simultaneous use of beta-blockers and diltiazem for parenteral administration is not recommended.

Sudden withdrawal of diltiazem can lead to the development of an anginal attack.

Patients with impaired liver and / or kidney function and the elderly require dosage adjustment.

Drug interaction

With simultaneous use with beta-blockers (including propranolol, atenolol, metoprolol, pindolol, sotalol), an additive cardiodepressant effect is possible along with an increase in antianginal action in most patients. Patients with preexisting left ventricular dysfunction or conduction abnormalities are at increased risk of severe and threatening bradycardia.

Diltiazem inhibits the metabolism of propranolol, metoprolol, but not atenolol.

With simultaneous use with amiodarone, the negative inotropic effect, bradycardia, conduction disturbances, AV blockade are enhanced.

Since diltiazem inhibits the isoenzyme CYP3A4, which is involved in the metabolism of atorvastatin, lovastatin and simvastatin, drug interactions are theoretically possible due to an increase in plasma concentrations of statins. Cases of the development of rhabdomyolysis are described.

With simultaneous use with buspirone, the concentration of buspirone in the blood plasma increases, its therapeutic and side effects are enhanced.

With simultaneous use with vecuronium chloride, an increase in the duration of neuromuscular blockade is possible.

With simultaneous use with digoxin, digitoxin, an increase in the concentration of digoxin and digitoxin in blood plasma is possible.

With simultaneous use with imipramine, the concentration of imipramine in the blood plasma increases and there is a risk of developing unwanted changes on the ECG.

Cases of increased plasma concentrations of trimipramine and nortriptyline with simultaneous use with diltiazem have been described.

Diltiazem increases the bioavailability of imipramine by decreasing its clearance. Changes in the ECG are due to an increase in the concentration of imipramine in the blood plasma and the additive inhibitory effect of diltiazem and imipramine on AV conduction. It is believed that diltiazem interacts in the same way with trimipramine and nortriptyline.

With simultaneous use with insulin, a case of a decrease in the effectiveness of insulin has been described.

Due to the inhibition of the metabolism of anticonvulsants in the liver under the influence of diltiazem and a decrease in their clearance from the body, it is possible to increase the concentration of carbamazepine and phenytoin in the blood plasma with the risk of developing toxic effects.

With simultaneous use with lithium carbonate, cases of the development of acute parkinsonism syndrome, psychosis have been described.

With simultaneous use with midazolam, triazolam, the concentration of midazolam and triazolam in the blood plasma increases and their effects are enhanced due to the inhibition of the CYP3A4 isoenzyme under the influence of diltiazem, with the participation of which these benzodiazepines are metabolized.

When used simultaneously with sodium amidotrizoate, the antihypertensive effect of diltiazem may be enhanced.

With simultaneous use with sodium nitroprusside, a significant increase in efficiency is possible with controlled arterial hypotension.

With simultaneous use with nifedipine, the antihypertensive effect is enhanced.

Rifampicin induces the activity of liver enzymes, accelerating the metabolism of diltiazem, which leads to a decrease in its effectiveness.

With simultaneous use with theophylline, a slight decrease in the metabolism of theophylline in the liver is possible, apparently due to inhibition of the CYP1A2 isoenzyme under the influence of diltiazem.

With simultaneous use with cisapride, a case of impaired consciousness has been described, apparently due to a pronounced prolongation of the QT interval. It is believed that diltiazem inhibits the activity of the isoenzyme CYP3A4, which leads to an increase in the concentration of cisapride in the blood plasma and, possibly, to an increase in its cardiotoxicity.

With simultaneous use, diltiazem inhibits the metabolism of cyclosporine in the liver, which leads to a decrease in its excretion and an increase in plasma concentration. At the same time, a decrease in the manifestations of nephrotoxicity and an increase in the immunosuppressive effect were noted.

With simultaneous use with cimetidine, the concentration of diltiazem in the blood plasma increases due to the inhibition of its oxidative metabolism in the liver under the influence of cimetidine. The effects of diltiazem may be enhanced.

With simultaneous use with enflurane, cases of violation of the AV conduction of the myocardium have been noted.


Cardizem side effects

Get emergency medical help if you have signs of an allergic reaction to Cardizem: hives; Labored breathing; Swelling of the face, lips, tongue, or throat.

Call your doctor at once if you have:

  • slow heartbeats;
  • Pounding heartbeats or fluttering in your chest;
  • Frivolous feeling like you might disappear;
  • Heart problems - shortness of breath (even with mild exertion), swelling, rapid weight gain;
  • Iver problems - nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or a
  • severe skin reaction - fever, sore throat, swelling in your face or tongue, burning eyes, skin pain accompanied by a red or purple skin rash that spreads (especially on the face or upper body) and causes blistering and peeling.

Common Cardizem side effects may include:

  • Dizziness, weakness;
  • Headache;
  • nausea; or a
  • rash.

This is not a complete list of side effects and others may arise. Ask your doctor about side effects.