Diltiazem hdrochoride

CLINICAL USE

Analgesia

DOSE IN NORMAL RENAL FUNCTION

Oral: 30 mg every 4–6 hrsSC/IM: up to 50 mg every 4–6 hrs

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :451.5

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data

%Excreted unchanged in urine &nbsp &nbsp : 13–22

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1.1

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :3.5–5/>6

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Use small doses and titrate to response

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use small doses and titrate to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsNone known

ADMINISTRATION

Reconstition

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Route

Oral, IM, SC

Rate of Administration

–

Comments

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OTHER INFORMATION

Increased and prolonged effect in renal impairment, enhancing respiratory depression and constipationIncreased CNS sensitivity in renal impairment. Accumulation of active metabolites can occur – cautionEffects can be reversed by naloxone dihydrocodeine tartrate.

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