Angizem CD

📦 Every order is covered by our Reshipment Assurance Policy — if your parcel does not arrive within 20 business days, we reship it.

Why order from MedsBase

Our generic medications are sourced from WHO-GMP certified manufacturers and shipped worldwide in discreet, plain packaging — no medication name on the parcel exterior. Card payments are routed through a regulated processor (statement descriptors include a regulated card-payment processor — never “MedsBase” or any medication name). Crypto and SEPA bank transfer are also accepted. Every order is backed by our Reshipment Assurance Policy.

What Is Angizem CD?

Angizem CD is an oral 90 / 120 mg diltiazem tablet from Sun Pharma, supplied in 30-90 capsules. Introduced 1982 (Tanabe as Cardizem). Sits between the DHPs (pure vasodilators) and verapamil (strong cardiac depressant) — diltiazem has balanced vascular + cardiac effects.

Diltiazem belongs to the non-dihydropyridine calcium-channel blocker subclass, distinguished from the dihydropyridines (amlodipine, nifedipine) by its direct cardiac effects — slowing AV nodal conduction, reducing heart rate, and (more for verapamil than diltiazem) reducing cardiac contractility. This profile makes non-DHPs useful when hypertension coexists with conditions needing rate control (atrial fibrillation, supraventricular tachycardia, chronic angina).

How Diltiazem Works

Diltiazem blocks L-type voltage-gated calcium channels in BOTH vascular smooth muscle AND cardiac muscle + conduction tissue (unlike DHPs, which are vascular-selective). This produces:

• Arterial vasodilation — reduced systemic vascular resistance, lower BP
• Reduced AV nodal conduction velocity — slower ventricular rate in atrial fibrillation/flutter; termination of reentrant SVT
• Negative chronotropy — slower sinus heart rate
• Negative inotropy — reduced cardiac contractility (significant for verapamil, modest for diltiazem)
• Reduced myocardial oxygen demand — the anti-anginal effect
• Relaxation of coronary vasospasm — first-line for Prinzmetal/variant angina

Approved and Evidence-Based Uses

• Hypertension — particularly when HR control is also needed
• Chronic stable angina
• Prinzmetal / vasospastic angina — first-line for coronary spasm
• Atrial fibrillation / flutter rate control — alternative to beta-blockers when beta-blockade is contraindicated (e.g. asthma)
• Supraventricular tachycardia (IV formulation for acute termination)

Do NOT combine diltiazem with a beta-blocker in routine practice — additive bradycardia and heart-block risk.

Angizem CD Dosage

Hypertension:

• Starting dose: IR 30-60 mg four times daily; CD/XL 180-240 mg once daily
• Target dose: IR 60-90 mg QDS (240-360 mg/day); CD/XL 180-360 mg once daily
• Titrate every 1-2 weeks

Administration: with or without food. Swallow whole — do NOT crush or split extended-release (SR/CD/XL) formulations.

Monitoring:

• Pulse and BP at baseline, 2 weeks, 4 weeks, and periodically thereafter
• Watch for bradycardia (<50 bpm = dose reduction)
• ECG at baseline and if any symptomatic change (consider PR prolongation / AV block)
• Baseline and periodic LFTs (hepatic metabolism)
• In patients on digoxin: check digoxin level (both non-DHPs raise digoxin levels ~70%)

Discontinuation: taper over 1-2 weeks if on high-dose chronic therapy — abrupt stop can cause rebound angina in CAD patients.

Side Effects

Common:

• Bradycardia (pulse <50 bpm) — dose-related; primary reason for dose reduction
• Constipation — particularly verapamil (up to 40% of users); less common with diltiazem
• Dizziness, fatigue
• Headache (less than DHPs)
• Flushing (less than DHPs)
• Peripheral oedema (less than DHPs; still possible)
• Nausea, abdominal discomfort

Important but uncommon:

• Heart block (PR prolongation, first-to-third degree AV block) — particularly when combined with beta-blockers, digoxin, or in pre-existing conduction disease
• Worsening heart failure — non-DHPs are contraindicated in HF-REF because of their negative inotropy
• Gingival hyperplasia (long-term; less common than nifedipine)
• Hepatic enzyme elevation (usually mild, reversible)
• Erectile dysfunction (more common with verapamil)

Contraindications

• Heart failure with reduced ejection fraction (HF-REF) — non-DHPs are contraindicated; can precipitate acute decompensation
• Second or third-degree AV block without a functioning pacemaker
• Sinus bradycardia <50 bpm
• Sick sinus syndrome without pacemaker
• Cardiogenic shock
• Severe aortic stenosis
• Wolff-Parkinson-White syndrome with atrial fibrillation — can precipitate rapid conduction via the accessory pathway and ventricular fibrillation
• Concurrent beta-blocker (routine practice) — additive bradycardia / heart-block
• Known hypersensitivity to diltiazem

Pregnancy: not routine first-line. Verapamil has been used in maternal SVT and fetal SVT (crosses placenta). Diltiazem is generally avoided in pregnancy. For antihypertensive use in pregnancy, labetalol, methyldopa, and nifedipine MR are the safer options.

Breastfeeding: small amounts excreted in milk; generally considered acceptable with infant monitoring.

Drug Interactions

• Beta-blockers — contraindicated in routine practice. Additive bradycardia, heart block, acute heart-failure precipitation. If both are essential, requires cardiology supervision, ECG monitoring, and sometimes pacemaker backup.
• Digoxin — non-DHPs raise digoxin levels by ~70% (both diltiazem and verapamil inhibit P-glycoprotein). Reduce digoxin dose by 30-50% when adding a non-DHP; check levels.
• Amiodarone — additive AV-block risk
• Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir, grapefruit juice) — raise non-DHP levels
• Strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine) — reduce non-DHP levels
• Simvastatin, lovastatin — both non-DHPs raise statin levels; cap simvastatin at 20 mg/day (10 mg/day with verapamil)
• Cyclosporin, tacrolimus — raised by non-DHPs (used therapeutically in transplant medicine to reduce calcineurin-inhibitor dose)
• Dabigatran — verapamil increases dabigatran exposure; avoid or reduce dose
• Lithium — non-DHPs can cause lithium neurotoxicity; monitor lithium levels
• Grapefruit juice — CYP3A4 inhibition raises non-DHP plasma levels 1.5-2×

DHP vs Non-DHP CCBs

Storage

Store below 25°C. Keep out of reach of children.

Frequently Asked Questions

Why can’t I take Angizem CD with a beta-blocker?

Non-DHP CCBs and beta-blockers BOTH slow AV nodal conduction and reduce cardiac contractility. Combining them produces additive effects: bradycardia, PR prolongation, second- or third-degree heart block, and precipitation of heart failure in susceptible patients. Fatal outcomes have been reported. If BP/HR control requires both mechanisms, switch to a dihydropyridine CCB (amlodipine, nifedipine retard) which is safe with beta-blockers.

Why do I have new constipation on Angizem CD?

Non-DHP CCBs reduce gastrointestinal smooth-muscle motility (the same mechanism that relaxes vascular smooth muscle). Constipation affects up to 40% of verapamil users and a smaller percentage of diltiazem users. Management: increase dietary fibre, adequate fluid, gentle laxative (lactulose, macrogol). If severe, consider switching to a DHP or diltiazem (if on verapamil).

Can I take Angizem CD if I have atrial fibrillation?

Yes — non-DHP CCBs are one of the standard options for AF rate control, particularly in patients where beta-blockers are contraindicated (asthma, severe peripheral vascular disease). Diltiazem and verapamil both slow AV nodal conduction and reduce the ventricular response rate. Contraindicated in AF with Wolff-Parkinson-White syndrome — can precipitate VF.

Can I take Angizem CD if I have heart failure?

Generally no. Non-DHP CCBs have negative inotropic effects that can precipitate decompensation in heart failure with reduced ejection fraction (HF-REF). If you have HF-REF, avoid non-DHP CCBs. Amlodipine is the CCB of choice if one is needed in HF-REF (safe profile per PRAISE and V-HeFT-III trials).

Can I drink alcohol on Angizem CD?

Moderate alcohol is generally acceptable but alcohol potentiates the hypotensive and bradycardic effects. Heavy drinking independently raises BP and should be avoided.

What about grapefruit juice?

Grapefruit (juice and fresh fruit) inhibits CYP3A4 metabolism and can raise diltiazem plasma levels by 1.5-2×. Avoid on treatment days, or consume consistently — sporadic grapefruit disrupts BP/HR control.

Where can I buy Angizem CD online?

You can buy Angizem CD (diltiazem 90 / 120 mg, 30-90 capsules) from MedsBase with discreet packaging and worldwide shipping.

Related Antihypertensives on MedsBase

• Amlode — Amlodipine 5/10 mg (DHP CCB)
• Calaptin 40 — Verapamil IR 40 mg
• Dilzem — Diltiazem IR 30/60 mg
• Losar — Losartan (ARB alternative)
• Nimodip — Nimodipine (subarachnoid haemorrhage)
• Ramcor — Ramipril (ACEi alternative)
• Browse all High Blood Pressure Medications

More options in High Blood Pressure Medication

Ranked by recent MedsBase order volume — what other customers in this category are picking.

Telmaheal

US$9.00 – US$36.00Rango de precios: desde US$9.00 hasta US$36.00

Losar

US$6.53 – US$29.25Rango de precios: desde US$6.53 hasta US$29.25

Amlode

US$5.50 – US$24.00Rango de precios: desde US$5.50 hasta US$24.00

Minoxytop

US$22.00 – US$170.00Rango de precios: desde US$22.00 hasta US$170.00