Angizem CD - 90

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Angizem CD - 90

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

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 Angizem CD - 90

Property Description
Active ingredient Diltiazem hydrochloride
Form Controlled-Delivery (CD) Oral Tablet/Capsule
Pharmacological class Non-dihydropyridine Calcium Channel Blocker (CCB)
Common use (Class Level) Management of cardiovascular conditions
Origin Synthetic Benzothiazepine derivative

Angizem CD - 90 is a synthetic, prescription-only cardiovascular medication, clinically recognized for its role in managing conditions requiring precise control over heart function and peripheral circulation. It is defined by its active component, Diltiazem hydrochloride, and its placement within the therapeutic group of calcium channel blockers (CCBs). It is administered via the oral route.


Angizem CD - 90: Core Identity and Pharmacological Classification

Angizem CD - 90 is primarily defined by the active substance, Diltiazem hydrochloride, which is chemically a Benzothiazepine derivative. This compound is classified as a non-dihydropyridine Calcium Channel Blocker (CCB), characterizing its ability to modulate both vascular tone and cardiac conduction. This classification means Diltiazem exerts functional effects on both the peripheral blood vessels and the heart's electrical system, separating its mechanism from CCBs that primarily target only blood vessels.


What Does the Controlled-Delivery (CD) Formulation Mean?

The CD in Angizem CD signifies a Controlled-Delivery, or sustained-release, oral tablet or capsule formulation. This specific preparation is designed to ensure the Diltiazem hydrochloride is released slowly and evenly over many hours into the body, a feature in pharmacotherapy for chronic conditions. This controlled mechanism is intended for maintaining a stable, consistent concentration of the active ingredient in the bloodstream, avoiding sharp concentration fluctuations and supporting continuous management throughout the day.


General Therapeutic Purpose of Diltiazem

The general purpose of Diltiazem is to decrease the overall workload on the heart and promote efficient blood flow. By inhibiting the influx of calcium ions into cardiac and vascular smooth muscle cells, the medication relaxes and widens the blood vessels (vasodilation) while modulating the speed of electrical signals within the heart. This combined physiological action helps to stabilize cardiovascular function, for instance, in managing consistently elevated blood pressure.

What side effects are possible with Angizem CD - 90?

Adverse Reactions and Safety Profile

Angizem CD (diltiazem extended-release) is associated with a range of possible side effects, predominantly affecting the cardiovascular, nervous, and gastrointestinal systems. All reported adverse events and safety limitations are based on official governmental regulatory documents.

Adverse Reactions Summary

Classification Examples of Documented Reactions
Common Headache, dizziness, peripheral edema (swelling of hands, feet, ankles), constipation, nausea, flushing.
Serious / Clinically Significant Second- or third-degree AV block, Sick Sinus Syndrome (without a pacemaker), severe hypotension (low blood pressure), acute hepatic injury (liver damage), and rare but severe skin reactions (e.g., Stevens-Johnson syndrome).

Safety Considerations and Restrictions

  • Contraindications: Use is strictly prohibited in patients with Sick Sinus Syndrome or Second- or Third-Degree AV block (unless a functioning ventricular pacemaker is present), severe hypotension (systolic BP less than 90 mm Hg), or acute myocardial infarction with pulmonary congestion.
  • Population-Specific: The drug is not recommended for use in children (safety and efficacy not established). It is contraindicated or not recommended in pregnancy and during breastfeeding due to documented risks based on animal and limited human data.
  • Dose Dependence: The incidence of certain adverse reactions, including first-degree AV block and sinus bradycardia (slow heart rate), is explicitly noted to increase as the dosage increases.
  • Monitoring Notes: Laboratory parameters for hepatic and renal function should be monitored at regular intervals during prolonged therapy. Close observation is also necessary for potential cardiac conduction disturbances, especially when co-administered with other heart-affecting medications like beta-blockers or digitalis.

Overdose and Emergency Response

Overdose and When to Seek Help

Official regulatory documents define the overdose profile of Diltiazem hydrochloride, the active component of Angizem CD - 90, based on severe cardiovascular manifestations that require immediate clinical intervention. Overdose or an exaggerated response may present with documented clinical findings including bradycardia (abnormally slow heart rate), severe hypotension (low blood pressure), high-degree atrioventricular (AV) block, and potentially cardiac failure.

Immediate medical attention is required for any suspected overdose due to the necessity of complex, controlled emergency procedures. Regulator-mandated actions include initiating appropriate supportive measures, such as gastrointestinal decontamination, and specific pharmacological management based on the manifestation. For instance, Atropine or Isoproterenol may be needed for severe bradycardia, while Vasopressors or Inotropic agents are required for managing hypotension or cardiac failure, respectively. Specialized procedures like cardiac pacing are mandated for fixed high-degree AV block.

Official statements confirm the drug is not effectively removed by peritoneal or hemodialysis. Due to the controlled-delivery (CD) nature of the formulation, close and continuous hospital monitoring is necessary, as effects may be prolonged or delayed. Individuals with pre-existing cardiac impairment may experience more severe outcomes.

Therapeutic Uses of Angizem CD - 90

What Angizem CD - 90 Treats: Main Uses and Benefits

Angizem CD - 90 (Diltiazem CD) is commonly used in the management of certain chronic cardiovascular conditions, addressing symptoms that interfere with daily function. The controlled-delivery formulation supports continuous, prolonged symptomatic management. Its use is generally considered relevant for key cardiovascular therapeutic areas.


Therapeutic Scope and Patient Benefit

This medication is applied in conditions involving persistently elevated systemic blood pressure (hypertension), chronic stable angina, and certain supraventricular arrhythmias like atrial fibrillation. A primary therapeutic role is to provide support that helps ease the symptom burden of elevated blood pressure, which assists in reducing the overall strain on the cardiovascular system. For patients experiencing chest pain, the drug is relevant for managing anginal episodes, which, along with the management of a rapid and irregular heart rate in arrhythmia, helps maintain functional stability.

“The therapeutic approach supports patients in coping more steadily with symptom fluctuations associated with chronic heart conditions.”

Quick Fact: Relief for Chest Pain Episodes The medication is applied when symptomatic discomfort is linked to organ-specific functional stress, which supports improved comfort during periods of heightened symptoms.

Regulatory References

  1. National Library of Medicine's DailyMed service

Eligibility and Restrictions for Use

Angizem CD-90 (Diltiazem CD) eligibility is strictly defined by regulatory documents, which outline populations that are absolutely prohibited or require conditional use based on clinical status or life stage.

Absolute Contraindications (Must Not Use)

The medicine must not be used by individuals diagnosed with absolute contraindications, which include known Hypersensitivity to Diltiazem, Cardiogenic Shock, and Severe Hypotension. Use is also prohibited in patients with pre-existing cardiac conduction abnormalities such as Sick Sinus Syndrome or Second- or Third-Degree Atrioventricular (AV) Block, unless a functioning ventricular pacemaker is present. Patients experiencing an Acute Myocardial Infarction (MI) with Pulmonary Congestion are also excluded.

Special Population Eligibility

Population Group Regulatory Status
Pediatric Patients (Children) Safety and effectiveness are not established; use is not recommended.
Pregnancy Contraindicated (European labeling); use only if the potential benefit justifies the potential risk (US labeling).
Lactation (Breastfeeding) Diltiazem is excreted in human milk; avoid breastfeeding.

Conditional Use and Restrictions

Use is restricted and requires caution in patients with hepatic impairment (liver problems) or renal impairment (kidney problems). The medicine must also be used with caution in patients with Congestive Heart Failure or impaired ventricular function. Geriatric patients are typically subject to careful monitoring.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official interaction profile of Diltiazem CD is fundamentally defined by its documented roles in drug metabolism and cardiac function. Diltiazem is classified as a clinically relevant inhibitor of the Cytochrome P450 3A4 enzyme system (CYP3A4) and the P-glycoprotein (P-gp) efflux transporter. This established pharmacokinetic basis indicates that co-administration can increase the systemic exposure (plasma concentration) of numerous other medicinal products that are substrates of these systems.

Official Regulatory Restrictions

A severe restriction is documented concerning pharmacodynamic interactions. Co-administration with Intravenous Beta-Blockers is officially classified as a contraindicated combination due to the potential for critical, additive effects that depress cardiac conduction and contractility.

Interaction Type Examples of Affected Substances (Exposure Increased)
Metabolic/PK Midazolam, Triazolam, Carbamazepine, Propranolol, Cimetidine (increases Diltiazem levels).
Pharmacodynamic Digitalis (additive effect on AV conduction), Oral Beta-Blockers, Anesthetics, Clonidine.

Formulation and Population Constraints

The controlled-delivery (CD) formulation has a specific substance constraint: the simultaneous consumption of alcohol must be avoided, as regulatory documents note that alcohol increases the drug's release rate, leading to increased systemic exposure. Additionally, patients with existing hepatic or renal impairment may be at a heightened risk regarding the interaction effects of co-administered CYP3A4 substrates, requiring appropriate management as defined in official prescribing information.

Mechanism of Action

How Angizem CD - 90 Works

The mechanism of Angizem CD - 90 (Diltiazem) centers on the targeted blockade of Voltage-Gated L-Type Calcium Channels ( CaV1.2). By inhibiting the flow of Ca^2+ ions into key cells, Diltiazem directly modulates the mechanical force of the heart and the electrical signaling within its conduction system. This blockade defines the drug's mechanism within the non-dihydropyridine class.


Controlling Vascular Resistance and Myocardial Force

This domain covers the drug's influence on the muscular component of the cardiovascular system. By reducing Ca^2+ entry into arterial smooth muscle cells, the mechanism induces vasodilation, leading to a reduction in systemic vascular resistance (SVR) and afterload. Simultaneously, the blockade of L-type channels in cardiac muscle cells limits the Ca^2+ available for contraction, producing a reduction in the force of myocardial pumping (negative inotropy).


Modulating Electrical Conduction Time

This domain focuses on Diltiazem's impact on the heart's electrical pathways. The drug preferentially affects the Ca^2+-dependent action potentials within the Atrioventricular (AV) node, slowing the speed at which electrical signals are transmitted from the upper to the lower chambers. This action effectively prolongs the AV nodal refractory period, resulting in a reduction in the overall electrical activity rate of the ventricles (negative dromotropy).

Dosage and Administration Information

How to Use Angizem CD - 90: Administration Guidelines

Angizem CD - 90 is an Extended-Release (CD) formulation of diltiazem hydrochloride, administered via the oral route for long-term chronic management. The Controlled-Delivery mechanism is designed to provide a sustained release over a full 24-hour period.


Dosing and Frequency

This medication is taken once daily at approximately the same time each day to maintain consistent blood concentration. For most adult indications, initial doses typically range from 180 mg to 240 mg once daily. Doses are adjusted gradually, usually at intervals of 7 to 14 days, based on clinical need, with maximum doses generally not exceeding 360 mg to 540 mg once daily.


Administration Conditions

Procedural Requirement Guideline
Physical Handling The capsule or tablet must be swallowed whole; it must not be chewed, crushed, or broken.
Timing May be taken with or without food.
Missed Dose If a dose is missed, it should not be doubled; the patient should simply take the next scheduled dose at the regular time.

Population-Specific Administration Rules

Caution and specialized monitoring are used when prescribing this medication to certain populations. For older adults and patients with hepatic or renal impairment, a lower initial starting dose may be necessary. The safety and efficacy of diltiazem extended-release products have not been established for the pediatric population.

Recent Clinical Evidence

Research evidence / Overview of studies for Angizem CD - 90

Evidence for Use in Managing High Blood Pressure (Systemic Hypertension)

Research has widely explored Diltiazem CD in studies of patients with consistently elevated blood pressure in adults with essential hypertension. This research involved randomized, double-blind, placebo-controlled clinical trials (RCTs). The studies monitored outcomes, primarily focusing on the measurement of Systolic and Diastolic Blood Pressure (BP). Longer-term comparative research was also conducted, which compared cardiovascular event endpoints, such as stroke or heart attack, with outcomes observed when using other agents used for the condition. Research has also included specific studies examining the condition in elderly patient populations with hypertension.

Short-term trials described patterns in blood pressure measurements when Diltiazem CD was compared to an inactive placebo. What remains uncertain is the full long-term context for all available doses. Evidence is limited regarding the use of the highest once-daily dose strengths of the controlled-delivery formulation in extended, long-term trials.


Evidence for Use in Managing Chronic Stable Angina (Chest Pain)

Diltiazem CD was evaluated in research involving participants with chest pain episodes associated with chronic stable angina. Research in this area primarily consists of short-term randomized, placebo-controlled trials. These studies monitored outcomes related to symptoms in observed populations. Key study outcomes were related to functional capacity, specifically measuring the length of time participants could engage in exercise before the onset of anginal episodes. Controlled studies reported measurements of participants' functional capacity, with findings described patterns observed in the measurement of functional capacity outcomes. The majority of this research is predominantly short-term, providing limited insight into the maintenance of symptomatic changes beyond the initial observation period.


What Is Still Uncertain About Angizem CD - 90 Evidence

While the core research base is substantial for common indications, several research limitations frames apply. Sample sizes were modest in some of the more specialized studies, particularly those concerning vasospastic angina. Evidence quality varies across studies, and there is a recognized lack of comprehensive long-term data for the highest dose strengths of the controlled-delivery formulation. Comparative evidence is lacking for certain long-term endpoints when Diltiazem is studied alongside other common heart medications. Research provides context but not individual predictions, and the results apply only to the specific populations and conditions studied.

Key Studies & References

  1. DailyMed Drug Label for Diltiazem Hydrochloride Extended-Release Capsules (Setting Therapeutic Scope)
  2. General Evidence for Diltiazem in Hypertension (Derived from RCTs and Meta-analyses)
  3. General Evidence for Diltiazem in Chronic Stable Angina (Derived from RCTs and Systematic Reviews)
  4. General Evidence for Diltiazem in Atrial Arrhythmias (Derived from Controlled Studies)

Frequently Asked Questions (FAQ)

Common questions about Angizem CD - 90 (FAQ)

Q: Why is Angizem CD - 90 prescribed instead of regular Angizem?

The CD stands for Controlled-Delivery, which is a sustained-release formulation. Official product information states this design ensures the medication is released slowly and evenly over 24 hours. This controlled delivery supports a consistent therapeutic concentration and allows the medicine to be taken only once daily.

Q: Are there any common over-the-counter medicines that interact with Angizem CD - 90?

Regulatory documents indicate that Diltiazem affects the body's metabolism of many other drugs. This means there is a potential for interaction with certain over-the-counter medicines, vitamins, and supplements. Patients are encouraged to discuss all products they use with a healthcare provider.

Q: What heart conditions is Angizem CD - 90 used for?

According to official US labels, this medicine is approved for treating systemic hypertension (high blood pressure). It is also used in the management of chronic stable angina, angina due to coronary artery spasm, and to control the rapid ventricular rate in specific heart rhythm conditions like atrial fibrillation or flutter.

Q: Why do some people say Angizem CD - 90 causes constipation?

Constipation is listed as a commonly reported side effect in official safety summaries. This effect is believed to be linked to how the medicine acts on the smooth muscle in the digestive tract.

Q: What should I do if I notice a change in my heart rate while using this medicine?

If a patient experiences severe symptoms such as fainting, chest pain, significant dizziness, or shortness of breath associated with a change in heart rhythm, seeking immediate medical attention or contacting their healthcare provider is advised. Official warnings state that such symptoms may signal a serious cardiac conduction issue.

Q: Why might a doctor stop prescribing Angizem CD - 90?

A healthcare provider may discontinue this medicine if a patient develops certain serious conditions. These documented reasons include the development of severe hypotension (very low blood pressure), new or worsening cardiac conduction problems, or signs of liver injury.

Q: Do other medicines make Angizem CD - 90 less effective?

Yes, official regulatory information indicates that certain medicines can affect how Diltiazem is processed by the body. This may result in lower blood levels of Diltiazem, which could reduce its intended effectiveness. Consultation with a healthcare provider regarding all current medications is essential to assess potential interactions.

Q: Are there common reasons why people stop taking Angizem CD - 90?

Aside from severe reactions, common side effects such as persistent headaches, dizziness, or fatigue can sometimes lead to discontinuation if they are severe or do not improve. Stopping medication abruptly without clinical guidance is generally discouraged.

Q: What distinguishes Angizem CD - 90 from other calcium channel blockers?

Diltiazem is officially classified as a non-dihydropyridine calcium channel blocker. This classification is key because it means the medicine works in two ways: relaxing blood vessel muscle and modulating the electrical conduction speed within the heart. Other types of calcium channel blockers usually target only the blood vessels.

Q: Can Angizem CD - 90 be used for purposes other than heart-related conditions?

The official FDA-approved label and regulatory documents only describe the use of this medicine for specific cardiovascular conditions, such as hypertension and angina. There are no other approved uses listed on the core prescribing information.

Q: Is it better to take this medicine in the morning or at night?

Official administration rules state that the medicine should be taken once daily at approximately the same time each day to maintain steady blood levels. The exact timing (morning or night) depends on the patient’s specific treatment plan and the type of chronic condition being managed, as directed by their doctor.

Q: Are there any known long-term complications associated with Angizem CD - 90 use?

Official warnings advise that during prolonged therapy, the medicine requires regular monitoring. This is done to check for potential long-term issues, particularly changes in the heart’s electrical system (cardiac conduction abnormalities) and possible effects on liver and kidney function.

Q: How quickly does Angizem CD - 90 start working?

Pharmacological studies show that detectable levels of the medicine reach the bloodstream within approximately 2 hours after administration. However, the full therapeutic benefit in controlling blood pressure or angina often takes up to 2 weeks of consistent daily use to be achieved.

Q: Can Angizem CD - 90 cause extreme tiredness?

Unusual tiredness or weakness, which is sometimes referred to as asthenia or fatigue, is a commonly reported side effect. This is listed in the official safety summary for patients taking extended-release Diltiazem.

Q: Does Angizem CD - 90 cause weight gain or loss?

Weight gain may be observed, which is often associated with fluid retention in the hands, feet, and ankles (peripheral edema). This fluid retention is a common documented side effect. Unexplained or rapid weight gain may warrant discussion with a healthcare provider.

Q: Does Angizem CD - 90 interact with grapefruit juice?

Yes, regulatory patient information advises that consuming grapefruit or grapefruit juice may increase the amount of the medicine in your blood. This increase in concentration could potentially heighten the risk of experiencing side effects. It is generally advised to limit or avoid excessive consumption.

Q: Is it safe to take Angizem CD - 90 with vitamins or supplements?

Official regulatory text advises caution because Diltiazem is known to affect how other substances are processed by the body. Patients are advised to inform their doctor of all vitamins, minerals, and supplements to allow for a review of possible interactions before starting treatment.

Q: Is there a generic version of Angizem CD - 90 available?

Yes, the active ingredient Diltiazem hydrochloride is widely available in generic extended-release capsules and tablets. These generic products are reviewed by the FDA and considered therapeutically equivalent to the brand-name product.

Q: Does taking Angizem CD - 90 affect my ability to drive or operate machinery?

The medicine is known to cause common side effects such as dizziness, lightheadedness, or unusual weakness, especially when a patient first starts treatment. Official patient information notes that patients should exercise caution regarding driving or operating heavy machinery until they understand the medicine's effect on their concentration and reaction time.

Q: Is Angizem CD - 90 habit-forming or addictive?

Official regulatory documents that address drug abuse and dependence potential do not indicate that Diltiazem has an association with being habit-forming or addictive.

Q: Is Angizem CD - 90 commonly used in people with diabetes?

Official warnings advise caution for patients with diabetes. Regulatory documents note that the medicine may affect blood glucose levels in some individuals, which may require additional monitoring by a doctor.

Q: What is the significance of the '90' in the drug name?

The '90' in the drug name refers to the dosage strength of the active ingredient. This indicates that the medicine contains 90 milligrams (90 mg) of Diltiazem hydrochloride.

Q: Does the drug come in different strengths?

Yes, Diltiazem extended-release capsules and tablets are manufactured in several different strengths. Regulatory documents confirm the availability of strengths that typically include 120 mg, 180 mg, 240 mg, 300 mg, and higher.

Q: Is it normal to see the pill casing in stool after taking Angizem CD - 90?

Yes, this is a normal occurrence with controlled-release products. Official patient information confirms that it is expected to occasionally see the empty, intact outer shell of the capsule or tablet pass in the stool. This simply means the active medicine has already been released and absorbed.

How should Angizem CD - 90 be stored and disposed of?

How to Store and Dispose of Angizem CD - 90

Required Storage Conditions

Angizem CD-90 (Diltiazem Hydrochloride Extended-Release Capsules) must be stored at Controlled Room Temperature, defined as 25 C (77 F), with permitted excursions between 15 C to 30 C (59 F to 86 F). The product must be kept in a tight, light-resistant container and it is mandatory to avoid excessive humidity and protect from light.

Handling and Disposal

The label requires the medicine to be stored out of reach of children. Unused or expired medication must be discarded properly after the expiration date. Disposal must not involve flushing the medicine down the toilet or placing it in household trash. To ensure safe disposal, individuals should consult a pharmacist or local waste management agency for appropriate collection programs.

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

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