INFORMATION FOR CONSUMERS

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Consumer Medicine Information

Cardizem^® CD

Diltiazem hydrochloride 120, 180, and 240 mg capsules

What is in this leaflet

This leaflet answers some common questions about Cardizem CD capsules. It does not contain all the available information.

It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Cardizem CD against the benefits it is expected to have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine. You may need to read it again.

What Cardizem CD is used for

Cardizem CD capsules contain an active ingredient called diltiazem hydrochloride. They are designed to release the active ingredient slowly so that it works over 24 hours and can be taken once a day (CD stands for "controlled delivery").

Cardizem CD capsules belong to a group of medicines called calcium channel blockers or calcium antagonists. They work by opening up blood vessels, which lowers blood pressure and lets more blood and oxygen reach the heart. They do not change the amount of calcium in your blood or bones.

Cardizem CD capsules are used by some people to prevent angina and by others to treat hypertension (high blood pressure).

Angina is a pain or uncomfortable sensation in the chest, often spreading to the arms or neck and sometimes to the shoulders and back. The pain of angina is due to a shortage of oxygen to the heart.

High blood pressure can have many different causes including kidney disease, hardening of the arteries and some hormone imbalances. However, the vast majority of people with high blood pressure have no identifiable cause for it. If left untreated, high blood pressure can lead to serious health problems such as a stroke or heart attack.

Your doctor may have prescribed Cardizem CD for another reason. Ask your doctor if you have any questions about why this medicine has been prescribed for you.

There is no evidence that this medicine is addictive.

Cardizem CD is available only with a doctor's prescription.

Before you take Cardizem CD

When you must not take it:

Do not take Cardizem CD:

1. if you have an allergy to diltiazem hydrochloride or any of the ingredients listed at the end of this leaflet.
   
   Symptoms of an allergic reaction to this medicine may include:
   • asthma, wheezing or shortness of breath
   • swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing
   • hives, itching or skin rash
   • fainting
2. if you are pregnant, or intend to become pregnant.
   
   This medicine may affect your developing baby if it is taken during pregnancy.
3. if you are breastfeeding or intend to breastfeed.
   
   The active ingredient of this medicine passes into breast milk and may affect your baby.
4. if the packaging is torn or shows signs of tampering or if the capsules do not look quite right.
5. if the expiry date (EXP) printed on the pack has passed.
   
   If you take this medicine after the expiry date has passed, it may not work as well.

If you are not sure whether you should start taking Cardizem CD, contact your doctor.

Do not give Cardizem CD to a child.

The safety and effectiveness of this medicine has not been established in children.

Before you start to take it

Tell your doctor:

1. if you have any allergies to:
   • any other medicines
   • any other substances, such as foods, preservatives or dyes
2. if you are pregnant or intend to become pregnant.
   
   Cardizem CD capsules should not be used during pregnancy.
3. if you are breastfeeding or plan to breastfeed.
   
   Your doctor will discuss this situation with you. A decision will have to be made whether to discontinue breastfeeding or discontinue therapy taking into consideration the importance of the medicine.
4. if you have or have had any medical conditions, especially the following:
   • certain types of abnormal heart rhythm
   • hypotension (low blood pressure)
   • heart attack or other heart-related complications
   • impaired kidney or liver function
   • diabetes

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines may interfere with Cardizem CD capsules. These include:

• some other medicines for your heart or high blood pressure (eg. nitrates, beta blockers, digoxin, amiodarone)
• cyclosporin which you may have been given after a transplant operation or for rheumatoid arthritis
• rifampicin (for infections)
• carbamazepine (for epilepsy)
• lithium (for manic depression and some other mental illnesses)
• some medicines for prostate problems
• some medicines for gastric ulcers or reflux (cimetidine, ranitidine)
• benzodiazepines (for depression, alcohol withdrawal or anxiety)
• some medicines for lowering your blood cholesterol
• some medicines you may be given when in hospital
• dantrolene (a muscle relaxant)
• inhaled anaesthetic agents such as halothane, isoflurane, enflurane (for surgery)
• benzodiazepines or medicines used as sedatives or to treat anxiety such as midazolam, triazolam
• corticosteroids such as methylprednisolone, prednisone, cortisone
• antiarrhythmics or medicines used to treat irregular heart beats

Cardizem CD capsules may themselves be affected, or they may affect how well these medicines work. You may need to take different amounts of your medicine, or you may need to take different medicines. Your doctor will advise you.

Your doctor and pharmacist may have more information on medicines to be careful with or to avoid whilst taking Cardizem CD capsules.

Things to be careful of

Be careful driving or operating machinery until you know how this medicine affects you.

Cardizem CD may cause dizziness and fainting in some patients, especially when you first start to use them. Make sure you know how you react to this medicine before you drive a car, operate machinery, or do anything else that could be dangerous if this happens to you.

Be careful not to overdo physical activities when you first start taking this medicine.

You may feel better when you start taking this medicine, but you will need time to improve your physical fitness.

Get up slowly when getting out of bed or standing up if you feel light-headed, dizzy or faint.

If this is a problem and it gets worse or continues, talk to your doctor.

How to take Cardizem CD

How much to take

Cardizem CD capsules can be taken once a day, preferably at the same time every day. Your doctor will tell you how often and how much Cardizem CD to take. Follow all directions given to you by your doctor and pharmacist carefully. Write them down if necessary.

If you do not understand the instructions on the packaging of this medicine, ask your doctor or pharmacist for help.

How to take it

Swallow this medicine with a glass of water. Do not chew the capsule.

When to take it

Take this medicine at the same time every day.

How long to take it

If you are not sure how long to take your medicine for, talk to your doctor.

If you are taking Cardizem CD tablets for angina, do not suddenly stop taking them as this can cause severe angina for a day or two.

If you forget to take it

If you forget to take a dose and it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your capsules as you would normally.

Do not take a double dose to make up for the dose that you missed.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

Things you must do

Take this medicine exactly as your doctor has prescribed.

If you do not follow your doctor's instructions, you may not get relief from your attacks of angina, or your blood pressure may not be as well controlled as it could be.

If you are taking this medicine for angina, tell your doctor if you continue to have angina attacks or if they become more frequent.

Tell all your doctors, dentists and pharmacists that you are taking this medicine.

Do this especially if you plan to have any surgery. Cardizem CD may interact with some medicines you could be given during surgery.

Tell your doctor or pharmacist that you are taking Cardizem CD if you are about to be started on any new medicine.

Things you must not do

Do not use this medicine to treat any other complaints unless your doctor says to.

Do not give this medicine to anyone else, even if his or her symptoms seem similar to yours.

If you are taking this medicine for angina, do not suddenly stop taking your medicine since this can cause severe angina for a day or two.

Side Effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Cardizem CD capsules.

Cardizem CD capsules help most people with angina or high blood pressure, but they may have unwanted effects in a few people.

All medicines can have side effects. Sometimes they are serious, but most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist any questions you may have.

Tell your doctor if you notice any of the following and they worry you:

• swelling or flushing (feeling hot suddenly)
• headache
• nausea, vomiting, constipation, diarrhoea, indigestion, gastric pain
• dizziness
• light-headedness
• confusion, hallucinations, abnormal dreams, mental depression or mood changes
• trouble sleeping
• nervousness, tremor
• ringing or other persistent noise in the ears
• loss of memory
• dry mouth
• loss of appetite
• weight increase
• increased sensitivity to the sun
• unusual movements or uncontrollable movements
• rash or an itchy, burning or prickly sensation
• small round, raised itchy areas on the skin
• weakness or tiredness

These side effects are usually mild.

Tell your doctor immediately if you notice any of the following:

• you feel continuously light-headed or dizzy
• you notice your heart beating irregularly, slowly or very quickly
• you feel pain, which may be severe, in your left arm and chest
• you have blisters and bleeding in the lips, eyes, mouth, nose or genitals
• you have skin reactions such as red, painful or itchy spots, blisters or peeling of the skin

These are serious side effects. You may need urgent medical attention. Serious side effects are rare.

Other side effects not listed above may also occur in some patients. Tell your doctor if you notice anything else that is making you feel unwell.

Ask your doctor or pharmacist if you do not understand anything in this section.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre in New Zealand (telephone 0800 POISON or 0800 764766) or go to the Accident and Emergency Department at your nearest hospital if you think that you or anyone else may have taken too much Cardizem CD. Do this even if there are no signs of discomfort or poisoning.

If you take too much of Cardizem CD, you may:

• feel continuously light-headed or dizzy
• notice your heart beating very slowly
• feel pain, which could be severe, in your left arm and chest.

If any of these occur, you should get medical attention immediately.

Storage

Keep Cardizem CD capsules in their blister pack until it is time to take them.

If you take the medicine out of the blister pack it may not keep well.

Keep Cardizem CD capsules in a cool, dry place where it stays below 25°C. Do not store them, or any other medicine, in a bathroom or near a sink. Do not leave them in the car or on a windowsill.

Heat and dampness can destroy some medicines.

Keep this medicine where young children cannot reach it.

A locked cupboard at least one-and-a half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking your Cardizem CD, or it has passed its expiry date, ask your pharmacist what to do with any capsules that are left over.

Product description

What your medicine looks like

Cardizem CD capsules are available in three strengths (120 mg, 180 mg and 240 mg):

• the 120 mg capsules are light turquoise/opaque capsule printed with "Cardizem CD 120mg"
• the 180 mg capsules are light turquoise blue/blue capsule
• the 240 mg capsules are blue/blue capsule

Cardizem CD capsules are supplied in packs of 30. Each blister strip is calendarised and contains 15 capsules. For your first dose, take the capsule labelled "Take this capsule first". Take the next doses according to the day of the week which is printed on the blister foil.

Ingredients

Cardizem CD 120 mg, 180 mg and 240 mg capsules contain: diltiazem hydrochloride (120 mg, 180 mg or 240 mg, respectively), fumaric acid, purified talc, non-pareil seeds (sucrose), colloidal silica, white beeswax, ethylcellulose, castor oil, stearic acid, methacrylic acid copolymers, tributyl acetylcitrate, simethicone, gelatin, Brilliant Blue FCF CI 42090 and titanium dioxide.

Distributor

Cardizem CD capsules are distributed by:
sanofi-aventis new zealand limited
Level 8, James & Wells Tower
56 Cawley Street
Ellerslie, Auckland
Telephone: (09) 580 1810

This leaflet was prepared in May 2009.