CARTIA XT SUMMARY
Diltiazem hydrochloride is a calcium ion influx inhibitor (slow channel blocker or calcium antagonist).
Diltiazem hydrochloride extended-release capsules USP (once-a-day dosage) are indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive medications.
Diltiazem hydrochloride extended-release capsules USP (once-a-day dosage) is indicated for the management of chronic stable angina and angina due to coronary artery spasm.
Published Studies Related to Cartia XT (Diltiazem)
Topical diltiazem cream versus botulinum toxin a for the treatment of chronic
anal fissure: a double-blind randomized clinical trial. 
the purpose of this study... CONCLUSIONS: BTA yields higher healing rates in the short term, though after 3
Effects of diltiazem on pharmacokinetics of tacrolimus in relation to CYP3A5 genotype status in renal recipients: from retrospective to prospective. [2011.08]
The impact of CYP3A5*3, a CYP3A5 nonexpresser genotype, on inhibitory effects of diltiazem on tacrolimus metabolism has not been assessed. In retrospective study, when coadministered with diltiazem, mean increments in dose-adjusted C(0D7), C(max) and AUC(0-12 h) for tacrolimus were larger in CYP3A5 expressers than in CYP3A5 nonexpressers (48.7 vs 3.7%, 31.7 vs 17.2% and 38.2 vs 18.5%, respectively).
A randomized, prospective, double-blind, placebo-controlled trial of the effect of topical diltiazem on posthaemorrhoidectomy pain. [2011.03]
CONCLUSION: Perianal application of DTZ cream after haemorrhoidectomy significantly reduces postoperative pain and is perceived as beneficial, with no increase in associated morbidity. (c) 2011 The Authors. Colorectal Disease (c) 2011 The Association of Coloproctology of Great Britain and Ireland.
[A comparative study on the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate of patients with atrial fibrillation during anesthesia period]. [2010.11]
OBJECTIVE: To evaluate the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate in patients with atrial fibrillation (AF) during anesthesia period... CONCLUSIONS: Intravenous esmolol, amiodarone and diltiazem are all equally effective and safe on controlling rapid ventricular rate in patients with atrial fibrillation during the anesthesia period. Esmolol use is associated with the shortest mean reacting time and amiodarone use is associated with the lowest total side effect rate in this patient cohort.
Comparison of the effects of long-acting nifedipine CR and diltiazem R in patients with vasospastic angina: Aomori coronary spastic angina study. [2010.11]
CONCLUSION: Once-daily administration of nifedipine CR was as effective as twice-daily diltiazem R in the prevention of VSA attacks. Copyright (c) 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Clinical Trials Related to Cartia XT (Diltiazem)
Drug-Drug Interaction Study Between Colchicine and Diltiazem ER [Completed]
Colchicine is a substrate for both cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp).
Extended-release diltiazem (diltiazem ER) is a potent inhibitor of both CYP3A4 and P-gp.
This study will evaluate the effect of multiple doses of diltiazem ER on the pharmacokinetic
profile of a single 0. 6 mg dose of colchicine. A secondary objective is to evaluate the
safety and tolerability of this regimen in healthy volunteers. All study subjects will be
monitored for adverse events throughout the study period.
Treatment of Preclinical Hypertrophic Cardiomyopathy With Diltiazem [Completed]
This is a pilot clinical trial to assess whether the administration of diltiazem may be able
to decrease the development or progression of hypertrophic cardiomyopathy (HCM). Diltiazem
is a commonly used medication for the treatment of high blood pressure and studies on
animals with HCM suggest that diltiazem decreases disease development. This study
specifically targets individuals in the "prehypertrophic" phase of HCM-- those with
documented sarcomere gene mutations without echocardiographic or EKG evidence of LVH, and
therefore without a clinical diagnosis of HCM.
The hypothesis of this study is that starting diltiazem administration early in life (in the
prehypertrophic phase) will decrease the progression of HCM in individuals with sarcomere
gene mutations. This will be assessed by looking at an improvement in the heart's ability to
relax using echocardiography, as well as exploratory analyses of a broad range of features
reflecting the heart's structure and function.
Ischaemia-r�perfusion During the Coronary Surgery With Beating Heart [Active, not recruiting]
Less oxidative stress occurs during off-pump than on-pump coronary artery bypass graft
(CABG) surgery but warm ischaemia-reperfusion injury may occur following transient coronary
artery clamping. The aim of this study was to compare the preventive effects of diltiazem
and N-acetylcysteine (NAC), alone or in combination, on biomarkers of myocardial damage and
oxidative stress during off-pump CABG surgery.
Study to Evaluate the Interaction Potential of Clarithromycin XL on Diltiazem Hydrochloride Cream 2% in Healthy Subjects [Completed]
Randomized Trial Comparing Diltiazem and Metoprolol For Atrial Fibrillation Rate Control [Recruiting]
Atrial Fibrillation and atrial flutter (AF/FL) is the usually irregular beating of the heart
and is a rapidly growing cause of hospitalization. Between 1993 to 2007 AF/FL
hospitalizations have increased 203% compared to a 71% increase for all hospitalizations.
Changing procedure management such as ablation, transesophageal have had a minimal impact on
the trends and there is a need to evaluate Emergency Department (ED) management options of
AF/FL that may decrease hospitalizations.
The most commonly used medications to control heart rate are metoprolol (MET), a beta
blocker, or diltiazem (DT), a calcium channel blocker. Beta blockers are medications that
cause the heart to beat more slowly and with less force. DT also helps blood vessels open
up to improve blood flow. Both DT and MET are used alone or together with other medicines
to treat severe chest pain (angina), high blood pressure (hypertension) or rapid heartbeat.
Both are equally acceptable according to recent guidelines for AF/FL. There are limited
studies comparing MET to DT for rate control for AF/FL.
The initial goal for AF/FL management in the Emergency Department is usually rate control.
The most commonly used rate control medications are metoprolol (MET), a beta blocker, or
diltiazem (DT) a calcium blocker. Three major guidelines, including the American College of
Cardiology (ACC) and the American Heart Association (AHA) indicate beta blockers and DT are
equally acceptable medications for rate control in AF (3,4,5) assuming no contraindications.
There are limited studies comparing beta blockers (BB) to DT for rate control for AF:
1. Demircan, et. al., compared bolus intravenous BB and DT in 40 patients over a 20 minute
period. No follow-up information after 20 minutes was reported. No attempt was made
to look at intermediate or long term results. No patients converted to normal sinus
rhythm over this short treatment period and there was slightly more rate decrease at 20
minutes, with DT versus BB (6).
2. Time from medication administration to heart rate and rhythm control. Additionally,
currently guidelines consider BB or DT medications to slow AF/FL; however, there are
some suggestions that BB may not only slow heart rate in AF/FL (as does DT) but also
increase all AF/FL conversion from AF/FL to normal sinus rhythm(2), and aid in
maintaining normal sinus rhythm (NSR) after cardioversion (10). With recent onset AF/FL
occurring within 48 hours prior to the arrival to the ED, approximately 50% of AF/FL
patients convert to normal rhythm spontaneously within 24 hours after arrival to the ED
(6), making evaluation of current limited studies difficult. Thus, the investigators
wish to examine the effect of initial medication strategy on time to NSR in a larger
sample than has been previously performed.
3. A randomized study of 48 patients in China reported significantly slower heart rate up
to 20 minutes with DT 10mg IV versus metoprolol 5mg IV but not after 30 minutes (7).
4. A retrospective study of post-operative coronary bypass patients showed the intravenous
administration of the BB, esmolol, to be more effective than DT for rate control and
conversion of AF/FL (8).
5. Hassan et al reported no difference in conversion to regular rhythm with esmolol verses
DT in a small, under powered, randomized study of fifty ED patients (9). Conversion to
sinus rhythm occurred in 10 patients (42%) in the DT group compared with 10 patients
(39%) in the esmolol group (P = 1. 0). There were no statistically significant
differences in heart rate between the two medications at 1, 6, 12, and 24 hours after
initiation of esmolol or DT infusion.
Examples of such well quoted strategy trials are the COURAGE trial published in the New
England Journal of Medicine and the PROMISE Trial, a worldwide multi-centered study that is
nearing completion goal of 10,000 patients of which, Charleston Area Medical Center (CAMC)
has enrolled approximately 100 patients. In this trial, patients being evaluated for chest
pain will be randomized to two treatment strategies and subsequent outcomes will be
Strategy trials do not attempt to manage treatment after an initial management strategy has
been determined by randomization, but, whether the initial treatment affects long-term
This will be a prospective, randomized study comparing the outcomes of a strategy using
either MET or DT in patients with AF presenting to the Charleston Area Medical Center (CAMC)
ED. After presentation and receiving consent, the patient will be randomized to receive
either MET or DT.
Reports of Suspected Cartia XT (Diltiazem) Side Effects
Orthostatic Hypotension (2),
Feeling of Body Temperature Change (2),
Muscle Spasms (2), more >>
Page last updated: 2013-02-10