Adult:
Initially, 250 mcg/kg by bolus IV Inj over 2 mins, if necessary, after 15 min, may administer another dose of 350 mcg/kg. Individualsie subsequent doses. In patients with atrial fibrillation or flutter: 5-10 mg/hr infusion, increased in increments of 5 mg/hr up to a rate of 15 mg/hr continued for 24 hr.
Administration
Normal Release Prep: May be taken with or without food. (Admin instructions for modified release prep may vary according to brands, refer to lit.)
Precautions
Elderly. Hepatic or renal impairment; impaired left ventricular function; prolonged AV periods; DM; hypotension. Avoid abrupt withdrawal and long-term use. Patients with sick-sinus syndrome, preexisting AV block, bradycardia and those taking beta-blockers or digitalis are at risk of developing AV block, bradycardia, asystole or sinus arrest.
Potentially Life-threatening
Adverse Drug Reactions
Increased depression of cardiac conduction with amiodarone, b-blockers, digoxin and mefloquine. May potentiate risk of bradycardia and conduction disturbance of propranolol and risk of neurotoxicity of lithium.
Increases serum theophylline levels. Cimetidine may increase plasma concentrations of diltiazem. Concurrent use may lead to increased blood ciclosporin levels.
