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Indications:

Angina pectoris,Hypertension,Cardiac arrhythmias

Contraindications:

Sick-sinus syndrome; 2nd or 3rd ° AV block; porphyria. Severe congestive cardiac failure; marked bradycardia. Pregnancy and lactation.

Adverse reactions:

Headache, ankle oedema, hypotension, dizziness, fatigue, flushing, nausea, GI discomfort, gingival hyperplasia, rashes, erythema multiforme, exfoliative dermatitis, photosensitivity, occasionally hepatitis. Potentially Fatal: AV block, bradycardia, asystole, sinus arrest.

Interactions:

Increases serum theophylline levels. Cimetidine may increase plasma concentrations of diltiazem. Concurrent use may lead to increased blood ciclosporin levels. Potentially Fatal: Increased depression of cardiac conduction with amiodarone, β-blockers, digoxin and mefloquine. May potentiate risk of bradycardia and conduction disturbance of propranolol and risk of neurotoxicity of lithium. Food Interaction Serum levels may be elevated if taken with food.

Warnings:

Elderly. Hepatic or renal impairment; impaired left ventricular function; prolonged AV periods; DM; hypotension. Avoid abrupt withdrawal and long-term use. Patients with sick-sinus syndrome, preexisting AV block, bradycardia and those taking beta-blockers or digitalis are at risk of developing AV block, bradycardia, asystole or sinus arrest. pregnancy: Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

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