1. < Hypertrophic Cardiomyopathy (HCM)
Profile picture for mmicahk

Diltiazem

Posted by mmicahk @mmicahk, May 5 10:38am

I've been slowly having fatigue for a few years now, but the last year it has been getting worse.

I was diagnosed with obstructive HCM a year ago and started metoprolol back in November 2024 after an incident of sepsis in the hospital. My fatigue was getting worse since then, so my cardiologist had me back off to half my dose in February after seeing my resting heart rate is between 40-50bpm.

The fatigue hasn't gotten better so he wants me to stop taking metoprolol and see if the fatigue goes away. He said if it does, the backup would be Diltiazem to try next.

Has anyone had this medication and/or gone through this process of trying different medications?

I have some angina, but mostly just fatigue (which could be related to anything). My heart rate has been weirdly all over the place lately. It was fairly low/stable from November through March and then started getting weird the last month. Simple task of getting up to walk to the fridge could go from a 50bpm to 120bpm. No dizziness but feel my heart racing so I check.

My cardiologist is local to me, but I'll be seeing a second opinion in June in a more specialized heart center at Kaiser (Santa Clara) with a cardiologist that was at Stanford's HCM center.

Part of me is wondering if I just wait to make any changes until then but I had not heard of this medication so was wondering of others experience.

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) Support Group.

Profile picture for boatsforlife
boatsforlife | @boatsforlife | May 12 1:19am
In reply to @jmr091805 "The fact that you can be away for 3 weeks is something HOCM and Camzyos have..." + (show)
Profile picture for jmr091805 @jmr091805

The fact that you can be away for 3 weeks is something HOCM and Camzyos have prevented me from doing. Getting the echocardiogram for the Accredo Pharmacy to agree to deliver the next 30 pills each month so that I don't run out of my daily Camzyos pills has prevented me from being away for that long. How do you coordinate this?

Jump to this post

I've been on Camzyos for over 18 months now and my dosage has been stable for a long time, so maybe that's part of it. I suspect another reason is that I'm in Canada, and our system seems quite different from the US (which is where I assume you are located). I have a very good insurance policy and have had incredibly good support from my insurance company, the pharmacy, the manufacturer, my nurse-case-manager, and my cardiologist right from day 1. My wife and I went on a SIX week camping trip last year, and a single phone call resulted in them providing a one time (once per year maybe??) 30-day supply to ensure that I would not run out. Now that my dosage has stabilized, I'm getting echo tests every 3 months so we just had to schedule around that. As I said though, I'm so grateful for the support and cooperation I've encountered. It saddens me to hear the struggles so many people have had trying to get their regular monthly supply.

REPLY
Profile picture for susanml
susanml | @susanml | May 12 10:48am
In reply to @marigold13 "Susanml, How are your symptoms taking Diltiazen (Cardizem) and Candesartan? My doc is wanting to put..." + (show)
Profile picture for marigold13 @marigold13

Susanml, How are your symptoms taking Diltiazen (Cardizem) and Candesartan? My doc is wanting to put me on a BP med since taking me off Metoprolol my BP has gone up too high 170s and 180s. I see Boats4life is on Cardizem, too, and no side effects. Side effects are what I'm worried about. I'm on 5mg Camzyos since Monday. I'm getting some symptoms of SOB, light headed woozy feelings, and they seem to go away in the evening. But I'm wondering if my BP is contributing- the Metoprolol kept me in the 145/150 area which isn't the greatest but not as worrisome as BP now. There were moments where I could feel Camzyos was giving me a positive effect, but as it builds up in my system, I feel like symptoms are getting worse and can't differentiate between Camzyos or high BP.

Jump to this post

I’ve had no adverse effects on diltiazen and candesartan ( 24mg) though I can sleep like a log for 10 + hours. Not sure if that’s a symptom of the drugs or that I just like to sleep! My BP is about 140-150. Bit high I know but when candesartan is increased then it goes too far down. Happy on the 5mg of Camzyos. I too wish I understood the correlation between HCM and BP. Best wishes

REPLY
Profile picture for sharona09
sharona09 | @sharona09 | Jun 19 12:33am

I have been on D for a year with no issues or side effects

REPLY
Profile picture for chrisf1974
chrisf1974 | @chrisf1974 | Jul 17 8:06am

Has anyone had any side effects from taking Cardizem and working/exercising in hot humid weather? I take 180 extended release daily and have some side effects since it has become hot and humid. These include: dizziness, occasional nausea, pins and needles feeling in extremities. Just curious if anyone has had these issues while on this medication in hot, humid conditions. Thanks

REPLY
Profile picture for Debra, Volunteer Mentor
Mentor
Debra, Volunteer Mentor | @karukgirl | Jul 17 9:37am

Welcome to Mayo Clinic Connect @chrisf1974 , I'm glad you found this online support group for HCM.
I found this from the Mayo Clinic:
https://www.mayoclinic.org/drugs-supplements/diltiazem-oral-route/description/drg-20071775
And found this online regarding ER Cardizem 180mg:

Cardizem 180 mg 24-hour extended release is a medication used to treat high blood pressure and control heart rate in conditions like atrial fibrillation. It works by relaxing blood vessels and slowing the heart rate, and it should be taken as prescribed by a doctor. Wikipedia healthy.kaiserpermanente.org

Overview of Cardizem 180 mg Extended Release
Cardizem is a medication that contains diltiazem, a non-dihydropyridine calcium channel blocker. It is primarily used to manage high blood pressure, angina (chest pain), and certain heart rhythm disorders.

Dosage and Administration
Form: Extended-release capsule
Strength: 180 mg
Frequency: Typically taken once daily
Instructions: Swallow the capsule whole. Do not crush or chew, as this can release the drug too quickly and increase side effects. If you have difficulty swallowing, you may open the capsule and sprinkle the contents on a spoonful of applesauce, but consume it immediately without chewing.
Uses
Cardizem is indicated for:

High blood pressure (hypertension)
Angina (chest pain)
Atrial fibrillation or flutter (irregular heartbeats)
Side Effects
Common side effects may include:

Swelling
Dizziness
Headaches
Low blood pressure
Serious side effects can occur, such as:

Slow heart rate
Heart failure
Liver problems
Allergic reactions
Precautions
Allergies: Do not use if allergic to diltiazem or any of its components.
Medical History: Inform your doctor if you have a history of heart disease, low blood pressure, or irregular heart rhythms.
Pregnancy and Breastfeeding: Use is not recommended during pregnancy, and safety during breastfeeding is unclear.
Always follow your healthcare provider's instructions regarding dosage and administration.

Wikipedia
WebMD

Have you talked to your cardiologist about these symptoms?
I would definitely put a call into to their office and get some guidance. We can't make medical judgements or diagnose here on Connect, but we can share our opinions, all for FREE! For what it's worth!
I would not hesitate to contact your doctor.

REPLY
View MoreView Less
Please sign in or register to post a reply.