Matzim LA 240mg Tablets

Diltiazem is a non-dihydropyridine calcium channel blocker that inhibits the influx of extracellular calcium ions across the myocardial and vascular smooth muscle cell membranes. 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 improve oxygen supply.

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, consult your doctor). Seek immediate medical attention if you experience:
+ Shortness of breath
+ Sudden weight gain
+ Swelling in the arms or legs
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other severe skin reactions (sometimes life-threatening). Seek medical help right away if you notice:
+ Red, swollen, blistered, or peeling skin
+ Other skin irritation (with or without fever)
+ Red or irritated eyes
+ Sores in your mouth, throat, nose, or eyes

Other Possible Side Effects

As with any medication, you may experience side effects. While many people have no side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Headache
* Feeling dizzy, tired, or weak

This is not an exhaustive list of possible side effects. If you have questions or concerns, 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.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
Certain types of abnormal heart rhythms, as this medication is not suitable for use with many types of irregular heartbeats. 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 health problems you are experiencing. Your doctor and pharmacist need this information to ensure safe use of this medication with your other treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

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, avoid driving and other activities that require alertness 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 be cautious 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 this medication and during treatment. Discuss this with your doctor.

If you have high blood pressure and are taking this medication, 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. Additionally, talk to your doctor before consuming alcohol while taking this medication.

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, plan to become pregnant, or are breastfeeding, inform your doctor. You will need to discuss the potential benefits and risks of this medication to both you and your baby.

• Ivabradine (risk of severe bradycardia)
• Dantrolene (IV) (risk of cardiovascular collapse)

• 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
• Fentanyl (CYP3A4 substrate) - increased fentanyl levels, respiratory depression
• Immunosuppressants (e.g., cyclosporine, tacrolimus, sirolimus) - increased immunosuppressant levels, toxicity
• Alpha-blockers (e.g., prazosin, doxazosin) - increased risk of hypotension
• Other CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) - increased diltiazem levels
• Other CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin) - decreased diltiazem levels

• Clonidine - additive bradycardia/hypotension
• Nitrates - additive hypotensive effects
• Theophylline - increased theophylline levels
• Buspirone - increased buspirone levels
• Midazolam/Triazolam - increased benzodiazepine levels
• Phenytoin - increased phenytoin levels
• Grapefruit juice - increased diltiazem levels

• Cimetidine - increased diltiazem levels (minor effect)
• Ranitidine - increased diltiazem levels (minor effect)

• Dizziness
• Lightheadedness
• Fatigue
• Headache
• Swelling in ankles/feet (edema)
• Shortness of breath
• Chest pain (worsening or new)
• Palpitations
• Yellowing of skin/eyes (jaundice)
• Dark urine
• Unusual tiredness (signs of liver dysfunction)

Category C. Diltiazem should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects, but there are no adequate and well-controlled studies in pregnant women.

Diltiazem is excreted in breast milk. The American Academy of Pediatrics considers diltiazem to be compatible with breastfeeding, but caution is advised. Monitor the infant for bradycardia, hypotension, and sedation.

Safety and effectiveness in pediatric patients have not been established for hypertension or angina. Use is generally not recommended. Limited off-label use for supraventricular tachycardia in critical care settings, typically IV.

Elderly patients may be more sensitive to the effects of diltiazem, particularly hypotensive and bradycardic effects. A lower starting dose and slower titration may be appropriate. Monitor closely for adverse effects.

• Extended-release diltiazem formulations are not interchangeable; ensure the patient receives the specific brand/formulation prescribed.
• Advise patients to take the medication consistently at the same time each day to maintain steady drug levels.
• Counsel patients on the importance of not crushing or chewing extended-release tablets to avoid dose dumping and potential adverse effects.
• Diltiazem is a potent CYP3A4 inhibitor; carefully review concomitant medications for potential drug-drug interactions, especially with statins, immunosuppressants, and other cardiovascular drugs.
• Monitor for signs of peripheral edema, a common side effect, and differentiate from signs of heart failure.
• Patients with pre-existing second- or third-degree AV block or sick sinus syndrome (without a pacemaker) should generally not receive diltiazem due to the risk of severe bradycardia or asystole.

• Other non-dihydropyridine calcium channel blockers (e.g., verapamil)
• Dihydropyridine calcium channel blockers (e.g., amlodipine, nifedipine)
• Beta-blockers (e.g., metoprolol, atenolol)
• ACE inhibitors (e.g., lisinopril, enalapril)
• Angiotensin Receptor Blockers (ARBs) (e.g., losartan, valsartan)
• Thiazide diuretics (e.g., hydrochlorothiazide)
• Nitrates (for angina) (e.g., isosorbide mononitrate)
• Antiarrhythmics (e.g., amiodarone, flecainide for arrhythmias)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. 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 it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.