Hello,

I have to stop Atacand, I feel so tired and sleepy. I have tried Norvasc with no effect on my BP and also no side effects so I want try another CCB, I heard a lot of Med in that group like Diltiazim, Cardizem SR and others. So anyone on CCB could tell me about the good ones and the starting dosage.

my blood pressure was well controlled on Zebeta 5mg then I switched to Cozaar 50 and still good and now with Atacand 8 mg it's good too so my blood pressure responses to Meds good.
Thanks,
Michael

They are so different, Mike.
The best approach is for you to work your way through the three that are generics and have been around the longest.
They are: verapamil, diltiazem and nifedipine. From the name, the nifedipine is most likely closest to the amlodipine (Norvasc.)
I've tried only one: Norvasc...HATED it!

Thanks Lenin,

Could you tell me the diltiazim dosage please? I will go for the SR which is called Cardizem SR, it's the same as diltiazim but extend form right?

I heard it's not save to take it in my age?
Thanks again, I don't know what to say :). You help me soooooooooo much
Michael

Thanks Lenin,

Could you tell me the diltiazim dosage please? I will go for the SR which is called Cardizem SR, it's the same as diltiazim but extend form right?

I heard it's not save to take it in my age?
Thanks again, I don't know what to say :). You help me soooooooooo much
Michael
Hi Mike,
Thought maybe I could help since I've been on diltiazem on and off for a long time.
Yes, Diltiazem SR (generic) is the same as Cardizem SR. It also comes in another brand name, Tiazac.
The doses are 120, 180, 240. You may feel some side effects at first (though I didn't) but they will probably go away.
Hope this helps,
Cass

Hello Cass,

Thanks :), yes you are really helping me. In Egypt, we have 90, 120 and 180 mg of the SR brand (I think it's the extended release but I don't know what SR stands for) so I'm confused. I don't know which one to start with, so what do you suggest?
Thanks,
Michael

Hello Cass,

Thanks :), yes you are really helping me. In Egypt, we have 90, 120 and 180 mg of the SR brand (I think it's the extended release but I don't know what SR stands for) so I'm confused. I don't know which one to start with, so what do you suggest?
Thanks,
Michael
SR = slow release (I think)
Cass

It's confusing, Mike.
Here's what's available at the most popular of the United States online providers:

Cardizem
• Cardizem 30mg, Tablets
• Cardizem 60mg, Tablets
• Cardizem 90mg, Tablets
• Cardizem 120mg, Tablets

Cardizem CD
• Cardizem CD 30 300mg 24 Hour Capsule, Bottle
• Cardizem CD 120mg, 24 Hour Capsule
• Cardizem CD 180mg, 24 Hour Capsule
• Cardizem CD 240mg, 24 Hour Capsule
• Cardizem CD 360mg, 24 Hour Capsule

Cardizem LA
• Cardizem LA 120mg, 24 Hour Tablets
• Cardizem LA 180mg, 24 Hour Tablets
• Cardizem LA 240mg, 24 Hour Tablets
• Cardizem LA 300mg, 24 Hour Tablets
• Cardizem LA 360mg, 24 Hour Tablets
• Cardizem LA 420mg, 24 Hour Tablets

Cardizem SR
• Cardizem SR 90mg, 12 Hour Capsule
• Cardizem SR 120mg, 12 Hour Capsule

Diltiazem HCl
• Diltiazem HCl 30mg, Tablets
• Diltiazem HCl 60mg, Tablets
• Diltiazem HCl 90mg, Tablets
• Diltiazem HCl 120mg, Tablets

What I surmise is that the Diltiazen is only available as a fast acting formulation but the Cardizem is available as SR (Slow Release?,) LA (presumably long acting but how this differs from SR, who knows)...and CD I don't have a clue on what that means...(plays music, perhaps???) :D.

I DO know that the Cardizem costs 6 to 8 times as much as the diltiazem.

I'd try the diltiazem 60's to start...maybe twice a day if necessary. THen adjust up or down depending on results and side effects.

It's confusing, Mike.
Here's what's available at the most popular of the United States online providers:



What I surmise is that the Diltiazen is only available as a fast acting formulation but the Cardizem is available as SR (Slow Release?,) LA (presumably long acting but how this differs from SR, who knows)...and CD I don't have a clue on what that means...(plays music, perhaps???) :D.

I DO know that the Cardizem costs 6 to 8 times as much as the diltiazem.

I'd try the diltiazem 60's to start...maybe twice a day if necessary. THen adjust up or down depending on results and side effects.
You can get the generic in the SR. I'm sure because I've used it in the past.
But it's a huge capsule that would choke a horse :D

Cass,

I looked harder and was able to find a Diltaiazem HCL CR which is a 12 hour formulation at about $ .60 a pill in the 90 mg. Unfortunately the 90 mg. costs 3 times as much as the plain 90's.

I see that the LA is the only 24 hour formulation.

Tiazac is expensive but maybe the best form. There's a generic equivalent to Tiazac,
but I can't remember the name. Both are long lasting or extended release once-a-day. Cardizem CD is also close to the same thing. In any case I'd start with the 180 and work up to the 300 if necessary. The higher doses do work significantly better, but never take more than you can get by on.

The cost is not an issue because those CCBs are not expensive in Egypt. I'm more confused than before :) lol. But let me see what I understand here, I'm sure that we have Cardizem SR 90mg and Cardizem SR 120mg 12 Hour Capsule but I don't know which one to start with because I'm afraid to take the 180mg in the first day.

So I will check if we have Cardizem CD 120mg, 24 Hour Capsule and if I didn't I will start with 2 x 90mg Cardizem SR or 1 120mg Cardizem SR?????

I hope that we have that Cardizem CD which last for 24 hours because I don't like to take the med twice daily.
It's really confusing :). Thanks all for help, I really can't thank you enough though.
Michael

Mike,
I understand your fear, I'm the worst baby you ever saw when it comes to new medication- but- there really isn't that much difference in the 120 and 180 as far as side effects. The 180 just seems to last longer.
Question - can you just buy meds there without a RX?
Cass

Cass,

I looked harder and was able to find a Diltaiazem HCL CR which is a 12 hour formulation at about $ .60 a pill in the 90 mg. Unfortunately the 90 mg. costs 3 times as much as the plain 90's.

I see that the LA is the only 24 hour formulation.
Ok I'll take your word for it. It's been a couple of years since I took the generic.
Now I'm as confused as Mike. :confused: It appears that diltiazem comes with it's very own alphabet. I just checked my tiazac downstairs and it's tiazac SA?

SA, CD, LA, SR? Could they all be different. I thought my Tiazac and the generic form I took were all the 24 hr ones.

Lenin,
OK- I looked it up and SA is sustained action. How do you find out if it's a 12 or 24 hour?
Cass

Tiazac is expensive but maybe the best form. There's a generic equivalent to Tiazac,
but I can't remember the name. Both are long lasting or extended release once-a-day. Cardizem CD is also close to the same thing. In any case I'd start with the 180 and work up to the 300 if necessary. The higher doses do work significantly better, but never take more than you can get by on.
I like Tiazac the best too. I had the option of the generic you are talking about (tztia? something like that) But my doc perferred the brand and it only cost $3 a month more
I take Tiazac SA 180.
Sorry I mentioned the ARB - heart attack stuff, lol,but I take an ACEI and every time I get a sore throat I think I'm having an allergic reaction.
Cass

On diltiazem, I don't see any point in taking anything but the sustained or extended release once a day version. Apparentlly the more sustained--slow and constant--the release, the less the danger. The ARB and heart attack issue I'd like to more about.
The good thing about ARBs is th at they are so side effect free. The bad side is they don't work that well (especially for the money). The bad side would get a lot badder if it were clear they are actually dangerous. As far as I can tell, my health depends on these stupid pills...

hello all,

Thanks for helping me, I don't know what are RX Cass :).Anyway, I can go to the Pharmacy and get whatever med I want without a doctor. Today I started 90mg of the SR brand and I hope it will be effective. I will take another one after 12 hours.

I have read something that makes me :( "Ditiazem SR may cause depression of artioventricular nodal conduction and bradycardia" what this means?

Thanks again,
Michael

Hello pal,

I have been on Cozaar 50mg then switched on Atacand 8mg and you know what both controlled my Blood Pressure more than Ziac 5mg but I couldn't tolerate thier side effects. After I take an ARB by one hour I feel like I'm a dead man walking in the house :(, I feel so tired and sleepy and I have to sleep more 4 hours plus the 8 that I already sleep. I couldn't do it with ARBs and for me they were no side effects free, I'm not sure but maybe because my body responded very well to them I got those side effects???

Thanks,
Michael

I forgot to ask, is there any drug interaction between Diltiazim SR and other meds?
Thanks,
Michael

Michael,

Can you just go into a pharmacy in Egypt and buy what you want without going through the nonsense of a doctor's visit and prescription (like Mexico?) If so, I am moving to Cairo...make that Alexandria (I like the beach!) :D:D

If that's all that's needed, just go in and pick up some non-time release 60's and take one or two a day and see what it does for and TO you. Monitor your BP and you'll soon enough see if you have peaks and troughs and want time release instead. You'll also find out soon enough if you get dizzy, become fatigued, have ED, or whatever and then you can move on to the next drug!

You won't achieve the perfect drug at the perfect dosage at the first stab...so start simple. It's not like you'll be stuck with this choice forever.

Hello Lenin,

Yes we can do that :) lol. Welcome to Egypt Lenin, anytime you feel that you want come to Egypt just let me know.

Lenin CCBs causes ED???????? what about the statement that says "Ditiazem SR may cause depression of artioventricular nodal conduction and bradycardia".

I didn't know that. Dear I have tried most of the Medications so this is my last choise. :(
Thanks,
Michael

hello all,

Thanks for helping me, I don't know what are RX Cass :).Anyway, I can go to the Pharmacy and get whatever med I want without a doctor. Today I started 90mg of the SR brand and I hope it will be effective. I will take another one after 12 hours.

I have read something that makes me :( "Ditiazem SR may cause depression of artioventricular nodal conduction and bradycardia" what this means?

Thanks again,
Michael
Michael,
Here are the side effects I found listed for diltiazem. These are the most common but you can't absolutely rule out anything. I have had side effects to some medication that wasn't listed anywhere. You can just give it a try like Lenin says and see what happens. I don't know what artioventricular nodal conduction is but bradycardia is a slower heartbeat. I've taken diltiazem on and off for 17 yrs and the only depression I had came from the beta blocker atenolol.

Although side effects from diltiazem are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

dizziness or lightheadedness
flushing (feeling of warmth)
headache
excessive tiredness
slower heartbeat
upset stomach
loss of appetite
vomiting
diarrhea
constipation
stomach pain
dry mouth
difficulty falling asleep or staying asleep

Just don't panic and sonner or later you will come across the right med or med combo.

You are lucky to just be able to try different meds to see if they work. We have to see a doctor and then convince him to let us try what we want.
by ht eway RX means prescription.

Cass

Hello Cass,

Thanks for your help :), yes it's good that I can go and get any Med I want. Anyway, I don't panic when I read about those side effects because I know that everyone is different and I'm sure of that because when I took Cozaar and Atacand I got many side effects are MOST people don't get :(. And when I used Norvasc I didn't experience any side effects at all, except headache for a few days, today I started with 90 Diltiazim SR and my blood pressure dropped from 140/100 to 130/90 in 5 or 6 hours :) and I don't feel anything wrong like when I was on ARBs and BBs.

Cass is there any drug interaction between Diltiazim SR and supplements or other Medications?
Thanks for help
Michael

It makes sense to say that almost any bpmedication could cause ED. They RELAX things, after all. But I don't think CCBs, esp. dlitiazem, is anywhere near the top of the
list on that. And all in all, in my experience, normalizing bp had exactly the opposite effect, although nothing works perfectly on someone over 50.

Hello Pal,

What do you mean by "normalizing bp had exactly the opposite effect"? I'm 23 and if I got ED from that age I will not be able to get marry :(.
Thanks,
Michael

Hello Cass,

Thanks for your help :), yes it's good that I can go and get any Med I want. Anyway, I don't panic when I read about those side effects because I know that everyone is different and I'm sure of that because when I took Cozaar and Atacand I got many side effects are MOST people don't get :(. And when I used Norvasc I didn't experience any side effects at all, except headache for a few days, today I started with 90 Diltiazim SR and my blood pressure dropped from 140/100 to 130/90 in 5 or 6 hours :) and I don't feel anything wrong like when I was on ARBs and BBs.

Cass is there any drug interaction between Diltiazim SR and supplements or other Medications?
Thanks for help
Michael
The only interaction that I know of is grapefruit juice. I also heard somewhere not to take calcium supplements near the time you take the diltiazem.
I eat grapefruit quite frequently and I take calcium suplements twice a day. I just keep it all a few hours apart.
Good luck - I hope the "no side effects" continue,
Cass

Now I'm worry about CCBs causing ED for MEN :(. Oh God, there must be a problem with each medication. some cause depression and others cause cough and some others cause fatigue and sleepiness.
Thanks,
Michael

I was considerably older than you and had very high bp (around 200 systolic).
Everything was tensed up apparently. They couldn't find a vein to take blood etc.
I wouldn't worry about ED either from bp or the medicine, unless you take a beta blocker or in some cases a diuretic. CCBs and ARBs have their dangers, apparently,
but ED is a very unlikely one. Hpb is in most cases symptomless and its effects are long-term. Even if you left yours untreated, you'd likely be ok for a long time.

Hello Pal,

Thanks and I hope that Diltiazim SR is the best med for ME, as I tried the other groups and didn't like any of them.

I noticed that my eyes are started to get red after I took Diltiazim SR by 10 hours so is there a relation?

Thanks again for help dear
Michael

Michael,

Now don't get all upset...I was just using ED in a laundry list of things to look for with ANY drug:
You'll also find out soon enough if you get dizzy, become fatigued, have ED, or whatever and then you can move on to the next drug!

Basically what I meant for was keep your eyes open for any side effects you don't like, of ANY kind. No, CCB's aren't high on the list of ED causes.

Hello Lenin,

Thanks :). I'm watching for side effects. Anyway, I have read in the enclosed leaflet the following

"Ditiazem SR may cause depression of artioventricular nodal conduction and bradycardia"

Do you know what this means?

Another thing, it's safe to drink beer while I'm on CCBs???
Thanks Lenin,
Michael