Uses of Tilhazem

Tilhazem medicine is made in the form of tablets, with the main ingredient being Diltiazem hydrochloride. It is used for the treatment of essential hypertension, and for the treatment/prophylaxis of angina.

1 Tilhazem 60mg tablet has the main ingredient is 60mg Diltiazem and other excipients. Diltiazem is a calcium antagonist, which reduces the release of calcium from stores in the endoplasmic reticulum. This leads to a decrease in intracellular calcium availability, reducing myocardial oxygen consumption. The drug helps to increase exercise capacity, improve indicators of myocardial ischemia in patients with angina pectoris. Diltiazem also dilates small and large coronary arteries, relieves vasospastic angina, and reduces response to catecholamines but has little effect on peripheral vasculature. Therefore, Diltiazem does not cause reflex tachycardia. A slight decrease in heart rate is accompanied by an increase in cardiac output, while improving myocardial perfusion and reducing myocardial work.
Indications for the use of Tilhazem:
Treatment and prevention of angina (mainly spontaneous pain, exercise angina and Prinzmetal's angina); Treatment of idiopathic mild to moderate hypertension. Contraindications to the use of Tilhazem:
Patients who are sensitive to Diltiazem hydrochloride or its components; People with sinus node dysfunction; The patient has a very slow heart rate (less than 40 beats/min); Patients with atrioventricular block - 2nd and 3rd degree ventricles without pacemaker; Patients with left ventricular failure with pulmonary congestion, patients with acute myocardial infarction and pulmonary congestion.

Usage: Orally. The patient should swallow the tablet whole with a glass of water, do not crush or chew the tablet.
Dosage:
Usual dose: Take 1 tablet 60mg/time x 3 times/day, drink right before main meal; Angina or variant angina: For adults, the starting dose is 1 tablet of 60mg/time x 3 times/day or 30mg/time x 4 times/day. The dose can be increased as needed after about 1-2 days; Idiopathic (mild to moderate) hypertension: The usual dose for adults is 30-60mg/time x 3 times/day. Dosage may be adjusted according to the patient's age and severity of symptoms. Tilhazem can be used alone or in combination with other antihypertensive drugs (ACE inhibitors, diuretics, beta-blockers); Elderly people: The dose should be reduced; Patients with liver failure, kidney failure: The dose should be reduced; Patients with bradycardia below 50 beats/min: Do not increase dose. Overdose: Most patients who take an overdose of Diltiazem will lead to hypoglycemia after about 8 hours of taking the drug. Patients may also have sinus bradycardia, 1st - 3rd degree atrioventricular block, which can lead to cardiac arrest.
If an overdose is detected early and hospitalized immediately, the patient will be prescribed by the doctor to wash the stomach or drink activated charcoal to reduce the absorption of Diltiazem, osmotic diuresis. In case of low blood pressure, the patient can be infused with calcium gluconate, the drugs dobutamine, dopamine or isoprenaline, ... and other measures to support circulation. In case of arrhythmia or high-grade atrioventricular block, the patient can use atropine, isoprenaline. If that fails, the patient may need a pacemaker.
Missed dose: When forgetting to take a dose of Tilhazem, the patient should take it as soon as he remembers. If it is almost time for the next dose, skip the missed dose and continue the dosing schedule with the next dose as originally scheduled. Patients should not take a double dose to make up for a missed dose.

When using Tilhazem, patients may experience some side effects such as:
Common: Whole body: Lower extremity edema, weakness, fatigue; Nervous: Insomnia, dizziness; Cardiovascular: Bradycardia, 1st degree atrioventricular block; Gastrointestinal: Nausea ; Skin: Allergic rash; Uncommon: Cardiovascular: Arrhythmia, angina, bundle branch block, 2nd and 3rd degree atrioventricular block, ECG abnormalities, hypotension, congestive heart failure, syncope, palpitations, tachycardia, ventricular extrasystoles; Neurological: Asthenia, abnormal dreams, amnesia, hallucinations, insomnia, abnormal gait, paresthesia, nervousness, somnolence, tinnitus, tremors, personality changes; Digestive: Constipation, diarrhea, anorexia, dry mouth, nausea, vomiting, weight gain; Hepatobiliary: Mild and transient elevation of liver enzymes (SGPT, SGOT, LDH and alkaline phosphatase) during the initial period of treatment; Skin: Petal spots, skin itching, erythema multiforme, sensitivity to sunlight or UV rays, exfoliative dermatitis. When experiencing side effects of Tilhazem, patients should stop taking the drug and immediately notify the doctor or go to the nearest hospital for timely examination and treatment.

Some problems patients need to keep in mind before and while using Tilhazem:
Diltiazem component in the drug reduces conduction and prolongs the refractory period of the AV node, without significantly prolonging the recovery time. sinus node (except in patients with weak sinus syndrome). This effect of the drug rarely causes abnormal bradycardia or 2nd and 3rd degree atrioventricular block; In patients with first-degree atrioventricular block or PR interval (ie, AV nodal conduction time) prolonged bradycardia (because sinus rhythm and cardiac conduction may be oversuppressed) should be monitored for increased strong. In contrast, no special attention is required for cases with only 1-branch block; In patients with Prinzmetal's angina, an increase in asystole (2-5 seconds) was observed after a single dose of Diltiazem 60 mg; Diltiazem component worsens congestive heart failure in patients with pre-existing impaired left ventricular function; Tilhazem should be used with caution in patients with low blood pressure (systolic blood pressure less than 90mmHg); Mild, transient elevations in transaminases (LDH, SGOT, SGPT), with/without elevation of alkaline phosphatase and bilirubin tend to occur after about 1-8 weeks of the first dose of Diltiazem. When the drug is discontinued, these reactions disappear; When using the drug Diltiazem, regular monitoring is required in patients with diabetes; Diltiazem should be used with caution in patients with serious disorders of liver and kidney function, in patients with impaired liver and kidney function, or in the elderly (due to possible increased plasma concentrations of Diltiazem); Do not stop taking Diltiazem suddenly without consulting your doctor. Dosage should be reduced gradually, observing symptoms after stopping treatment with Diltiazem; When using Tilhazem, skin side effects may appear transient and disappear afterwards. However, the patient should stop taking the drug if the skin reactions persist; Special attention should be paid to those who are contraindicated and cautious when using Diltiazem. The patient's health should be regularly monitored, especially the heart rate and electrocardiogram at the first time of taking the drug; In case of surgical anesthesia, the patient should inform the anesthesiologist that he is taking Diltiazem; Diltiazem can be used without danger in patients with chronic respiratory disorders; Due to the antihypertensive effect of Tilhazem, patients may experience dizziness. Care should be taken when using the drug if driving, working at height, operating machinery; Tilhazem is contraindicated in women who are pregnant or may become pregnant (animal studies have shown teratogenicity). Patients should inform their doctor if they find out they are pregnant for advice on whether to continue taking the drug or not. At the same time, patients should also inform their doctor if they are trying to become pregnant; Tilhazem should not be used during lactation because Diltiazem hydrochloride can be excreted in breast milk. If it is necessary to take the drug, breastfeeding should be discontinued for the duration of treatment.

Some of the drug interactions of Tilhazem include:
Diltiazem should be used with caution with diuretics, beta-blockers, ACE inhibitors and other antihypertensive drugs. It is necessary to monitor the patient's health closely because the synergistic effect of these drugs will lower blood pressure more. With alpha-receptor blockers, arterial blood pressure should be closely monitored, since the combination of the two drugs can cause severe orthostatic hypotension; Diltiazem should not be used in combination with antiarrhythmic drugs or esmolol, beta-blockers used in patients with heart failure (carvedilol, bisoprolol, metoprolol,...), pimozide, cisapride, dantrolene (infusion), sultopride , reserpine or ergot alkaloids (digoxin). The reason is that this combination can cause inhibition of sinus rhythm and cardiac conduction due to synergistic effects; Diltiazem should not be used in combination with calcium antagonists of the dihydropyridine group, theophylline, benzodiazepines (triazolam, midazolam (IV)), cyclosporin, carbamazepine, imipramine, phenytoin,... because Diltiazem inhibits cytochrome P450 liver enzymes, which increase blood levels of these drugs. Therefore, drug dosage should be adjusted during the time of drug combination and after discontinuation of the drug combination; When used concurrently, the drugs cimetidine, ranitidine or HIV protease inhibitors may increase blood levels of Diltiazem due to its ability to inhibit cytochrome P450. The result is a drop in blood pressure and a slow heart rate; If used concurrently, Rifampicin reduces the concentration of Diltiazem in the blood because the drug has an inducer effect on liver enzymes. When using Tilhazem, patients should follow the doctor's instructions about the route, dose and duration of taking the drug. This is a prerequisite for the treatment of the disease to be highly effective and to limit dangerous side effects.