A non-dihydropyridine member of calcium channel blockers, used in the treatment of hypertension, angina pectoris, and some types of arrhythmia.

A class 3 anti-anginal drug, and a class IV antiarrhythmic.

Metabolized by and acts as an inhibitor of the CYP3A4 enzyme.

Has an oral bioavailability of 40%, and a half-life of 3-4.5 hours.

An effective preventive medication for migraine.

A potent vasodilator, increasing blood flow and variably decreasing the heart rate via strong depression of A-V node conduction.

Potent vasodilator of coronary vessels.

Vasodilator of peripheral vessels, reducing peripheral resistance and afterload.

Has a negative inotropic effect causing a modest decrease in heart muscle contractility and reduces myocardium oxygen consumption.

Has a negative chronotropic effect with a modest lowering of heart rate due to slowing of the SA (sinoatrial) node, and as a result reduces myocardium oxygen consumption.

Slow conduction through the AV node, increasing time for each cardiac beat, thus reducing myocrdial oxygen sonsumption.

Side effects include: hypotension, bradycardia, dizziness, and flushing.

Indications include: stable angina, variant angina, unstable angina, supraventricular tacchycardias, atria fibrillation or flutter, and hypertension.

Precautionary use in patients with reduced ventricular function as inotropic and chronotropic effects may increase cardiac compensation.

Use should be avoided in patients with SA or AV nodal abnormalities, because of its negative chronotropic and dromotropic effects and in patients with systolic blood pressures below 90 mm Hg.

May paradoxically increase ventricular rate in patients with WPW syndrome because of accessory conduction pathways.

Relatively contraindicated in sick sinus syndrome, atrioventricular node conduction disturbances, bradycardia, impaired left ventricle function, peripheral artery occlusive disease, and chronic obstructive pulmonary disease.

Should be used with caution with beta-blockers because, as the combination may be associated with dysrhythmia and AV node block.

Should not be used concurrently with quinidine because of reduced clearance of both drugs and potential pharmacodynamic effects at the SA and AV nodes.

Used in the treatment of anal fissures orally or applied topically.

In elderly patients with atrial fibrillation, receiving apoxaban or rivaroxaban, diltiazem was associated with greater risk of serious bleeding then meta-prolol, particularly for diltiazem doses exceeding 120 mg per day. (Ray WA): diltiazem inhibits Apixaban in rivaroxiban elimination.

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