Diltiazem Hydrochloride XR Side Effects

Generic name: diltiazem

Medically reviewed by Drugs.com. Last updated on Mar 11, 2024.

Note: This document provides detailed information about Diltiazem Hydrochloride XR Side Effects associated with diltiazem. Some dosage forms listed on this page may not apply specifically to the brand name Diltiazem Hydrochloride XR.

Applies to diltiazem: oral capsule extended release, oral capsule extended release 12 hr, oral capsule extended release 24 hr, oral tablet, oral tablet extended release, oral tablet extended release 24 hr.

Other dosage forms:

• intravenous powder for solution, intravenous solution

Serious side effects

Along with its needed effects, diltiazem (the active ingredient contained in Diltiazem Hydrochloride XR) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking diltiazem:

More common side effects

• body aches or pain
• congestion
• cough
• dryness or soreness of the throat
• fever
• hoarseness
• runny nose
• tender or swollen glands in the neck
• trouble swallowing
• voice changes

Less common side effects

• chest pain, discomfort, or tightness
• chills
• diarrhea
• difficult or labored breathing
• feeling faint, dizzy, or lightheaded
• feeling of warmth or heat
• flushing or redness of the skin, especially on the face and neck
• general feeling of discomfort or illness
• headache
• joint pain
• loss of appetite
• muscle aches and pains
• nausea
• shivering
• slow or irregular heartbeat
• sweating
• swelling of the hands, ankles, feet, or lower legs
• trouble sleeping
• unusual tiredness or weakness
• vomiting

Incidence not known

• blistering, peeling, or loosening of the skin
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• no heartbeat
• red skin lesions, often with a purple center
• red, irritated eyes
• sores, ulcers, or white spots in the mouth or on the lips

Other side effects

Some side effects of diltiazem may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• sneezing
• stuffy nose

Less common side effects

• acid or sour stomach
• belching
• constipation
• continuing ringing or buzzing or other unexplained noise in the ears
• degenerative disease of the joint
• difficulty with moving
• hearing loss
• heartburn
• indigestion
• lack or loss of strength
• muscle aching or cramping
• muscle pains or stiffness
• pain or tenderness around the eyes and cheekbones
• rash
• stomach discomfort, upset, or pain
• swollen joints

Incidence not known

• loss or thinning of the hair

For healthcare professionals

Applies to diltiazem: compounding powder, intravenous powder for injection, intravenous solution, oral capsule extended release, oral tablet, oral tablet extended release.

General adverse events

The most commonly reported side effects include edema, headache, and dizziness.^[Ref]

Cardiovascular

• Very common (10% or more): Peripheral edema (up to 15%)
• Common (1% to 10%): Arrhythmia (junctional rhythm/isorhythmic dissociation), asymptomatic/symptomatic hypotension, atrioventricular (AV) block (first/second/third degree), bradycardia, bundle branch block, ECG abnormality, edema, extrasystole/ventricular extrasystole, flushing, lower limb edema, palpitations, vasodilation
• Uncommon (0.1% to 1%): Orthostatic hypotension
• Frequency not reported: Angina, asystole/cardiac arrest, atrial flutter, chest pain, development/aggravation of congestive heart failure, hypotension, sinoatrial block, sinus node dysfunction, sinus pause/arrest, vasculitis, ventricular arrhythmia, ventricular fibrillation, ventricular tachycardia/tachycardia
• Postmarketing reports: Myocardial infarction, vasodilation symptoms (flushing, lower limb edema, sweating)^[Ref]

A patient with Prinzmetal's angina developed asystole after a single, 60 mg dose.

Myocardial infarction was not readily distinguishable from the natural history of the disease.

Vasodilatory events (e.g., peripheral edema, headache, flushing) are dose-related and may be more common in elderly patients.

First degree AV block and sinus bradycardia occurred more frequently with higher doses.^[Ref]

Other

• Common (1% to 10%): Asthenia, fatigue, flu syndrome, infection, malaise, pain
• Frequency not reported: Thirst, tinnitus^[Ref]

Gastrointestinal

• Common (1% to 10%): Abdominal enlargement, constipation, dyspepsia, gastric pain, nausea
• Uncommon (0.1% to 1%): Diarrhea, vomiting
• Rare (0.01% to 0.1%): Dry mouth
• Frequency not reported: Gastrointestinal disorder, gingivitis, gingival hyperplasia^[Ref]

Dermatologic

• Common (1% to 10%): Erythema, hot flushes, rash, urticaria
• Frequency not reported: Acute generalized exanthematous pustular dermatitis, desquamative erythema with/without fever exfoliative dermatitis, facial edema, hyperhidrosis/sweating, hyperpigmentation, leukocytoclastic vasculitis, petechiae, photosensitivity (lichenoid keratosis), pruritus, Steven-Johnson's syndrome
• Postmarketing reports: Allergic dermatitis, alopecia, angioneurotic edema, erythema multiforme, generalized dermatitis, musculocutaneous reactions, simple erythema, toxic epidermal necrolysis^[Ref]

Well-documented cases of rashes (as leukocytoclastic vasculitis) have been reported, but a definitive between these events and this drug have not been established.

Lichenoid keratosis and hyperpigmentation occurred in skin exposed to the sun.^[Ref]

Respiratory

• Common (1% to 10%): Bronchitis, cough, increased cough, pharyngitis, sinus/nasal congestion
• Frequency not reported: Dyspnea, epistaxis
• Postmarketing reports: Asthma aggravation, bronchospasm^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache, lightheadedness
• Frequency not reported: Amnesia, dysgeusia, extrapyramidal syndrome/symptoms, gait abnormality, paresthesia, somnolence, syncope, tremor^[Ref]

Dizziness occurred more frequently with higher doses.^[Ref]

Musculoskeletal

• Common (1% to 10%): Myalgia
• Frequency not reported: Creatine phosphokinase (CPK) increase, muscle cramp, muscle pain, muscle weakness, myopathy, neck rigidity, osteoarticular pain^[Ref]

Metabolic

• Common (1% to 10%): Gout
• Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, mild elevation of alkaline phosphatase, mild elevation of lactate dehydrogenase, thirst, weight increase^[Ref]

Genitourinary

• Common (1% to 10%): Impotence
• Frequency not reported: Albuminuria, crystalluria, nocturia, polyuria, sexual difficulties^[Ref]

Ocular

• Common (1% to 10%): Conjunctivitis
• Frequency not reported: Amblyopia, eye irritation, periorbital edema, retinopathy^[Ref]

Local

• Common (1% to 10%): Injection site reactions (e.g., itching, burning)^[Ref]

Psychiatric

• Uncommon (0.1% to 1%): Insomnia, nervousness
• Frequency not reported: Abnormal dreams, depression, hallucinations, mood changes (including depression), personality change^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Increased hepatic enzymes (ALT, AST)
• Frequency not reported: Clinical hepatitis/hepatitis^[Ref]

There were rare cases of clinical hepatitis that were reversible with discontinuation of this drug.^[Ref]

Hematologic

• Frequency not reported: Eosinophilia, hemolytic anemia, increased bleeding time, leukopenia, lymphadenopathy, thrombocytopenia
• Postmarketing reports: Purpura^[Ref]

Hypersensitivity

• Frequency not reported: Allergic reactions, angioedema (including facial/periorbital edema)^[Ref]

Endocrine

• Frequency not reported: Gynecomastia^[Ref]

Further information

Diltiazem Hydrochloride XR side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer