Matzim LA 300mg 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 and coronary vasodilation, resulting in decreased peripheral vascular resistance and reduced afterload. In the heart, it decreases myocardial contractility, slows sinoatrial (SA) node firing, and prolongs atrioventricular (AV) node conduction, leading to a reduction in heart rate and myocardial oxygen demand.

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
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Fatigue
+ 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
+ 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 (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

Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you are bothered by any of the following side effects or if they persist, contact your doctor or seek medical attention:

Headache
Dizziness
Fatigue
* Weakness

This is not an exhaustive list of possible side effects. 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.

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 use of this medication:

Any allergies you have, including allergies to this drug, 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 health problems you may have. Your doctor and pharmacist need this information to assess potential interactions and ensure safe use of this medication. Never start, stop, or adjust the dose of any medication without consulting your doctor first.

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 exercise caution when climbing 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. Discuss any concerns or questions 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, planning to become pregnant, or breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby.

• Dantrolene (IV) (risk of hyperkalemia and myocardial depression)
• Ivabradine (additive heart rate lowering effects)

• Beta-blockers (e.g., metoprolol, carvedilol) - increased risk of bradycardia, AV block, heart failure
• Digoxin - increased digoxin levels, risk of bradycardia, AV block
• Amiodarone - increased risk of bradycardia, AV block, hypotension
• Statins (e.g., simvastatin, lovastatin, atorvastatin) - increased statin levels due to CYP3A4 inhibition, risk of myopathy/rhabdomyolysis
• Cyclosporine, Tacrolimus, Sirolimus, Everolimus - increased immunosuppressant levels due to CYP3A4 inhibition, risk of toxicity
• Fentanyl - increased fentanyl levels, risk of respiratory depression
• Midazolam, Triazolam - increased benzodiazepine levels, prolonged sedation
• Carbamazepine - increased carbamazepine levels, risk of toxicity
• Rifampin - decreased diltiazem levels, reduced efficacy
• Alpha-blockers (e.g., prazosin, doxazosin) - increased risk of orthostatic hypotension

• Other antihypertensives (e.g., ACE inhibitors, ARBs, diuretics) - additive hypotensive effects
• Cimetidine, Ranitidine - may increase diltiazem levels (less significant than CYP3A4 inhibitors)
• Grapefruit juice - may increase diltiazem levels (CYP3A4 inhibition)
• Clonidine - increased risk of bradycardia, AV block

• NSAIDs - may reduce antihypertensive effect (minor interaction)

• Dizziness
• Lightheadedness
• Fainting (syncope)
• Swelling of ankles/feet (peripheral edema)
• Shortness of breath
• Unusual fatigue or weakness
• Slow or irregular heartbeat
• Chest pain (angina, monitor for improvement or worsening)
• Headache
• Nausea

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, but there are no adequate and well-controlled studies in pregnant women.

Diltiazem is excreted in human breast milk. The American Academy of Pediatrics considers diltiazem to be compatible with breastfeeding, but caution is advised. Monitor the infant for potential adverse effects such as bradycardia, hypotension, or sedation.

Safety and effectiveness in pediatric patients have not been established for hypertension or angina. Use is generally not recommended in children for these indications. Limited data exist for other specific conditions, but generally, it is not a first-line agent.

Geriatric patients may be more sensitive to the hypotensive and bradycardic effects of diltiazem. Start with lower doses and titrate slowly, monitoring blood pressure and heart rate closely. Increased risk of peripheral edema.

• Matzim LA is an extended-release formulation designed for once-daily dosing. Emphasize to patients not to crush, chew, or divide the tablets.
• Advise patients to take the medication at approximately the same time each day to maintain consistent drug levels.
• Monitor heart rate and blood pressure regularly, especially during initiation and dose adjustments, to avoid excessive bradycardia or hypotension.
• Educate patients about common side effects like peripheral edema (swelling of ankles/feet) and dizziness, and when to report them.
• Caution patients about potential drug interactions, particularly with beta-blockers, digoxin, and CYP3A4 substrates (e.g., certain statins, immunosuppressants).
• Remind patients to avoid grapefruit and grapefruit juice due to the risk of increased diltiazem levels and side effects.
• Diltiazem is a non-dihydropyridine CCB, meaning it has significant effects on cardiac conduction and contractility, unlike dihydropyridines (e.g., amlodipine) which primarily affect vascular smooth muscle.

• Other Calcium Channel Blockers (e.g., Amlodipine, Felodipine, Nifedipine for dihydropyridines; Verapamil for other non-dihydropyridine)
• Beta-blockers (e.g., Metoprolol, Atenolol, Carvedilol)
• 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, Nitroglycerin)

If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this 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, including the amount taken and the time it happened, to facilitate prompt and effective treatment.