Diltiazem ER 420mg Capsules (24 Hr)
It is used to treat high blood pressure.It is used to treat some types of chest pain (angina).It may be given to you for other reasons. Talk with the doctor.
Drug Class
Calcium Channel Blocker
Pharmacologic Class
Benzothiazepine Calcium Channel Blocker
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Diltiazem is a medication that helps relax blood vessels and slow down your heart rate. This makes it easier for your heart to pump blood, which can help lower high blood pressure and reduce chest pain (angina). It's a long-acting capsule, meaning you usually take it once a day.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, it's essential to take it as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. Take your medication at the same time every day to establish a routine. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
Some medications may need to be taken with food, while others should be taken on an empty stomach. Check with your pharmacist to determine the best way to take your specific medication. In some cases, you may be able to open the medication and mix it with a spoonful of applesauce, but be sure to check with your pharmacist first to see if this is acceptable. Other medications must be swallowed whole, so it's crucial to follow the correct administration instructions.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, protected from light, and in a dry place. Avoid storing your medication in a bathroom, as the humidity and temperature fluctuations can affect its potency. Keep all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion or overdose.
When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by your pharmacist or healthcare provider. Instead, check with your pharmacist for guidance on the best disposal method. You may also want to explore local drug take-back programs in your area, which can provide a safe and environmentally responsible way to dispose of unwanted medications.
What to Do If You Miss a Dose
If you miss a dose of your medication, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one, as this can increase the risk of adverse effects.
To get the most benefit from your medication, it's essential to take it as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. Take your medication at the same time every day to establish a routine. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
Some medications may need to be taken with food, while others should be taken on an empty stomach. Check with your pharmacist to determine the best way to take your specific medication. In some cases, you may be able to open the medication and mix it with a spoonful of applesauce, but be sure to check with your pharmacist first to see if this is acceptable. Other medications must be swallowed whole, so it's crucial to follow the correct administration instructions.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, protected from light, and in a dry place. Avoid storing your medication in a bathroom, as the humidity and temperature fluctuations can affect its potency. Keep all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion or overdose.
When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by your pharmacist or healthcare provider. Instead, check with your pharmacist for guidance on the best disposal method. You may also want to explore local drug take-back programs in your area, which can provide a safe and environmentally responsible way to dispose of unwanted medications.
What to Do If You Miss a Dose
If you miss a dose of your medication, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one, as this can increase the risk of adverse effects.
Lifestyle & Tips
- Take the medication exactly as prescribed, usually once daily, at the same time each day.
- Swallow the capsule whole; do not crush, chew, or divide it.
- Do not stop taking this medication suddenly without consulting your doctor, as it can worsen your condition.
- Monitor your blood pressure and heart rate regularly as advised by your doctor.
- Maintain a healthy lifestyle, including a balanced diet (low in sodium and saturated fats), regular exercise, and limiting alcohol intake.
- Avoid grapefruit and grapefruit juice while taking this medication, as it can increase drug levels and side effects.
- Report any new or worsening symptoms to your doctor.
Available Forms & Alternatives
Available Strengths:
- Diltiazem SR 120mg Capsules (12 Hr)
- Diltiazem ER 90mg Capsules (12 Hr)
- Diltiazem ER 60mg Capsules (12 Hr)
- Diltiazem XR 120mg Capsules (24 Hr)
- Diltiazem 30mg Tablets
- Diltiazem 120mg Tablets
- Diltiazem 90mg Tablets
- Diltiazem XR 240mg Capsules (24 Hr)
- Diltiazem 60mg Tablets
- Diltiazem ER 180mg Caps (xr-24h)
- Diltiazem ER 360mg Capsules (24 Hr)
- Diltiazem ER 360mg (24 Hr/cd) Caps
- Diltiazem ER 420mg Tablets
- Diltiazem ER 180mg Capsules (24 Hr)
- Diltiazem ER 240mg Capsules (24 Hr)
- Diltiazem ER 420mg Capsules (24 Hr)
- Diltiazem ER 240mg Tabs (la 24hr)
- Diltiazem ER 120mg Capsules (24 Hr)
- Diltiazem ER 300mg Capsules (24 Hr)
- Diltiazem Hcl ER 180mg Tablets
- Diltiazem ER 300mg Capsules (24 Hr)
- Diltiazem ER 360mg Tablets (la 24h)
- Diltiazem ER 180mg Capsules
- Diltiazem ER 360mg Capsules (24 Hr)
- Diltiazem Hcl ER 180mg Tablets
- Diltiazem ER 360mg Tablets (la 24h)
- Diltiazem ER 300mg Tablets (la 24h)
- Diltiazem CD 240mg Capsules (24 Hr)
- Diltiazem CD 300mg Capsules (24 Hr)
- Diltiazem CD 180mg Capsules (24 Hr)
- Diltiazem ER 360mg (24 Hr/cd) Caps
- Diltiazem CD 120mg Capsules (24 Hr)
- Diltiazem CD 240mg Capsules (24 Hr)
- Diltiazem CD 180mg Capsules (24 Hr)
- Diltiazem CD 120mg Capsules (24 Hr)
- Diltiazem ER 360mg (24 Hr/cd) Caps
- Diltiazem CD 300mg Capsules (24 Hr)
- Diltiazem CD 180mg Capsules (24hr)
- Diltiazem ER 120mg Tablets (la 24h)
- Diltiazem ER 120mg Tablets (la 24h)
- Diltiazem 5mg/ml Inj, 5ml
- Diltiazem 125mg/25ml Inj, 25ml
- Diltiazem 50mg/10ml Inj, 10ml
- Diltiazem 100mg Inj, 1 Vial
Dosing & Administration
Adult Dosing
Standard Dose:
420 mg once daily
Dose Range:
120 - 540 mg
Condition-Specific Dosing:
hypertension:
Initial dose typically 180-240 mg once daily, titrate up to 420 mg once daily based on response.
chronicStableAngina:
Initial dose typically 120-180 mg once daily, titrate up to 420 mg once daily based on response.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established (safety and efficacy not established for ER formulations)
Adolescent:
Not established (safety and efficacy not established for ER formulations)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment generally needed, monitor for exaggerated effects.
Moderate:
No specific adjustment generally needed, monitor for exaggerated effects.
Severe:
Use with caution, monitor for exaggerated effects. Lower starting doses may be considered.
Dialysis:
Diltiazem is not significantly removed by dialysis. Use with caution, monitor for exaggerated effects.
Hepatic Impairment:
Mild:
Use with caution, monitor for exaggerated effects.
Moderate:
Use with caution, monitor for exaggerated effects. Lower starting doses may be considered.
Severe:
Use with caution, monitor for exaggerated effects. Lower starting doses may be considered due to prolonged half-life.
Pharmacology
Mechanism of Action
Diltiazem is a non-dihydropyridine calcium channel blocker. It inhibits the influx of extracellular calcium ions across the myocardial and vascular smooth muscle cell membranes through voltage-dependent L-type calcium channels. This leads to relaxation of vascular smooth muscle, resulting in peripheral and coronary vasodilation, and a reduction in myocardial contractility and heart rate. These actions decrease myocardial oxygen demand and increase myocardial oxygen supply.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 40-65% (variable due to first-pass metabolism, for ER formulations)
Tmax:
Approximately 10-14 hours (for ER formulations)
FoodEffect:
Food may increase bioavailability and delay Tmax, but generally does not significantly alter overall exposure for ER formulations; can be taken with or without food.
Distribution:
Vd:
Approximately 3-13 L/kg
ProteinBinding:
Approximately 70-85%
CnssPenetration:
Limited
Elimination:
HalfLife:
Approximately 5-10 hours (for ER formulations, can be longer with chronic dosing)
Clearance:
Approximately 0.6-1.3 L/min
ExcretionRoute:
Primarily urine (approximately 60-65%) and feces (approximately 35%)
Unchanged:
Less than 4% (in urine)
Pharmacodynamics
OnsetOfAction:
Within 30-60 minutes (for ER formulations, clinical effect may take longer to stabilize)
PeakEffect:
Approximately 10-14 hours (for ER formulations)
DurationOfAction:
24 hours (for ER formulations)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Severe dizziness or fainting
Slow heartbeat
New or worsening abnormal heartbeat
Worsening heart failure (if you have a history of heart failure), characterized by:
+ Shortness of breath
+ Significant weight gain
+ Swelling in the arms or legs
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other severe skin reactions, which may be life-threatening
+ Symptoms may include:
- Red, swollen, blistered, or peeling skin
- Skin irritation (with or without fever)
- Red or irritated eyes
- Sores in the mouth, throat, nose, or eyes
Other Possible Side Effects
Most people experience either no side effects or only mild side effects while taking this medication. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention:
Headache
* Feeling dizzy, tired, or weak
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Severe dizziness or fainting
Slow heartbeat
New or worsening abnormal heartbeat
Worsening heart failure (if you have a history of heart failure), characterized by:
+ Shortness of breath
+ Significant weight gain
+ Swelling in the arms or legs
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other severe skin reactions, which may be life-threatening
+ Symptoms may include:
- Red, swollen, blistered, or peeling skin
- Skin irritation (with or without fever)
- Red or irritated eyes
- Sores in the mouth, throat, nose, or eyes
Other Possible Side Effects
Most people experience either no side effects or only mild side effects while taking this medication. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention:
Headache
* Feeling dizzy, tired, or weak
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe dizziness or fainting
- Very slow heart rate (e.g., less than 50 beats per minute)
- Shortness of breath, especially with exertion or lying down
- Swelling in your ankles, feet, or legs
- Unusual fatigue or weakness
- Worsening chest pain
- Signs of liver problems (e.g., yellowing of skin/eyes, dark urine, persistent nausea/vomiting, severe stomach pain)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction and its symptoms.
Certain types of abnormal heart rhythms, as this medication is not suitable for all types. If you are unsure, consult your doctor or pharmacist for guidance.
Specific health conditions, including:
+ Fluid accumulation in the lungs
+ Low blood pressure
+ Recent heart attack
Concurrent use of certain medications, such as:
+ Ivabradine
+ Rifampin
This list is not exhaustive, and it is crucial to disclose all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any existing health problems. Your doctor and pharmacist need this information to assess potential interactions and ensure safe treatment. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction and its symptoms.
Certain types of abnormal heart rhythms, as this medication is not suitable for all types. If you are unsure, consult your doctor or pharmacist for guidance.
Specific health conditions, including:
+ Fluid accumulation in the lungs
+ Low blood pressure
+ Recent heart attack
Concurrent use of certain medications, such as:
+ Ivabradine
+ Rifampin
This list is not exhaustive, and it is crucial to disclose all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any existing health problems. Your doctor and pharmacist need this information to assess potential interactions and ensure safe treatment. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
When starting this medication, be cautious when performing tasks that require alertness, such as driving, until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and exercise caution when navigating stairs.
As directed by your doctor, regularly monitor your blood pressure and heart rate. You may need to undergo an electrocardiogram (ECG) before initiating treatment and periodically while taking this medication. Consult with your doctor regarding the frequency of these checks.
If you have high blood pressure, consult your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.
If you consume grapefruit juice or eat grapefruit regularly, discuss this with your doctor, as it may interact with your medication. Additionally, you may need to avoid consuming alcohol while taking this medication; consult your doctor or pharmacist to determine if this is necessary.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to discuss the potential benefits and risks of this medication to both you and your baby.
When starting this medication, be cautious when performing tasks that require alertness, such as driving, until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and exercise caution when navigating stairs.
As directed by your doctor, regularly monitor your blood pressure and heart rate. You may need to undergo an electrocardiogram (ECG) before initiating treatment and periodically while taking this medication. Consult with your doctor regarding the frequency of these checks.
If you have high blood pressure, consult your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.
If you consume grapefruit juice or eat grapefruit regularly, discuss this with your doctor, as it may interact with your medication. Additionally, you may need to avoid consuming alcohol while taking this medication; consult your doctor or pharmacist to determine if this is necessary.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as they will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe hypotension (very low blood pressure)
- Profound bradycardia (extremely slow heart rate)
- Heart block (abnormal heart rhythm)
- Cardiogenic shock
- Asystole (cardiac arrest)
- Dizziness
- Fainting
- Confusion
- Lethargy
What to Do:
Seek immediate medical attention. Call 911 or your local emergency number. For poison control, call 1-800-222-1222. Treatment may involve gastric lavage, activated charcoal, IV fluids, atropine, calcium gluconate, vasopressors, or cardiac pacing.
Drug Interactions
Contraindicated Interactions
- Ivabradine (risk of severe bradycardia)
- Dantrolene (IV) (risk of hyperkalemia and myocardial depression)
Major Interactions
- Beta-blockers (e.g., metoprolol, carvedilol) - increased risk of bradycardia, AV block, heart failure
- Digoxin - increased digoxin levels, risk of toxicity
- Amiodarone - increased risk of bradycardia, AV block, hypotension
- Statins (e.g., simvastatin, lovastatin) - increased statin levels, risk of myopathy/rhabdomyolysis (diltiazem is a CYP3A4 inhibitor)
- Fentanyl (CYP3A4 substrate) - increased fentanyl levels, risk of respiratory depression
- Immunosuppressants (e.g., cyclosporine, tacrolimus, sirolimus) - increased immunosuppressant levels, risk of toxicity
- Alpha-blockers (e.g., prazosin, doxazosin) - increased risk of hypotension
- Clonidine - increased risk of bradycardia, AV block
Moderate Interactions
- Other antihypertensives - additive hypotensive effects
- CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, grapefruit juice) - increased diltiazem levels
- CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin, St. John's Wort) - decreased diltiazem levels
- Benzodiazepines (e.g., midazolam, triazolam) - increased benzodiazepine levels
- Carbamazepine - increased carbamazepine levels
- Theophylline - increased theophylline levels
Minor Interactions
- NSAIDs - may reduce antihypertensive effect
- Cimetidine - may increase diltiazem levels
Monitoring
Baseline Monitoring
Blood Pressure (BP)
Rationale: To establish baseline and guide initial dosing.
Timing: Prior to initiation
Heart Rate (HR)
Rationale: To establish baseline and assess for bradycardia.
Timing: Prior to initiation
Electrocardiogram (ECG)
Rationale: To assess for pre-existing conduction abnormalities (e.g., AV block).
Timing: Prior to initiation, especially in patients with cardiac history
Liver Function Tests (LFTs)
Rationale: Diltiazem is metabolized by the liver; to assess baseline hepatic function.
Timing: Prior to initiation, especially in patients with hepatic impairment
Renal Function (SCr, BUN)
Rationale: To assess baseline renal function, though renal excretion is minor.
Timing: Prior to initiation, especially in patients with renal impairment
Routine Monitoring
Blood Pressure (BP)
Frequency: Regularly, e.g., weekly during titration, then monthly/quarterly once stable
Target: <130/80 mmHg (or individualized target)
Action Threshold: Persistent hypotension (<90/60 mmHg) or uncontrolled hypertension
Heart Rate (HR)
Frequency: Regularly, e.g., weekly during titration, then monthly/quarterly once stable
Target: 50-90 bpm (or individualized target)
Action Threshold: Persistent bradycardia (<50 bpm) or symptomatic bradycardia
Symptoms of edema
Frequency: At each visit
Target: Absence of significant peripheral edema
Action Threshold: New or worsening peripheral edema
Symptoms of dizziness/lightheadedness
Frequency: At each visit
Target: Absence of symptoms
Action Threshold: New or worsening dizziness/lightheadedness
ECG (PR interval)
Frequency: Periodically, or if symptoms of conduction disturbance occur
Target: Normal PR interval (<0.20 sec)
Action Threshold: Significant prolongation of PR interval or development of AV block
Liver Function Tests (LFTs)
Frequency: Periodically, or if symptoms of hepatic dysfunction occur
Target: Within normal limits
Action Threshold: Significant elevation of liver enzymes
Symptom Monitoring
- Dizziness
- Lightheadedness
- Fatigue
- Headache
- Peripheral edema (swelling of ankles/feet)
- Bradycardia (slow heart rate)
- Palpitations
- Shortness of breath
- Chest pain (worsening angina)
- Constipation
- Rash
Special Patient Groups
Pregnancy
Diltiazem is Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects on the fetus.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity observed in animal studies at high doses; human data are limited.
Second Trimester:
Limited human data; use with caution.
Third Trimester:
Limited human data; use with caution. May cause fetal bradycardia or hypotension.
Lactation
Diltiazem is excreted in breast milk. The American Academy of Pediatrics considers it compatible with breastfeeding, but caution is advised. Monitor the infant for bradycardia, hypotension, and sedation.
Infant Risk:
L3 (Moderately Safe). Potential for infant bradycardia, hypotension, or sedation. Monitor infant closely.
Pediatric Use
Safety and efficacy of diltiazem extended-release formulations have not been established in pediatric patients. Use is generally not recommended.
Geriatric Use
Geriatric patients may be more sensitive to the effects of diltiazem, particularly regarding hypotension and bradycardia. Lower starting doses and careful titration are recommended. Monitor renal and hepatic function more closely.
Clinical Information
Clinical Pearls
- Diltiazem ER is designed for once-daily dosing; emphasize adherence and not crushing/chewing capsules.
- It is a non-dihydropyridine CCB, affecting both vascular smooth muscle and cardiac conduction/contractility, unlike dihydropyridines (e.g., amlodipine) which are primarily vasodilators.
- Caution is paramount when co-administering with beta-blockers or digoxin due to additive effects on heart rate and AV conduction.
- Patients should be advised to avoid grapefruit products due to potential for increased diltiazem levels.
- Peripheral edema is a common side effect, but it is typically less pronounced than with dihydropyridine CCBs.
- Monitor for signs of heart failure exacerbation, especially in patients with pre-existing left ventricular dysfunction.
Alternative Therapies
- Other Calcium Channel Blockers (e.g., Amlodipine, Felodipine, Verapamil)
- Beta-blockers (e.g., Metoprolol, Atenolol)
- ACE Inhibitors (e.g., Lisinopril, Ramipril)
- Angiotensin Receptor Blockers (ARBs) (e.g., Valsartan, Losartan)
- Diuretics (e.g., Hydrochlorothiazide, Furosemide)
- Nitrates (for angina, e.g., Isosorbide mononitrate)
Cost & Coverage
Average Cost:
Varies widely, typically $50-$300+ per 30 capsules
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.