Angitil XL (diltiazem XL) is a generic version of Cardizem SR, a calcium channel blocker that reduces blood pressure and strain on the heart. This makes it a useful treatment for hypertension, angina, and certain heart arrhythmias.

This product is also very similar to Angitil SR. The XL in Angitil XL stands for extended release, while the SR in Angitil SR and Cardizem SR stands for sustained release. Both products are designed to release the medication slowly over time, meaning they're taken only once or twice per day, compared to up to four times per day with regular tablets.

In this product the designation XL versus SR has to do with dosage strength:

• Angitil SR is available in 90, 120, or 180 mg capsules
• Angitil XL is available in 240 or 300 mg capsules.

Otherwise the two products work the same, and are commonly used to help manage hypertension and angina. While calcium channel blockers also slow heart rate, and thus are used to help manage certain heart arrhythmias, Angitil XL (and the SR version) is not marketed as such a treatment.

Patients under age 18 should not use Angitil XL or SR, or Cardizem SR, without explicit doctor approval.

Taking Angitil XL

Patients taking diltiazem for the first time are usually started on lower doses, around 90 or 120 mg per day. These lower strengths are not available as Angitil XL; patients will want to get them from the Angitil SR page.

Capsules should not be split, crushed, opened and dissolved, or otherwise damaged; doing so destroys the sustained-release mechanism. Patients should buy capsules in the prescribed dose.

While most patients are started on lower doses, the majority have dosage gradually increased to either:

• 120 or 180 mg twice per day; or
• 240 or 300 mg once per day.

For the latter, Angitil XL is ideal. Some patients taking 120 or 180 mg twice per day can switch to the more convenient once-per-day dosing offered by Angitil XL, but the fact is some patients simply respond better to twice-per-day dosing. Speak with a doctor before switching.

In managing angina, the medication works by widening arterial walls, increasing the volume of blood and oxygen delivered to the heart. Patients taking Angitil XL (or SR) are less likely to experience angina when under strain, be it physical or emotional. Angina can still happen, however, and many angina patients also have a rescue treatment to stop angina quickly. Angitil XL will not help stop a current angina attack.

In hypertension, Angitil XL also works by widening and relaxing blood vessels, which reduces restriction and thus reduces blood pressure. Angitil XL also help reduce the speed and strength of individual heart beats, which further reduces blood pressure. Angitil XL can be used on its own or with other blood pressure-reducing medications, which should, of course, be approved by a doctor first.

Regardless of what Angitil XL is used to treat, patients will likely need to attend regular doctor checkups---sometimes once a week or every two weeks---until a good maintenance dose is found. While both angina and hypertension can be monitored by patients at home, side effects are more difficult to detect and regular doctor visits will help screen for developing side effects as well as make sure the medication is working as intended.

Potential Complications

Some individuals are not good candidates for Angitil XL, at increased risk of severe side effects. Speak carefully with a doctor about risks if there is a history of:

• Sick sinus syndrome
• Severe bradycardia (slow heartbeat)
• Heart failure
• Left ventricular failure
• Atrioventricular block

The above are complicated conditions and some patients who have them will be able to take Angitil XL, but others will need modified doses or be told to avoid the medication.

Side effects from Angitil XL are relatively common, but most are transient---meaning they'll stop occurring in a week or two as the body adjusts to the medication:

• Mild dizziness
• Stomach upset
• Headache
• Constipation
• Edema in extremities
• Flushing

If the above become severe or persist past the first few weeks of treatment, a doctor should be consulted.

It's important that any doctor treating an Angitil XL (or any calcium channel blocker) patient is notified that the medication is being taken; it can alter test results. It's particularly important prior to any procedure that involves an anesthetic, as anesthesia can significantly slow heart rate.

Numerous other medications can interact with Angitil XL; double check with a doctor or pharmacist before mixing other medications with this product, including seemingly-innocous over-the-counter varieties.