Drugs Q & A

Why Take Diltiazem On Empty Stomach (3 Reasons)

Diltiazem is a medication that belongs to the class of drugs known as calcium channel blockers. It is primarily used to treat high blood pressure (hypertension), angina (chest pain), and certain types of irregular heart rhythms (arrhythmias).

Diltiazem works by blocking the entry of calcium into the smooth muscle cells of the heart and blood vessels. By doing so, it relaxes and widens the blood vessels, which helps to lower blood pressure and improve blood flow to the heart. It also reduces the workload of the heart, making it useful in the management of angina and certain arrhythmias.

The history of diltiazem dates back to the mid-1960s when it was first synthesized by scientists at the Belgian pharmaceutical company Janssen Pharmaceutica. Initial research focused on developing a compound that would selectively dilate coronary arteries while having minimal effects on other blood vessels. This led to the discovery of diltiazem, which exhibited potent vasodilatory effects on coronary arteries.

In the early 1970s, clinical trials began to evaluate the efficacy and safety of diltiazem in patients with angina and hypertension. The results showed promising outcomes, leading to the approval of diltiazem for medical use in several countries. It was first introduced to the market under the trade name “Cardizem” by Marion Merrell Dow Pharmaceuticals.

Over the years, diltiazem has become widely prescribed for various cardiovascular conditions. It is available in different formulations, including immediate-release tablets, extended-release capsules, and intravenous formulations. The extended-release formulations are designed to provide a more prolonged effect, allowing for once-daily dosing.

Diltiazem is effective not only in managing hypertension, angina, and arrhythmias but also in preventing certain types of migraines. It is commonly used as a second-line treatment option when other medications are not well tolerated or contraindicated.

How is Diltiazem taken?

Diltiazem is available in different formulations, and the specific dosing instructions may vary depending on the condition being treated and the formulation prescribed by the healthcare provider. It is essential to follow the instructions provided by your healthcare professional and the directions on the medication label. Here are some general guidelines for taking diltiazem:

1.      Immediate-Release Tablets: These tablets are typically taken 3 to 4 times per day, with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew the tablet unless your healthcare provider specifically instructs you to do so.

2.      Extended-Release Capsules: Extended-release capsules are designed to release the medication slowly over time, allowing for once-daily dosing. These capsules should be swallowed whole and should not be opened, crushed, or chewed. Take the capsule with a glass of water, and follow your healthcare provider’s instructions regarding whether to take it with or without food.

3.      Intravenous (IV) Formulation: Diltiazem is also available as an intravenous formulation, typically administered in a hospital setting under medical supervision. The dosage and infusion rate will be determined by your healthcare provider based on your specific condition and needs.

It is important to take diltiazem as prescribed and not to change the dosage or stop taking the medication without consulting your healthcare professional. Even if you feel better, it is crucial to continue taking the medication as directed to maintain its effectiveness.

If you have any questions or concerns about the dosing or administration of diltiazem, it is best to consult your healthcare provider or pharmacist for clarification and guidance based on your specific situation.

Why Take Diltiazem On An Empty Stomach?

The instructions to take diltiazem on an empty stomach may vary depending on the specific formulation prescribed by your healthcare provider. However, there are a few reasons why some medications, including diltiazem, are recommended to be taken on an empty stomach:

1.      Absorption: Taking diltiazem on an empty stomach may enhance its absorption into the bloodstream. Some medications can be affected by the presence of food in the stomach, which can slow down or alter the absorption process. By taking diltiazem on an empty stomach, you can help ensure consistent and predictable absorption of the medication.

2.      Interactions with Food: Certain foods, particularly those high in fat content, can interfere with the absorption of diltiazem and other medications. Fat-rich meals can delay the absorption of diltiazem, resulting in a slower onset of action or decreased effectiveness. Taking diltiazem on an empty stomach minimizes the potential for such interactions.

3.      Optimal Blood Levels: Taking diltiazem on an empty stomach may help achieve and maintain optimal blood levels of the medication. Consistency in blood levels is crucial for achieving the desired therapeutic effect and controlling conditions such as high blood pressure or angina.

However, it’s important to note that not all formulations of diltiazem require an empty stomach. Extended-release formulations, for example, may be designed to be taken with or without food, as they are specifically formulated to provide a gradual and sustained release of the medication over time.

Always follow the specific instructions provided by your healthcare provider or the directions on the medication label regarding whether diltiazem should be taken on an empty stomach or with food. If you have any doubts or concerns about the administration of diltiazem, it is best to consult your healthcare provider or pharmacist for clarification based on your specific situation.

How To Make Diltiazem More Effective

To ensure the effectiveness of diltiazem, it is important to follow your healthcare provider’s instructions and consider the following recommendations:

1.      Take it as prescribed: Follow the prescribed dosage and schedule provided by your healthcare provider. Do not skip doses or alter the dosage without consulting them first. Consistency in taking the medication is crucial for maintaining therapeutic blood levels.

2.      Timing: Take diltiazem at the same time each day to establish a routine. This can help maintain consistent blood levels and ensure the medication is working effectively.

3.      Follow dietary guidelines: Some dietary factors can affect the absorption and effectiveness of diltiazem. Avoid consuming grapefruit or grapefruit juice, as it can interfere with the metabolism of the medication. Additionally, try to maintain a healthy diet and avoid excessive consumption of high-fat meals that may affect the absorption of diltiazem.

4.      Avoid interactions with other medications: Certain medications, both prescription and over-the-counter, can interact with diltiazem and affect its effectiveness. Inform your healthcare provider about all the medications you are taking, including supplements or herbal remedies, to ensure there are no potential interactions. Your healthcare provider can help adjust your medication regimen if necessary.

5.      Regular check-ups: Attend regular follow-up appointments with your healthcare provider to monitor your condition and the effectiveness of diltiazem. They may adjust the dosage or make other recommendations based on your progress and any changes in your health.

6.      Lifestyle modifications: Complementing diltiazem treatment with a healthy lifestyle can contribute to better overall cardiovascular health. Maintain a balanced diet, engage in regular physical activity, manage stress, and avoid tobacco and excessive alcohol consumption. These lifestyle modifications can help optimize the effectiveness of diltiazem in managing conditions like high blood pressure and angina.

Always consult your healthcare provider for personalized advice on how to optimize the effectiveness of diltiazem based on your specific medical condition and needs. They can provide guidance tailored to your situation and monitor your progress.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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