Generic Tiazac Cr

DILTIAZEM HCI
Tablets: 30, 60, 90 and 120 mg (Rx) Various, Cardizem (Marion Merrell Dow)
Capsules, sustained-release: 60, 90, 120, Various, Cardizem SR (Marion Merrell Dow)
180, 240, 300 and 360 mg (Rx) Cardizem CD (Marion Merrell Dow),
Dilacor XR (Rhone-Poulenc Rorer), Tiazac (Forest)
Injections: 25 mg (5 mg/50 mL),
50 mg (5 mg/mL) (Rx) Cardizem (Marion Merrell Dow)

Oral-
Tablets: Start with 30 mg 4 times/day before meals and at bedtime; gradually increase dosage to 180 to 360 mg (given in divided doses 3 or 4 times/day) at 1-to 2-day intervals until optimum response is obtained.
Sustained release:
Cardizem SR -Start with 60 to 120 mg twice daily. Adjust dosage when maximum antihypertensive effect is achieved (usually by 14 days chronic therapy). Optimum dosage range is 240 to 360 mg/day, but some patients may respond to lower doses.
Cardizem CD -
Hypertension: 180 to 240 mg once daily; some patients may respond to lower doses. Maximum antihypertensive effect is usually achieved by 14 days chronic therapy; therefore, adjust dosage accordingly. Usual range is 240 to 360 mg once daily; experience with doses > 360 mg is limited.
Angina: Start with 120 or 180 mg once daily. Some patients may respond to higher doses of up to 480 mg once daily. When necessary, titration may be carried out over a 7- to 14-day period.
Cardizem CD may be opened and administered, but do not crush.
Dilacor XR -
Hypertension: 180 to 240 mg once daily; adjust dose as needed. Individual patients, particularly those > 60 years of age, may respond to a lower dose of 120 mg. Usual range is 180 to 480 mg once daily. Although current clinical experience with the 540 mg dose is limited, the dose may be increased to 540 mg with little or no increased risk of adverse reactions. Do not exceed 540 mg once daily. Angina: Adjust dosage to each patient's needs, starting with a dose of 120 mg once daily, which may be titrated to doses of up to 480 mg once daily, when necessary, titration may be carried out over a 7- to 14-day period.
Hypertensive or anginal patients treated with other formulations of diltiazem can safely be switched to Dilacor XR at the nearest equivalent total daily dose. However, subsequent titration to higher or lower doses may be necessary and should be initiated as clinically indicated.
Administration in the morning on an empty stomach is recommended.
Parenteral -
Direct IV single injections (bolus): The initial dose is 0.25 mg/kg as a bolus administered over 2 minutes (20 mg is a reasonable dose for the average patient). If response is inadequate, a second dose may be administered after 15 minutes. The second bolus dose should be 0.35 mg/kg administered over 2 minutes (25 mg is a reasonable dose for the average patient). Individualize subsequent IV bolus doses. Dose patients with low body weights on a mg/kg basis. Some patients may respond to an initial dose of 0.15 mg/kg, although duration of action may be shorter.
Continuous IV infusion: For continued reduction of the heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter, an IV infusion may be administered. Immediately following bolus administration of 20 mg (0.25 mg/kg) or 25 mg (0.35 mg/kg) and reduction of heart rate, begin an IV infusion. The recommended initial infusion rate is 10 mg/hr. Some patients may maintain response to an initial rate of 5 mg/hr. The infusion rate may be increased in 5 mg/hr increments up to 15 mg/hr as needed, if further reduction in heart rate is required. The infusion may be maintained for up to 24 hours. Therefore, infusion duration > 24 hours and infusion rates > 15 mg/hr arc not recommended.
Concomitant therapy: Concomitant therapy with p-blockers or digitalis is usually well tolerated, but the effects of co-administration cannot be predicted, especially in patients with left ventricular dysfunction or cardiac conduction abnormalities. Use caution in titrating dosages for impaired renal or hepatic function patients, since dosage requirements are not available.
CARDIO & BLOOD – CHOLESTEROL

INFLAMMATORY MEDIATORS AND PHYSICAL ACTIVITY
Inflammatory mediators that are thought to be involved in the development and progression of CHD (Coronary Heart Disease) are reduced by physical activity. Recent data from the Women's Health Initiative prospective study of 75,343 women demonstrated that C-reactive protein (CRP) and IL-6 are independent predictors of CAD among these apparently healthy postmenopausal women. While hormone replacement therapy (HRT) is known to increase CRP, one of the striking findings of this study was that use or nonuse of HRT had less importance as a predictor of cardiovascular risk than did baseline levels of either CRP or IL-6. Thus, even after adjusting for total cholesterol/HDL and all other risk factors, the odds ratio for CAD significantly increased with increasing CRP levels.
Remarkably, physical activity can decrease CRP, along with many of the other inflammatory mediators. In a representative sample of 16,000 U.S. adults, progressive increases in leisure-time physical activity resulted in decreased blood CRP, fibrinogen concentration, and white blood cell (WBC) count, but with increased albumin concentration. This physical activity-induced decrease in CRP levels suggests that physical activity may reduce inflammation. Inflammation is considered to be critical in the pathogenesis of atherosclerotic disease.
*5/282/5*
CARDIO & BLOOD

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