{"id":51450,"date":"2023-09-20T09:21:39","date_gmt":"2023-09-20T09:21:39","guid":{"rendered":"https:\/\/medsname.com\/angizem\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"angizem","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/angizem\/","title":{"rendered":"Angizem"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 R\u0103spuns Rapid \u2014 Ce este Angizem?<\/h3>\n<p style=\"margin:0;\"><strong>Angizem<\/strong> este un <strong>Comprimat de diltiazem 30 \/ 60 mg cu eliberare imediat\u0103<\/strong> de la Sun Pharma \u2014 un blocant al canalelor de calciu benzotiazepinic non-dihidropiridinic. Spre deosebire de dihidropiridine (amlodipin\u0103, nifedipin\u0103) care ac\u021bioneaz\u0103 aproape exclusiv pe mu\u0219chiul neted arterial, diltiazemul are <strong>Efect cardiac moderat<\/strong> \u2014 \u00eencetine\u0219te conduc\u021bia nodal\u0103 AV \u0219i reduce frecven\u021ba cardiac\u0103 (util pentru controlul ritmului), dar are un efect inotropic negativ mai mic dec\u00e2t verapamilul, fiind astfel mai bine tolerat de pacien\u021bii cu func\u021bie ventricular\u0103 st\u00e2ng\u0103 la limit\u0103. Acest profil \u00eel face util pentru <strong>hipertensiune combinat\u0103 cu controlul frecven\u021bei cardiace<\/strong> (fibrila\u021bie atrial\u0103, angin\u0103 cronic\u0103, PSVT). Timpul de \u00eenjum\u0103t\u0103\u021bire plasmatic\u0103 pentru forma IR este de 3-5 ore (TDS\/QDS); formul\u0103rile CD\/XL au o eficacitate de 5-10 ore (o dat\u0103 pe zi). Doza tipic\u0103 pentru hipertensiune: <strong>IR 30-60 mg de patru ori pe zi; CD\/XL 180-240 mg o dat\u0103 pe zi<\/strong>, \u021bint\u0103 IR 60-90 mg QDS (240-360 mg\/zi); CD\/XL 180-360 mg o dat\u0103 pe zi. <strong>NU combina\u021bi diltiazemul cu un beta-blocant<\/strong> \u2014 risc aditiv de bradicardie \u0219i bloc cardiac. Contraindicat \u00een insuficien\u021b\u0103 cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103 (HF-REF), bloc AV de gradul doi\/trei, bradicardie sever\u0103, \u0219oc cardiogen \u0219i sindromul sinusului boln\u0103vos f\u0103r\u0103 stimulator cardiac.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Angizem?<\/h2>\n<p>Angizem este un comprimat oral de diltiazem 30\/60 mg de la Sun Pharma, furnizat \u00een cutii de 30-90 de comprimate. Introdus \u00een 1982 (Tanabe sub numele <strong>Cardizem<\/strong>). Se situeaz\u0103 \u00eentre DHP-uri (vasodilatatoare pure) \u0219i verapamil (depresant cardiac puternic) \u2014 diltiazemul are efecte echilibrate vasculare + cardiace.<\/p>\n<p>Diltiazemul apar\u021bine subclasei <strong>blocantelor canalelor de calciu non-dihidropiridinice<\/strong> , distinct\u0103 de dihidropiridine (amlodipin\u0103, nifedipin\u0103) prin <strong>efecte cardiace directe<\/strong> \u2014 \u00eencetinirea conduc\u021biei nodale AV, reducerea frecven\u021bei cardiace \u0219i (mai mult pentru verapamil dec\u00e2t pentru diltiazem) reducerea contractilit\u0103\u021bii cardiace. Acest profil face ca non-DHP s\u0103 fie utile atunci c\u00e2nd hipertensiunea coexista cu afec\u021biuni care necesit\u0103 controlul frecven\u021bei (fibrila\u021bie atrial\u0103, tahicardie supraventricular\u0103, angin\u0103 cronic\u0103).<\/p>\n<h2 class=\"wp-block-heading\">Cum Ac\u021bioneaz\u0103 Diltiazem<\/h2>\n<p>Diltiazem blocheaz\u0103 canalele de calciu dependente de voltaj de tip L at\u00e2t \u00een mu\u0219chiul neted vascular, c\u00e2t \u0219i \u00een mu\u0219chiul cardiac + \u021besutul de conduc\u021bie (spre deosebire de DHP, care sunt selectivi vascular). Acest lucru produce:<\/p>\n<ul>\n<li><strong>Vasodilata\u021bie arterial\u0103<\/strong> \u2014 rezisten\u021b\u0103 vascular\u0103 sistemic\u0103 redus\u0103, tensiune arterial\u0103 mai mic\u0103<\/li>\n<li><strong>Reducerea vitezei de conduc\u021bie nodal\u0103 AV<\/strong> \u2014 frecven\u021b\u0103 ventricular\u0103 mai mic\u0103 \u00een fibrila\u021bie\/flutter atrial; \u00eentreruperea SVT reentrant<\/li>\n<li><strong>Cronotropie negativ\u0103<\/strong> \u2014 frecven\u021b\u0103 cardiac\u0103 sinusal\u0103 mai mic\u0103<\/li>\n<li><strong>Inotropie negativ\u0103<\/strong> \u2014 contractilitate cardiac\u0103 redus\u0103 (semnificativ\u0103 pentru verapamil, moderat\u0103 pentru diltiazem)<\/li>\n<li><strong>Cerin\u021b\u0103 de oxigen miocardic redus\u0103<\/strong> \u2014 efectul antianginos<\/li>\n<li><strong>Relaxarea vasospasmului coronarian<\/strong> \u2014 tratament de prim\u0103 inten\u021bie pentru angina Prinzmetal\/variant\u0103<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Utiliz\u0103ri aprobate \u0219i bazate pe dovezi<\/h2>\n<ul>\n<li><strong>Hipertensiune arterial\u0103<\/strong> \u2014 \u00een special atunci c\u00e2nd este necesar\u0103 \u0219i controlul frecven\u021bei cardiace<\/li>\n<li><strong>Angin\u0103 cronic\u0103 stabil\u0103<\/strong><\/li>\n<li><strong>Angin\u0103 Prinzmetal\/vasospastic\u0103<\/strong> \u2014 tratament de prim\u0103 inten\u021bie pentru spasmul coronarian<\/li>\n<li><strong>Controlul frecven\u021bei \u00een fibrila\u021bia atrial\u0103\/flutter<\/strong> \u2014 alternativ\u0103 la beta-blocante atunci c\u00e2nd beta-blocajul este contraindiat (de ex. astm)<\/li>\n<li><strong>Tahicardie supraventricular\u0103<\/strong> (formul\u0103 IV pentru terminarea acut\u0103)<\/li>\n<\/ul>\n<p><strong>NU combina\u021bi diltiazemul cu un beta-blocant \u00een practica obi\u0219nuit\u0103 \u2014 risc aditiv de bradicardie \u0219i bloc cardiac.<\/strong><\/p>\n<h2 class=\"wp-block-heading\">Dozaj Angizem<\/h2>\n<p><strong>Hipertensiune arterial\u0103:<\/strong><\/p>\n<ul>\n<li><strong>Doza ini\u021bial\u0103:<\/strong> IR 30-60 mg de patru ori pe zi; CD\/XL 180-240 mg o dat\u0103 pe zi<\/li>\n<li><strong>Doza \u021bint\u0103:<\/strong> IR 60-90 mg de 4 ori pe zi (240-360 mg\/zi); CD\/XL 180-360 mg o dat\u0103 pe zi<\/li>\n<li>Titra\u021bi la fiecare 1-2 s\u0103pt\u0103m\u00e2ni<\/li>\n<\/ul>\n<p><strong>Administrare:<\/strong> cu sau f\u0103r\u0103 alimente. \u00cenghi\u021bi\u021bi comprimatul \u00eentreg \u2014 NU zdrobi\u021bi sau desp\u0103r\u021bi\u021bi formul\u0103rile cu eliberare prelungit\u0103 (SR\/CD\/XL).<\/p>\n<p><strong>Monitorizare:<\/strong><\/p>\n<ul>\n<li>Puls \u0219i TA la evaluarea ini\u021bial\u0103, dup\u0103 2 s\u0103pt\u0103m\u00e2ni, 4 s\u0103pt\u0103m\u00e2ni \u0219i periodic ulterior<\/li>\n<li>Monitoriza\u021bi bradicardia (&lt;50 bpm = reducere de doz\u0103)<\/li>\n<li>ECG la evaluarea ini\u021bial\u0103 \u0219i la orice modificare simptomatic\u0103 (lua\u021bi \u00een considerare prelungirea intervalului PR\/bloc AV)<\/li>\n<li>Teste hepatice ini\u021biale \u0219i periodice (metabolism hepatic)<\/li>\n<li>La pacien\u021bii care iau digoxin: verifica\u021bi nivelul de digoxin (ambele non-DHP cresc nivelul digoxinului cu ~70%)<\/li>\n<\/ul>\n<p><strong>\u00centrerupere:<\/strong> reducere progresiv\u0103 pe 1-2 s\u0103pt\u0103m\u00e2ni dac\u0103 se administreaz\u0103 terapie cronic\u0103 la doze mari \u2014 \u00eentreruperea brusc\u0103 poate provoca angin\u0103 de revenire la pacien\u021bii cu CAD.<\/p>\n<h2 class=\"wp-block-heading\">Efecte Secundare<\/h2>\n<p><strong>Frecvente:<\/strong><\/p>\n<ul>\n<li><strong>Bradicardie<\/strong> (puls &lt;50 bpm) \u2014 dependent de doz\u0103; motiv principal pentru reducerea dozei<\/li>\n<li><strong>Constipa\u021bie<\/strong> \u2014 \u00een special verapamil (p\u00e2n\u0103 la 40% dintre utilizatori); mai pu\u021bin frecvent cu diltiazem<\/li>\n<li>Ame\u021beli, oboseal\u0103<\/li>\n<li>Dureri de cap (mai pu\u021bin frecvente dec\u00e2t la DHPs<\/li>\n<li>Ruborire (mai pu\u021bin frecvent\u0103 dec\u00e2t la DHPs)<\/li>\n<li>Edem periferic (mai pu\u021bin frecvent dec\u00e2t la DHPs; totu\u0219i posibil)<\/li>\n<li>Grea\u021b\u0103, disconfort abdominal<\/li>\n<\/ul>\n<p><strong>Important dar neobi\u0219nuit:<\/strong><\/p>\n<ul>\n<li><strong>Bloc cardiac<\/strong> (prelungire PR, bloc AV de gradul I-III) \u2014 \u00een special atunci c\u00e2nd este combinat cu beta-blocante, digoxin sau \u00een cazul bolilor preexistente de conducere<\/li>\n<li><strong>\u00cenr\u0103ut\u0103\u021birea insuficien\u021bei cardiace<\/strong> \u2014 medicamentele non-DHP sunt contraindicat\u0103 \u00een IC-FER din cauza efectului inotrop negativ<\/li>\n<li>Hiperplazie gingival\u0103 (pe termen lung; mai pu\u021bin frecvent\u0103 dec\u00e2t la nifedipin\u0103)<\/li>\n<li>Cre\u0219terea enzimelor hepatice (de obicei u\u0219oar\u0103, reversibil\u0103)<\/li>\n<li>Disfunc\u021bie erectil\u0103 (mai frecvent\u0103 cu verapamilul)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii<\/h2>\n<ul>\n<li><strong>Insuficien\u021b\u0103 cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103 (IC-FER)<\/strong> \u2014 medicamentele non-DHP sunt contraindicate; pot precipita decompensarea acut\u0103<\/li>\n<li><strong>Bloc AV de gradul doi sau trei<\/strong> f\u0103r\u0103 un stimulator cardiac func\u021bional<\/li>\n<li><strong>Bradicardie sinusal\u0103 &lt;50 bpm<\/strong><\/li>\n<li><strong>Sindromul sinusului bolnav<\/strong> f\u0103r\u0103 stimulator cardiac<\/li>\n<li><strong>\u0218oc cardiogen<\/strong><\/li>\n<li><strong>Stenoz\u0103 aortic\u0103 sever\u0103<\/strong><\/li>\n<li><strong>Sindromul Wolff-Parkinson-White cu fibrila\u021bie atrial\u0103<\/strong> \u2014 poate precipita conduc\u021bia rapid\u0103 prin calea accesorie \u0219i fibrila\u021bie ventricular\u0103<\/li>\n<li><strong>Beta-blocant concomitent<\/strong> (practic\u0103 obi\u0219nuit\u0103) \u2014 bradicardie\/bloc cardiac aditiv\u0103<\/li>\n<li>Hipersensibilitate cunoscut\u0103 la diltiazem<\/li>\n<\/ul>\n<p><strong>Sarcina:<\/strong> nu este de obicei prima op\u021biune. Verapamilul a fost utilizat \u00een TSV maternal \u0219i TSV fetal (trece placenta). Diltiazemul este \u00een general evitat \u00een sarcin\u0103. Pentru utilizarea antihipertensiv\u0103 \u00een sarcin\u0103, <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a>, metildopa \u0219i nifedipin\u0103 MR sunt op\u021biunile mai sigure.<\/p>\n<p><strong>Al\u0103ptarea:<\/strong> cantit\u0103\u021bi mici eliminate \u00een lapte; \u00een general considerate acceptabile cu monitorizarea sugarului.<\/p>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Beta-blocante<\/strong> \u2014 <strong>contraindicate \u00een practica obi\u0219nuit\u0103.<\/strong> Bradicardie aditiv\u0103, bloc cardiac, precipita\u021bie a insuficien\u021bei cardiace acute. Dac\u0103 ambele sunt esen\u021biale, necesit\u0103 supraveghere cardiologic\u0103, monitorizare ECG \u0219i uneori stimulator cardiac de rezerv\u0103.<\/li>\n<li><strong>Digoxin\u0103<\/strong> \u2014 non-DHP cresc nivelurile de digoxin cu ~70% (at\u00e2t diltiazemul c\u00e2t \u0219i verapamilul inhib\u0103 glicoproteina P). Reduce\u021bi doza de digoxin cu 30-50% c\u00e2nd ad\u0103uga\u021bi un non-DHP; verifica\u021bi nivelurile.<\/li>\n<li><strong>Amiodaron\u0103<\/strong> \u2014 risc aditiv de bloc AV<\/li>\n<li><strong>Inhibitori puternici ai CYP3A4<\/strong> (ketoconazol, claritromicin\u0103, ritonavir, suc de grapefruit) \u2014 cresc nivelurile de non-DHP<\/li>\n<li><strong>Inductori puternici ai CYP3A4<\/strong> (rifampicin\u0103, fenitoin\u0103, carbamazepin\u0103) \u2014 reduc nivelurile de non-DHP<\/li>\n<li><strong>Simvastatin\u0103, lovastatin\u0103<\/strong> \u2014 ambii tipuri de non-DHP cresc nivelul statinelor; limita\u021bi simvastatina la 20 mg\/zi (10 mg\/zi cu verapamil)<\/li>\n<li><strong>Ciclosporin\u0103, tacrolimus<\/strong> \u2014 crescut de non-DHP (utilizat terapeutic \u00een medicina transplantului pentru a reduce doza de inhibitori de calcineurin\u0103)<\/li>\n<li><strong>Dabigatran<\/strong> \u2014 verapamilul cre\u0219te expunerea la dabigatran; evita\u021bi sau reduce\u021bi doza<\/li>\n<li><strong>Litiu<\/strong> \u2014 non-DHP pot provoca neurotoxicitate prin litiu; monitoriza\u021bi nivelurile de litiu<\/li>\n<li><strong>Suc de grapefruit<\/strong> \u2014 inhibi\u021bia CYP3A4 cre\u0219te nivelurile plasmatice de non-DHP de 1,5-2 ori<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">DHP vs non-DHP BCC<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\"><\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">DHP (amlodipin\u0103, nifedipin\u0103)<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Non-DHP (diltiazem)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Ac\u021biune principal\u0103<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vasodilata\u021bie arterial\u0103<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vasodilata\u021bie + depresie cardiac\u0103<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Efect asupra frecven\u021bei cardiace<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">U\u0219oar\u0103 cre\u0219tere reflex\u0103<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u2193 (util pentru controlul frecven\u021bei \u00een FA)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Combinare cu beta-blocant?<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Da (standard \u00een angina)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>NU<\/strong> (bradicardie \u0219i bloc aditiv)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Sigur \u00een IC-FER?<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Amlodipine: da<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>NU<\/strong> (inotropie negativ\u0103)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Edem periferic<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Frecvent (10-25%)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mai pu\u021bin frecvente (5-10%)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Constipa\u021bie<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pu\u021bin frecvente<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Frecvente (\u00een special la verapamil)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Depozitare<\/h2>\n<p>Depozita\u021bi sub 25\u00b0C. P\u0103stra\u021bi \u00een afara accesului copiilor.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">De ce nu pot lua Angizem cu un beta-blocant?<\/h3>\n<p>Blocatoarele de canale de calciu non-DHP \u0219i beta-blocantele AMBELE \u00eencetinesc conduc\u021bia nodal\u0103 AV \u0219i reduc contractilitatea cardiac\u0103. Combinarea lor produce efecte aditive: bradicardie, prelungirea intervalului PR, bloc cardiac de gradul doi sau trei \u0219i precipitatea insuficien\u021bei cardiace la pacien\u021bii susceptibili. Au fost raportate decese. Dac\u0103 controlul TA\/FB necesit\u0103 ambele mecanisme, trece\u021bi la un <strong>blocator de canale de calciu dihidropiridinic<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">amlodipine<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/nicardia-retard\/\">nifedipin\u0103 cu eliberare prelungit\u0103<\/a>) care este sigur cu beta-blocantele.<\/p>\n<h3 class=\"wp-block-heading\">De ce am constipa\u021bie nou\u0103 la Angizem?<\/h3>\n<p>Blocatoarele de canale de calciu non-DHP reduc motilitatea musculaturii netede gastrointestinale (acela\u0219i mecanism care relaxeaz\u0103 mu\u0219chiul neted vascular). Constipa\u021bia afecteaz\u0103 p\u00e2n\u0103 la 40% dintre utilizatorii de verapamil \u0219i un procentaj mai mic dintre cei care iau diltiazem. Management: cre\u0219te\u021bi fibra alimentar\u0103, lichide adecvate, laxativ bl\u00e2nd (lactuloz\u0103, macrogol). Dac\u0103 este sever\u0103, lua\u021bi \u00een considerare trecerea la un DHP sau diltiazem (dac\u0103 lua\u021bi verapamil).<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Angizem dac\u0103 am fibrila\u021bie atrial\u0103?<\/h3>\n<p>Da \u2014 blocurile canalelor de calciu non-DHP sunt una dintre op\u021biunile standard pentru <strong>controlul ritmului \u00een FA<\/strong>, \u00een special la pacien\u021bii \u00een care beta-blocantele sunt contraindicate (astm, boli vasculare periferice severe). Diltiazemul \u0219i verapamilul \u00eencetinesc conduc\u021bia nodal\u0103 AV \u0219i reduc frecven\u021ba de r\u0103spuns ventricular. <strong>Contraindicate \u00een FA cu sindrom Wolff-Parkinson-White<\/strong> \u2014 pot precipita FV.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Angizem dac\u0103 am insuficien\u021b\u0103 cardiac\u0103?<\/h3>\n<p>\u00cen general, nu. Blocurile canalelor de calciu non-DHP au efecte inotrope negative care pot precipita decompensarea \u00een insuficien\u021ba cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103 (IC-FER). Dac\u0103 ave\u021bi IC-FER, evita\u021bi blocurile canalelor de calciu non-DHP. <a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">Amlodipine<\/a> este blocantul canalelor de calciu de preferin\u021b\u0103 dac\u0103 este necesar \u00een IC-FER (profil sigur conform studiilor PRAISE \u0219i V-HeFT-III).<\/p>\n<h3 class=\"wp-block-heading\">Pot consuma alcool \u00een timp ce iau Angizem?<\/h3>\n<p>Consumul moderat de alcool este \u00een general acceptabil, dar alcoolul poten\u021beaz\u0103 efectele hipotensive \u0219i bradicardice. Consumul excesiv de alcool cre\u0219te independent TA \u0219i ar trebui evitat.<\/p>\n<h3 class=\"wp-block-heading\">Ce zici de sucul de grapefruit?<\/h3>\n<p>Grapefruitul (sucul \u0219i fructul proasp\u0103t) inhib\u0103 metabolismul CYP3A4 \u0219i poate cre\u0219te nivelurile plasmatice de diltiazem de 1,5-2\u00d7. Evita\u021bi \u00een zilele de tratament sau consuma\u021bi consistent \u2014 grapefruitul sporadic perturb\u0103 controlul TA\/FV.<\/p>\n<h3 class=\"wp-block-heading\">Unde pot cump\u0103ra Angizem online?<\/h3>\n<p>Pute\u021bi achizi\u021biona Angizem (diltiazem 30\/60 mg, 30-90 comprimate) de la MedsBase cu ambalaj discret \u0219i livrare la nivel mondial.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Antihipertensive \u00eenrudite pe MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/amlip\/\">Amlip \u2014 Amlodipin\u0103 2,5\/5 mg (DHP CCB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">Amlode \u2014 Amlodipin\u0103 5\/10 mg (DHP CCB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/aquazide\/\">Aquazide \u2014 Diuretic hidroclorotiazidic<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/concor\/\">Concor \u2014 Beta-blocant bisoprolol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/depin\/\">Depin \u2014 Nifedipin\u0103 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/dilzem-cd\/\">Dilzem CD \u2014 Diltiazem CD 120\/180 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/high-blood-pressure-medication\/\"><strong>R\u0103sfoi\u021bi toate medicamentele pentru hipertensiune arterial\u0103<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 Dezaprobare medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui medic calificat. Hipertensiunea, insuficien\u021ba cardiac\u0103 \u0219i aritmiile necesit\u0103 diagnostic, monitorizare \u0219i individualizarea dozei de c\u0103tre un medic \u2014 utiliza\u021bi \u00eentotdeauna beta-blocante sub \u00eendrumare medical\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Angizem este comprimatul de diltiazem 30\/60 mg cu eliberare imediat\u0103 de la Sun Pharma \u2014 blocant al canalelor de calciu benzotiazepinic non-dihidropiridinic. Echilibreaz\u0103 efectele vasculare + cardiace: vasodilata\u021bie plus \u00eencetinire nodal\u0103 AV \u0219i u\u0219oar\u0103 inotropie negativ\u0103. Utiliz\u0103ri principale: hipertensiune arterial\u0103 cu nevoie de control al frecven\u021bei cardiace, angin\u0103 cronic\u0103 stabil\u0103, angin\u0103 vasospastic\u0103 (Prinzmetal), controlul frecven\u021bei \u00een fibrila\u021bia atrial\u0103 c\u00e2nd beta-blocantele sunt contraindicate. NU combina\u021bi cu beta-blocante (bradicardie aditiv\u0103).<\/p>","protected":false},"featured_media":51451,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3359,3360],"class_list":{"0":"post-51450","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-angizem","11":"product_tag-diltiazem","13":"first","14":"outofstock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/51450","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=51450"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/51451"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=51450"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=51450"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=51450"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=51450"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}