Diltiazem (Cardizem) - Thoughts/Experiences

My cardiologist switched me from Metropolol to Cardizem today. (Mostly for rate control during AF I think.)

Any thoughts on Diltiazem (Cardizem)? What has your experience been with it? Did it help your afib (or fast pulse during afib) at all? Any side effects that you experienced? Do you know if this can be taken as a pill in the pocket?



Edited 1 time(s). Last edit at 02/04/2020 09:50PM by cirenepurzalot.

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cirenepurzalot
My cardiologist switched me from Metropolol to Cardizem today. (Mostly for rate control during AF I think.)

Any thoughts on Diltiazem (Cardizem)? What has your experience been with it? Did it help your afib (or fast pulse during afib) at all? Any side effects that you experienced? Do you know if this can be taken as a pill in the pocket?

Doubtful that it would prevent Afib, but yes, it should control high heart rate during an episode—the trick is getting g the right dose so that your HR and BP don’t go too low. I took it as a pill in the pocket—though I no longer take it as I am on an antiarrythmic.

Thanks Daisy! I appreciate it.

There is the extended release version, and then the short acting also. If you take the extended release form at the onset of an AFIB episode, it will take a while to start working, so having some immediate release pills available for recent onset AFIB is best, but if you are new to using this drug, one should titrate up on the dosage to figure out how much you need, and prevent over medicating.

Also, if you think you likely have Vagally Mediated AFIB, then you should discontinue the Cardizem after NSR is restored.

Thank you! I think they gave me extended release, but maybe I'll ask for immediate. And, thanks for the vagal-af tip!!!

Ask for the 60mg immediate release tablets. They are scored, so you can break them in half. The 120mg tablets are not scored. The most I ever took at one time was 60mg, which was right after onset of an AFIB episode. After that I take them 15-30mg as needed to bring my AFIB HR down in the 70's, which is in the range of my normal NSR HR, as I am the least Symptomatic, when I bring my HR down in this range of 70-82. After my HR stabilized, I would then add 120mg extended release every 18 hours. The extended release is good for sleeping over-night. If the Cardizem does not bring your HR down enough with a moderate dose, then you might consider adding a low dose of a Cardio-Selective Beta-Blocker, like Bystolic taken at 2.5 - 5mg every 12 hours. Each person is different, but I have found that after over 60 episodes taking these Drugs PIP, that this combo works best for me. Other veteran Afibbers, like Moderator-Shannon have also recommended this protocol. It's very unlikely your Doctor will be able to prescribe the exact proper dose at least initially. Be prepared to self-regulate yourself, and monitor your AFIB HR, and BP. Also if you are going to get Electro-Cardioverted, ease off of these Drugs 6-8 hours prior to the procedure, as they suppress the strength of the electrical impulses traveling through the Atria/AV Node to the Ventricles, which you don't want right after NSR is restored. This I would definitely discuss this aspect with your Dr. who would be doing the ECV.

The advantage to these Drugs like Cardizem and Bystolic compared to Metropolol, is that they are less likely to cause sedation, in addition to being a better choice for Vagal Afibbers.

Hope this helps.



Edited 4 time(s). Last edit at 02/06/2020 02:18AM by The Anti-Fib.

Thank you so much for taking the time to write such an informative and detailed post! I really appreciate it.

One small caveat - for me as a vagal afibber (and for others if I recall correctly) diltiazem as rate control (acute during AF attack) predisposed the AF to reorganise to AFlutter.

Thanks. Stupid question: Is that better or worse?

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mwcf
One small caveat - for me as a vagal afibber (and for others if I recall correctly) diltiazem as rate control (acute during AF attack) predisposed the AF to reorganise to AFlutter.

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mwcf
One small caveat - for me as a vagal afibber (and for others if I recall correctly) diltiazem as rate control (acute during AF attack) predisposed the AF to reorganise to AFlutter.

Were you on Flecainide? That sounds like effects of Flec.

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cirenepurzalot
Thanks. Stupid question: Is that better or worse?


One small caveat - for me as a vagal afibber (and for others if I recall correctly) diltiazem as rate control (acute during AF attack) predisposed the AF to reorganise to AFlutter.

Unless your Flutter rate was real high, I would think Flutter is a step in the right direction, as it is usually easier to convert into NSR from Flutter, vs AFIB, in addition to being less Symptomatic.

Yeah they gave me Diltiazem CD 120mg. I think that's extended release?

CD stands for Controlled Release, as far as I can tell, different brands of Cardizem use different terminology to describe the same thing, I think it is basically the same as XT (extended release). You should ask for Diltiazem HCL 60mg.

Thanks!

Has anyone taken eliquis with diltiazem cd?

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cirenepurzalot
Has anyone taken eliquis with diltiazem cd?

Millions of people. That's an extremely common combination. If you're worried about interactions there shouldn't be any.

Thanks. I was just worried because drugs.com said

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Diltiazem may increase the blood levels of apixaban, which may result in a higher risk of bleeding complications.

Edited 1 time(s). Last edit at 02/13/2020 08:49PM by cirenepurzalot.

The key word there is "may." The combination is very common and doesn't usually cause any problems.

Thanks!!