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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What should be the dosage of Diltiazem for treating hypertension?

Answered by
Dr.
Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 2079 Questions

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Posted on Fri, 24 Aug 2018 in General Health
Question: Dear Dr,
I have been treated hypertension with Diltiazem 90 bd + HCTZ 12.5mg, however, I developed Sciatica and Low Back Pain. I consulted with you, and you suggested me some options like Torsemide 5mg bd or Prasozin 1mg. None of them has worked because they also cause me Sciatica and Low Back Pain. I have upped the Diltiazem to 120 bd and my blood pressure is OK. My question is: Should I use Diltiazem 120 twice a day, or should I use 120 in the morning and 90 in the evening? Please help me with the dosage Dr Thanks in advance for your reply.
doctor
Answered by Dr. Bhanu Partap 7 hours later
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:

Hello,

Thanks for providing this feed back that even prazosin also didn't worked for you. So basically you are short of choices for Blood pressure control which makes lifestyle modifications even more important for you. So along with medication you should follow healthy lifestyle habits strictly and routinely.

Regarding Diltiazem, the maximum dose that can be taken daily is 420mg. So if 120 twice a day is suiting you then you can safely continue with this dose.

Also I would like to suggest you to get one renal ultrasound done to rule out renal artery stenosis. Also if possible start yoga/meditation as it will also be helpful.


Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhanu Partap 6 hours later
Diltiazem, the morning dose and the evening dose should be the same or can they be different? For example 120 morning- 90 evening?
doctor
Answered by Dr. Bhanu Partap 7 minutes later
Brief Answer:
Hello Again

Detailed Answer:

Hi,

Yes they can be different for morning and evening without an issue.

But what am trying to convey here is if you are already taking 120 mg in morning as well as 120 mg in evening and your blood pressure is well settled with that dose then its advisable to continue 120 mg both morning as well as evening.

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhanu Partap 4 hours later
Dear Dr,
I have read my blood pressure during daytime with the 120mg dose, and it goes okay. However, at night I'm sleeping and I don't know if 120 is necessary or maybe only 90 or 60. I know that Diltiazem reduces the heart rate per minute, and I would like to know if there could be any problem taking 120 at night.
Thanks in advance for your response,
Kind regards,
doctor
Answered by Dr. Bhanu Partap 24 minutes later
Brief Answer:
Hello Again

Detailed Answer:

Hi,

First of all kindly make it very clear what dose of Diltiazem you are taking presently?

Morning Dose _____?

Evening Dose _____?

What's your average bp readings and your average heart rate at rest and while working?

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Bhanu Partap 2 hours later
Hello Dr,

Morning Dose 120mg
Evening Dose 90mg

average bp readings = 138/88
average heart rate at rest = 82 per minute; while working= 90 per minute

Kind regards,
doctor
Answered by Dr. Bhanu Partap 51 minutes later
Brief Answer:
Hello Again

Detailed Answer:

Hi,

Your Blood pressure and heart rate are fine as of now with the current dose of 120 mg and 90 mg, so keeping that in mind its advisable that you should continue with 120 mg in morning and 90 mg in evening.

Along with that healthy lifestyle habits and regular bp monitoring is always recommended.

Hope I have answered your query.
Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Bhanu Partap 22 minutes later
Dear Dr,
One final question, I do not drink alcohol, however, I would like to know if cigarettes increase the blood pressure. I do not smoke daily, but once a month I smoke 1 cigarette, and I would like to know if I should avoid it.
Thanks and kind regards,
doctor
Answered by Dr. Bhanu Partap 4 minutes later
Brief Answer:
Not good at all

Detailed Answer:

Hi,

Even a single cigarette promotes vascular atherosclerosis which later on create significant issues. Also smoking causes vasoconstriction which ultimately increases blood pressure.

It should be stopped at once and for all.

Hope I have answered your query.
Let me know if I can assist you further.

Take Care,
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Prasad
doctor
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