Tildiem Retard (diltiazem SR) is a sustained-release calcium channel blocker, useful in helping patients manage both hypertension (high blood pressure) and angina (chest pain). The medication is a vasodilator that widens blood vessels, improving blood flow.

Tildiem Retard is most commonly used to treat:

• Mild to moderate hypertension (high blood pressure)
• Angina

Off-label it may be used to treat:

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

This product is designed to slowly release medication throughout the day, meaning in many cases patients need take just one dose per day. There are exceptions, however, and some patients take Tildiem Retard two or three times per day.

Tildiem Retard should not be administered to patients under 18 years old.

Treatment Basics

Tildiem Retard comes in capsules of 90 mg or 120 mg strengths. Capsules should be swallowed whole; destroying the integrity of the capsule will allow all of the medication to be released at once, ruining its sustained-release properties and putting the patient at risk of overdose. Patients who have difficulty swallowing whole capsules should speak with a doctor about alternative options.

In hypertension treatment usually consists of:

• Patients are started on a single 120 mg capsule taken once per day.
• Capsules should be taken at the same time each day.
• Results should be evaluated after 14 days.
• If needed, dosage may be increased to taking one 90 mg capsules twice per day, or one 120 mg capsule taken twice per day.
• Hypertension patients will usually be given another hypertension medication rather than increasing Tildiem Retard dosage over 240 mg per day.

Treating angina usually consists of:

• Patients are started on a single 90 mg capsule taken once per day.
• If needed, dosage may be increased to one 90 mg capsules taken three times per day; or
• Two 120 mg capsules taken twice per day.

Patients who experience serious or disruptive side effects at the starting doses of 90 or 120 mg may have dosage reduced even further, as may those who have other medical conditions or take other medications that put patients at increased risk of side effects. Speak with a doctor about alternative products.

Off-label uses can be quite variable. Patients interested in Tildiem Retard for off-label treatment should consult a doctor.

Potential Complications

There are some other medical conditions that put patients at increased risk of serious complications when Tildiem Retard is taken, namely:

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

And other medications known to interact with Tildiem Retard include:

• Digoxin
• Cimitidine
• Azole antifungals
• Macrolide antibiotics
• Benzodiapines
• Rifamycins
• St. John's wort
• Aprepitant
• Buspirone
• Ivabradine
• Cold or flu medications
• NSAIDs

All calcium channel blockers will lower blood pressure and slow heart rate, regardless of what they're taken to treat. Any medical condition or medications that reduce blood pressure and/or influence heart rate have the potential to cause serious complications and should be brought to the attention of the prescribing doctor

Don't be afraid to bring up any questions or concerns to a doctor, no matter how trivial they may seem.