Angitil

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Angitil

Property Description
Active ingredient Diltiazem Hydrochloride
Form Tablet, Extended-release capsule, Injectable solution
Pharmacological class Nondihydropyridine Calcium Channel Blocker (CCB)
General purpose Management of cardiovascular dynamics
Origin Synthetic compound

What Type of Medicine is Angitil?

Angitil is a prescription-only synthetic pharmaceutical drug whose core component is Diltiazem Hydrochloride. This single-component agent is classified as a cardiovascular medication intended for systemic use. Diltiazem belongs to the Nondihydropyridine Calcium Channel Blocker (CCB) pharmacological class. Its identity as a benzothiazepine derivative chemically distinguishes it from other calcium channel blockers, giving it a recognized ability to influence both vascular tone and the heart's electrical system. This unique dual activity is recognized for its role in rate control in certain cardiac rhythm disorders.

Angitil’s General Purpose and Formulation

The overall therapeutic purpose of Angitil is to modulate cardiovascular dynamics, working to improve blood flow and regulate the heart's electrical rhythm. The drug is generally employed in situations where reducing the heart's overall workload and concurrently lowering systemic blood pressure are essential. For example, it is typically used in a clinical setting to address a persistently fast or irregular heartbeat. Angitil is prepared in multiple dosage forms to suit different clinical needs, including the standard tablet and extended-release capsule for convenient oral administration, as well as an injectable solution for acute intravenous use. Diltiazem is categorized as an essential medicine, which emphasizes its established importance as a vital medication in global healthcare systems.

Regulatory References

  1. NIH MedlinePlus Diltiazem Information
  2. WHO Model List

What side effects are possible with Angitil?

Possible Side Effects and Safety Information

The safety profile for Angitil (diltiazem) is officially documented by government regulatory agencies and is categorized by the frequency and body system affected by adverse reactions.

Frequency-Classified Adverse Reactions

The most frequent adverse reactions reported in regulatory documents include common effects such as peripheral edema (swelling of ankles or feet), headache, flushing, and constipation. Less common effects include palpitations and vomiting.

Classification Examples of Reactions
Common Peripheral edema, headache, flushing, dizziness, constipation, nausea, general weakness.
Uncommon Bradycardia (slow heart rate), nervousness, insomnia, vomiting, diarrhea.
Not Known Heart failure, severe bradycardia, second- or third-degree AV block, acute hepatic injury, severe skin reactions.

Serious Adverse Reactions and Restrictions

Official documents highlight the potential for serious adverse reactions, which include severe cardiac conduction issues such as second- or third-degree atrioventricular (AV) block, acute liver injury (hepatitis), and severe skin disorders (e.g., Stevens-Johnson syndrome).

Contraindications define situations when Angitil must not be used. These include specific pre-existing heart conditions like sick sinus syndrome (without a pacemaker), second- or third-degree AV block (without a pacemaker), and severe hypotension. The medicine is also officially restricted for use with certain other drugs that are noted to increase the risk of serious adverse effects (e.g., dantrolene).

Population-Specific Safety Notes

Safety precautions are specifically noted for certain patient groups. Individuals with reduced ventricular function, a history of heart failure, or pre-existing hepatic or renal impairment may require close monitoring. The medicine is contraindicated during pregnancy and breastfeeding based on regulatory safety information.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documentation for Angitil (Diltiazem) identifies a clear profile of serious, life-threatening manifestations in the event of an overdose. The primary effects are severe cardiovascular disturbances, including profound bradycardia (abnormally slow heart rate), severe hypotension, and the development of high-degree Atrioventricular (AV) Block. Overdose may also present with confusion, dizziness, and hyperglycemia. The most serious outcomes recognized by regulatory sources are shock, cardiac arrest (asystole), and death. Individuals of advanced age or those with preexisting cardiac impairment are noted to be at a heightened risk for a more severe outcome.


Seeking Emergency Medical Help

Regulatory agencies require that individuals seek immediate medical help right away upon suspecting an overdose. Urgent action is mandated, specifically calling emergency services, if the person has collapsed, had a seizure, has trouble breathing, or cannot be awakened. Management focuses on supportive measures, as no specific antidote is consistently recognized. Officially described interventions include gastrointestinal decontamination, administration of intravenous Atropine, vasopressors, and potentially cardiac pacing. An overnight hospital stay and continuous cardiac monitoring may be required, particularly with extended-release formulations, due to the potential for delayed toxicity. The drug is officially noted as not being effectively removed by standard peritoneal or hemodialysis.

Therapeutic Uses of Angitil

Angitil (diltiazem) is a prescription medication utilized in managing certain cardiovascular conditions. Its primary role involves assisting with the control of high blood pressure, also known as hypertension. Maintaining blood pressure within a healthy range is part of a comprehensive strategy for reducing the potential risk of associated events like stroke and myocardial infarction.

The medication is also indicated for the management of chronic stable angina, which is chest discomfort caused by heart disease. Angitil supports the process of improving exercise tolerance in individuals with this condition and may help in reducing the frequency of anginal attacks. Furthermore, the medication serves a role in addressing certain types of supraventricular arrhythmias, which are abnormal heart rhythms.

Healthcare providers may prescribe Angitil alone or as a component of a combination therapy approach, evaluating the potential benefits and risks for each individual.

Quick Facts

  • May assist with: Management of high blood pressure (hypertension).
  • Supports the process of: Improving exercise tolerance in chronic stable angina.
  • Serves a role in: Addressing certain supraventricular arrhythmias.

Eligibility and Restrictions for Use

Angitil (diltiazem) eligibility is defined by strict regulatory contraindications, special warnings, and limitations related to age and physiological status.

Populations for whom use is Contraindicated

Category Exclusion Condition
Cardiac Conduction Sick Sinus Syndrome or Second-/Third-Degree AV Block (unless functioning ventricular pacemaker is present).
Hemodynamic Status Severe Hypotension (systolic BP < 90 mmHg); Cardiogenic Shock; Acute Myocardial Infarction with pulmonary congestion.
Other Hypersensitivity to diltiazem; Atrial Fibrillation/Flutter associated with an accessory bypass tract (e.g., Wolff-Parkinson-White syndrome).

Use in Special Populations

Population Official Regulatory Status
Pediatric Use is not recommended; safety and efficacy have not been established.
Pregnancy/Lactation Not recommended during pregnancy or breastfeeding; use is generally contraindicated or advised only when the benefit justifies the risk.
Hepatic/Renal Impairment Use with caution is required; regular monitoring of liver and kidney function is advised.

The drug is used with caution in patients with a history of Congestive Heart Failure or impaired ventricular function due to its negative effect on heart contractility. Older adults may require closer monitoring and careful dose titration.

What should I know about interactions with other medicines?

Angitil (diltiazem) is an inhibitor of the CYP3A4 enzyme and a P-glycoprotein substrate/inhibitor, meaning it can significantly interact with many other medications. These interactions can alter the levels of either Angitil or the other medicine, potentially leading to increased risk of side effects or reduced effectiveness. Always inform your healthcare provider about all medicines, over-the-counter drugs, vitamins, and herbal supplements you are taking.

Medications with Major Interaction Risk

Co-administration with medicines that also affect heart rhythm or blood pressure requires careful monitoring due to the risk of exaggerated effects like pronounced slow heart rate (bradycardia), heart conduction disturbances (e.g., AV block), or severe hypotension.

  • Beta-blockers (e.g., metoprolol, propranolol) and Antiarrhythmics (e.g., amiodarone, digoxin, quinidine) can increase the risk of cardiac adverse effects.
  • Ivabradine and Dantrolene (infusion) are generally contraindicated.

Other Significant Interactions

Angitil can increase the plasma concentrations of certain drugs, necessitating dose adjustment and monitoring:

  • Statins (e.g., simvastatin, atorvastatin, lovastatin) – Increased risk of muscle side effects. A lower dose of the statin may be required.
  • Immunosuppressants (e.g., ciclosporin, tacrolimus) – Increased drug levels may cause toxicity.
  • Anticonvulsants (e.g., carbamazepine, phenytoin) – Increased risk of toxicity from the anticonvulsant.
  • Direct Oral Anticoagulants (DOACs) (e.g., apixaban, rivaroxaban) – Increased risk of bleeding.

Conversely, some medicines can lower Angitil's effectiveness. For instance, Rifampicin can significantly decrease Angitil's blood levels, and St. John's Wort is also thought to reduce its effect.

Avoid excessive consumption of grapefruit and grapefruit juice, as it can increase Angitil's concentration in the body.

Mechanism of Action

Angitil, a benzothiazepine derivative, functions as a voltage-dependent inhibitor of the L-type calcium channels in the cardiac and vascular smooth muscle cell membranes.

By binding to the alpha-1 subunit of this channel, the compound restricts the transmembrane influx of extracellular calcium ions into the cytosol during the depolarization phase. This blockade diminishes the concentration of intracellular Ca^2+ available for the contractile process.

At the level of the myocardium, this action results in a negative inotropic effect (reduced force of contraction) and a negative chronotropic effect (slowing of the sinoatrial node firing rate). It also modulates the cardiac electrical conduction by impeding the slow channel function within the atrioventricular (AV) node, prolonging the effective refractory period.

In vascular tissue, the reduced intracellular calcium concentration facilitates the relaxation of the vascular smooth muscle cells, resulting in a decrease in peripheral vascular resistance and systemic arterial pressure. The compound's action is more pronounced in the coronary arteries. These combined hemodynamic alterations result in a reduced cardiac workload and an altered distribution of blood flow.

Dosage and Administration Information

Administration Scope

Angitil (diltiazem) is administered according to two primary, distinct protocols: oral maintenance therapy and acute intravenous (IV) intervention. The oral route is used for chronic management and is available in both Immediate-Release (IR) tablets and Extended-Release (ER) capsules/tablets. IR forms require administration multiple times per day, typically three to four times daily, with instructions to take the tablets before meals and at bedtime. In contrast, ER formulations are designed for once-daily dosing and should be swallowed whole without chewing or crushing, as doing so would disrupt the controlled release mechanism.


Dosing and Procedural Structure

Dosing schedules vary by form and indication. For chronic use, starting doses typically range from 30 mg four times a day for IR forms, or 120 mg to 240 mg once daily for ER forms. The daily dose may be adjusted at intervals of 7 to 14 days up to a maximum of 540 mg per day.

The intravenous route is reserved for acute settings, following a distinct protocol. This involves a rapid, initial IV bolus dose, administered over 2 minutes, followed, if necessary, by a second bolus and a continuous infusion. This acute infusion is generally limited to a duration of 24 hours or less. Due to the drug's metabolism, clinical practice includes careful monitoring of renal and hepatic function in patients with impairment.

Recent Clinical Evidence

Research evidence / Overview of studies for Angitil (Diltiazem)


Evidence for Use in Managing High Blood Pressure

The clinical evaluation of Angitil for high blood pressure was primarily conducted through randomized, double-blind, placebo-controlled trials (RCTs). These studies focused heavily on physiological measurements, using various protocols to monitor the change in blood pressure (both systolic and diastolic) over defined time intervals. Trials reported measurements showing patterns related to blood pressure change from baseline during the study periods. However, many trials assessing the most immediate physiological effect were relatively short-term, often lasting only a few weeks. Dedicated trials tracking the reduction of hard endpoints, such as the actual prevention of stroke or heart attack risk solely against a placebo over many years, remain limited.

Evidence for Use in Chronic Stable Angina

For chronic stable angina, research has explored the medication's effect on functional limitations and outcomes related to physical discomfort. Studies utilized randomized, double-blind trials. Researchers focused on measuring exercise capacity, assessing what changes were observed in patient performance on a standardized treadmill protocol during the study. Additionally, studies monitored patient-reported outcomes describing perceived discomfort. Trials described patterns related to changes observed in both functional capacity and symptom frequency. Follow-up durations were limited in many of these studies, focusing on the immediate symptomatic and functional impact over weeks or months.

Evidence for Use in Controlling Rapid Heart Rhythms

Research examining Angitil's role in acutely controlling rapid heart rates relies mainly on controlled clinical trials using the rapid-acting injectable (IV) formulation. The core outcomes monitored were acute, rapid physiological changes, specifically the time to control and the reduction of the ventricular rate. These acute trials reported rapid, measurable heart rate changes immediately following intravenous administration. The research largely focuses on the immediate, temporary physiological imbalance studied using the injectable form.

Key Evidence Gaps and Areas of Uncertainty

A primary limitation across the research base is that the follow-up durations were limited in many key trials. This means long-term effects are not fully established across all indications. The evidence quality varies across studies, and some studies utilized modest sample sizes relative to current standards. Overall, research describes patterns related to short-term physiological changes, but it highlights what is known—and what is still uncertain—regarding long-term patient outcomes.

Key Studies & References

  1. diltiazem hydrochloride injection Prescribing Information
  2. Diltiazem - StatPearls (General authoritative overview of indications, dosing, and safety)

Frequently Asked Questions (FAQ)

Common questions about Angitil (FAQ)


Q: What is the average time Angitil stays active in the body?

According to official product information, the rate at which Angitil is processed by the body is measured by its plasma elimination half-life. For the immediate-release tablet formulation, this process is generally completed within about 3.0 to 4.5 hours following a single or repeated dose.


Q: Is it normal to feel tired when starting Angitil?

Feeling unusually weak, which is sometimes referred to as Asthenia or general fatigue, is reported in regulatory documents as a possible side effect of Angitil. Persistent or severe tiredness should be discussed with a healthcare professional.


Q: Can Angitil cause weight gain or weight loss?

While not listed as a common side effect itself, official warnings note that rapid, unexplained weight increase may be a symptom that should be discussed with a healthcare provider immediately. This is because rapid weight change can sometimes be associated with heart failure, a serious reaction that the medication can affect.


Q: What are some signs that a side effect from Angitil might be serious?

Regulatory warnings highlight the potential for serious adverse reactions. Signs that suggest a serious adverse reaction, and warrant immediate discussion with a healthcare provider, may include severe symptoms like blistering or peeling of the skin, yellowing of the skin or eyes (jaundice), or symptoms of heart failure such as sudden swelling in the feet combined with unusual tiredness. Fainting or persistent lightheadedness can also be a sign of a dangerously slow heart rate.


Q: What happens if I accidentally miss a dose of Angitil?

Patient information typically advises taking the dose as soon as it is remembered, unless it is close to the time for the next scheduled dose. In that case, the missed dose should be skipped entirely. Never take two doses at once to make up for a missed one.


Q: What should I do if I accidentally take two doses of Angitil at once?

If more Angitil is taken than prescribed, urgent medical attention is warranted. Taking too much of this medication can cause serious symptoms such as fainting, extreme dizziness, or unusual sleepiness because it can dangerously slow the heart rate.


Q: Is Angitil better taken in the morning or at night?

The timing depends on the specific formulation prescribed. The immediate-release tablet form is directed to be taken before meals and also at bedtime. The common extended-release capsule is designed for once daily use, and for this version, consistency in the time of daily administration is advised.


Q: Does food affect the way Angitil is absorbed?

For the immediate-release tablet, the drug is well absorbed regardless of food. For some extended-release formulations, official studies have shown that consuming the medication alongside a high-fat content breakfast generally does not significantly change the extent to which the drug is absorbed by the body.


Q: Can taking Angitil make me dizzy or lightheaded?

Yes, regulatory documents list dizziness as a common adverse reaction for Angitil. Experiencing lightheadedness is also reported, as it can be a symptom related to the lowering of blood pressure (hypotension) that the drug is designed to cause.


Q: Is Angitil a blood thinner?

Angitil (Diltiazem) is chemically classified as a Calcium Channel Blocker, not an anticoagulant (blood thinner). However, official interaction information notes that it can increase the concentration of some blood-thinning medications, such as Direct Oral Anticoagulants (DOACs).


Q: Can Angitil cause changes in mood or anxiety?

Official adverse reaction lists note that some effects related to the central nervous system have been reported. Specifically, nervousness and insomnia (difficulty sleeping) are listed as uncommon side effects, and more general mental/mood changes like agitation or depression have also been reported.


Q: Are there generic versions of Angitil available?

Yes, according to government regulatory sources, the active ingredient in Angitil, diltiazem hydrochloride, has approved generic versions. These are available in various formulations and strengths approved by health authorities.


Q: Can Angitil interact with alcohol?

Official patient information states that alcohol should be used with caution. Since alcohol can independently lower blood pressure, combining it with Angitil may lead to an additive effect, significantly increasing the risk of side effects like dizziness or fainting. Consumption of alcohol should always be discussed with a healthcare professional.


Q: Does Angitil cause hair loss?

Loss or thinning of the hair, also known as alopecia, has been included in official regulatory documents as a rare or post-marketing adverse effect. This means the event has been reported by users, but the actual frequency is generally unknown.


Q: What is the typical starting dose of Angitil for heart conditions?

The specific dose varies greatly by form and indication. Official labeling provides typical starting ranges, such as initial doses for the most common extended-release capsules often being between 120 mg to 240 mg once daily.

How should Angitil be stored and disposed of?

Storage Requirements

Angitil (diltiazem hydrochloride) must be stored according to official regulatory guidelines to maintain its stability. Labeled storage temperature requirements for the capsules specify maintaining the product at Controlled Room Temperature, typically 20 C to 25 C (68 F to 77 F), while protecting it from excessive heat and freezing. The medicine must be kept in its original packaging and must not be used after its expiration date.

Handling and Disposal

To ensure safety, this medicine must be kept out of the sight and reach of children.

Regarding disposal, regulatory instructions prohibit discarding unused or expired Angitil through wastewater or household trash. Patients are officially instructed to ask a pharmacist for guidance on proper disposal, which typically involves utilizing a drug take-back program.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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