Diltiazem ER is a calcium channel blocker (CCB), approved to treat conditions like angina and high blood pressure or hypertension. Additionally, it can address certain heart arrhythmias such as atrial flutter or fibrillation and supraventricular tachycardia. The medication also has several recognized off-label uses. It may be considered in the treatment of migraines, tardive dyskinesias, hyperthyroidism, or as part of therapy during coronary bypass. A topical form of the medicine might also help improve anal fissures.
Calcium channel blockers like diltiazem ER are indicated for the treatment of angina and high blood pressure. The drug reduces the flow of calcium into the muscles and blood vessels of the heart. This creates lower flow impedance, which can bring blood pressure readings into a normal range. These effects also help with the sudden, painful contractions of blood vessels that may result in angina.
Not every CCB is equally suited to treat various heart arrhythmias, and some of them can actually induce irregular rhythms. Diltiazem ER is appropriate for only some kinds of arrythmias. It may address the symptoms caused by atrial flutter and fibrillation or by supraventricular tachycardia. Conversely, the drug is not advised in the presence of atrioventricular block, sick sinus symptom, or recent heart attack. In these instances, the medication may increase the risk that dangerous arrhythmias will occur.
Many drugs have a variety of off-label uses. Perhaps the most recognized non-indicated use of diltiazem ER is for migraine prevention. Employing the drug for coronary bypass makes a certain amount of sense, too, because it helps the heart contract with greater ease. This treatment wouldn’t be useful if the bypass surgery occurred shortly after a heart attack, however.
Another use that is fairly well acknowledged is as a topical treatment for anal fissures, though surgery is typically required to completely address this condition. Medical research is even more supportive of diltiazem ER use for hyperthyroidism. Though beta-blockers may be a first choice, CCBs are an appropriate substitute. Diltiazem is especially useful when managing crisis-level hyperthyroid conditions.
There is presently debate about prescribing diltiazem ER for conditions like tardive dyskinesias. These are movement disorders that are often caused by use of neuroleptic or antipsychotic medications. Studies to this point do not strongly conclude that this treatment is helpful, but there are anecdotal examples that suggest diltiazem ER may have some benefit.
Principally, patients will receive this drug for one of its approved uses. It should be stated, though, that there is nothing wrong with using a medication for an off-label purpose. Drugs are often found to be useful in ways that surpass the imaginations of their developers.