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AI-Generated response:

Are there any food or drug interactions to Cardizem?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Yes, there are food and drug interactions with Cardizem (diltiazem hydrochloride), particularly with CYP3A4 inducers such as barbiturates which can significantly decrease the bioavailability of Cardizem.

  • Cardizem is a substrate of the CYP3A4 enzyme system, and coadministration with CYP3A4 inducers like barbiturates can lead to decreased levels and efficacy of Cardizem.[1-5]

  • When using Cardizem with barbiturates, alternative therapies should be considered, or close monitoring of cardiovascular effects is recommended if no alternatives are available.[1-5]

  • Diltiazem also interacts with benzodiazepines, increasing their effects, which may require dosage adjustments.[6-7]

  • Concomitant use of diltiazem with drugs affecting cardiac contractility and conduction, such as beta-blockers or digitalis, may have additive effects on AV conduction.[6-7]

  • Food interactions specifically are not highlighted in the provided sources, but general caution is advised when diltiazem is taken with other medications due to its broad interaction profile.

Additional info

It's important to note that diltiazem's interaction with CYP3A4 inducers can significantly impact its therapeutic effectiveness, potentially requiring adjustments in dosing or even the consideration of alternative treatments. This interaction underscores the necessity of careful medication review and management in patients prescribed Cardizem, especially in those with complex medication regimens or those who are on medications for chronic conditions that might also involve CYP3A4 substrates or inducers. Monitoring clinical responses and side effects closely is crucial when there is an unavoidable necessity to coadminister these drugs. Additionally, the interaction with benzodiazepines suggests a need for vigilance regarding CNS effects, such as prolonged sedation, which could affect patient safety and quality of life.

References

Reference 1

1.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Interactions Cardizem: (Major) Cardizem is a CYP3A4 substrate. Coadministration of Cardizem with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Reference 2

2.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Interactions Cardizem: (Major) Cardizem is a CYP3A4 substrate. Coadministration of Cardizem with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Interactions Cardizem LA: (Major) Cardizem LA is a CYP3A4 substrate. Coadministration of Cardizem LA with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem LA. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Reference 3

3.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Interactions Cardizem: (Major) Cardizem is a CYP3A4 substrate. Coadministration of Cardizem with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Reference 4

4.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Interactions Cardizem: (Major) Cardizem is a CYP3A4 substrate. Coadministration of Cardizem with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Reference 5

5.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Interactions Cardizem: (Major) Cardizem is a CYP3A4 substrate. Coadministration of Cardizem with known CYP3A4 inducers, such as barbiturates, may significantly decrease the bioavailability of Cardizem. When possible, avoid coadministration of these drugs and consider alternative therapy. When an alternative therapy is not possible, patients should be monitored for the desired cardiovascular effects on heart rate, chest pain, or blood pressure.

Reference 6

6.

Food and Drug Administration (DailyMed).

Publish date: April 4, 2020.

Drug Interactions Drug Interactions Because of the potential for additive effects, slow titration is warranted in patients receiving Cardizem CD (diltiazem hydrochloride) concomitantly with other agents known to affect cardiac contractility and/or conduction (see WARNINGS ). Pharmacologic studies indicate that there may be additive effects in prolonging AV conduction when using beta-blockers or digitalis concomitantly with Cardizem CD (diltiazem hydrochloride) (see WARNINGS ). Diltiazem is both a substrate and an inhibitor of the cytochrome P450 3A4 enzyme system. Other drugs that are specific substrates, inhibitors, or inducers of this enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem. Patients taking other drugs that are substrates of CYP450 3A4, especially patients with renal and/or hepatic impairment, may require dosage adjustment when starting or stopping concomitantly administered diltiazem in order to maintain optimum therapeutic blood levels. Anesthetics: The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with anesthetics may be potentiated by calcium channel blockers. When used concomitantly, titrate anesthetics and calcium blockers slowly. Benzodiazepines: Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3- to 4-fold and the C max by 2-fold, compared to placebo. The elimination half-life of midazolam and triazolam also increased (1.5- to 2.5-fold) during coadministration with diltiazem. These pharmacokinetic effects seen during diltiazem coadministration can result in increased clinical effects (e.g., prolonged sedation) of both midazolam and triazolam.

Reference 7

7.

Food and Drug Administration (DailyMed).

Publish date: June 2, 2020.

Drug Interactions Drug Interactions Due to the potential for additive effects, caution and careful titration are warranted in patients receiving Cardizem (diltiazem hydrochloride) concomitantly with any agents known to affect cardiac contractility and/or conduction (see WARNINGS ). Pharmacologic studies indicate that there may be additive effects in prolonging AV conduction when using beta-blockers or digitalis concomitantly with Cardizem (diltiazem hydrochloride) (see WARNINGS ). As with all drugs, care should be exercised when treating patients with multiple medications. Diltiazem is both a substrate and an inhibitor of the cytochrome P450 3A4 enzyme system. Other drugs that are specific substrates, inhibitors, or inducers of this enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem. Patients taking other drugs that are substrates of CYP450 3A4, especially patients with renal and/or hepatic impairment, may require dosage adjustment when starting or stopping concomitantly administered diltiazem in order to maintain optimum therapeutic blood levels. Anesthetics: The depression of cardiac contractility, conductivity, and automaticity, as well as the vascular dilation associated with anesthetics, may be potentiated by calcium channel blockers. When used concomitantly, anesthetics and calcium blockers should be titrated carefully. Benzodiazepines: Studies showed that diltiazem increased the AUC of midazolam and triazolam by 3- to 4-fold and the C max by 2-fold, compared to placebo.

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