Tildiem LA (diltiazem XL) is used to help manage hypertension (high blood pressure) and angina (chest pain). This product is better known as the brand name Cardizem SR.

The LA in this product means it is sustained release; tablets are taken just once or twice per day versus three or four times with regular, fast-acting tablets.

Tildiem LA can be used in all patients over age 18, though there are some medical conditions which can significantly increase risk of side effects.

Tildiem LA Uses

Officially Tildiem LA is used to help manage:

• Mild to moderate Hypertension
• Angina

Off-label, Tildiem LA may be used to help treat:

• Certain heart arrhythmias
• Cluster headaches
• Raynaud's disease/phenomenon
• Tardive dyskinesia

Off-label uses are legal provided a doctor prescribes the medication. Because the medication hasn't undergone trials for off-label uses, dosage, frequency of administration, and duration of treatment can be quite variable. Patients interested in Tildiem LA for off-label uses are advised to consult a doctor and follow doctor instructions.

Treating Hypertension & Angina

Treatment for both hypertension and angina is quite similar. Treatment should be individualized for each patient according to patient response.

Tildiem LA comes in capsules, which should be swallowed whole; destroying capsule integrity will cause all of the medication to be absorbed rapidly, which can cause serious side effects. Taking capsules with food is optional.

In most cases:

• Patients are started on one 200 mg capsule per day.
• If insufficient, dosage may be increased to one 300 mg capsule per day; or
• Two 200 mg capsules per day; or
• One 300 mg capsule and one 200 mg capsule per day.

Patients who are at extra risk of serious side effects, or who experience side effects at lower doses, are typically restricted to:

• One 200 mg capsule per day; or
• One 300 mg capsule per day.

Patients who have hypertension and angina are usually encouraged to address the underlying issue by making and maintaining lifestyle changes, including:

• Dietary changes
• Adopting an exercise regimen
• Quitting smoking
• Maintaining healthy cholesterol levels
• Maintaining a healthy weight

Some patients aren't able to make appropriate changes, and for others changes may not provide enough benefit to stop relying on medication. These patients will likely need to take Tildiem LA or a similar product for the remainder of life. Making appropriate changes is still encouraged, if possible.

Regardless of what Tildiem LA is used to treat, doctor involvement is important. Doctors can check the medication's effectiveness, make dose adjustments, and monitor for developing side effects. A doctor can also help develop a discontinuation plan if treatment ends.

Warnings & Side Effects

All calcium channel blockers will lower blood pressure and slow heart rate, regardless of what it's taken to treat. Patients who have any medical condition or who take medications that reduce blood pressure and/or influence heart rate should use this product with caution. Elderly patients are also at increased risk of serious complications.

Other medical conditions that may cause Tildiem LA dosage to be lower or make the medication unsuitable include:

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

Patients with the above should be sure to discuss risks with a doctor before taking Tildiem LA, or any other calcium channel blocker.

Numerous other medications can interact with Tildiem LA, putting patients at risk of serious side effects. Double-check with a doctor or pharmacist before taking any other medications, including over-the-counter varieties.

More common side effects associated with Tildiem LA are mild and not cause for concern, including:

• Nausea
• Flushing
• Constipation
• Weakness
• Dizziness
• Headache

The above usually stop occurring as the body adjusts to treatment; speak with a doctor if severe or persistant.