Verwon Says:
Diltiazem Cd, Xr & Er
Updated
bckeyebaby Says:
What is the difference between diltiazem CD, diltiazem XR and diltiazem ER? Can you refer me to a website where I could research this information?
76 Replies (4 Pages)
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1
There is no difference, it's just different abbreviations for the same thing, a time released version of the medication, some places will us CR, ER or XR, there is no definitive way that it has to be done.
Diltiazem is a calcium channel blocker used to treat hypertension and angina.
You can read more here:
https://rxchat.com/wiki/Diltiazem/
Do you have any other questions?
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Rick Says:
Not quite true. These are indeed all timed release versions of diltiazem, but they all use different drug delivery systems and are released into the body at different rates. You can verify this if you look at the professional write-ups on each drug. For example, diltiazem CD, which is generic for the drug Cardizem CD, reaches peak levels in the blood 10-12 hours after dosing, and there is no changes due to taking it with food. Diltiazem XR is generic for the less-common brand Dilacor XR, which is reaches peak levels in the blood in 3-5 hours. Absorption of this version is accelerated when it is taken with food. Then there is Cardizem LA (no generic available yet) which has an even longer absorption time than CD (supposedly a benefit if taken at bedtime, since it will have its peak effect in the morning when heart attacks are most common). And there are at least two more versions! To make things more common, some drugstores will list several different versions as diltiazem ER; you just have to ask which brand name it is equivalent to. To make things even MORE confusing, many of the generic versions have their OWN names for diltiazem!
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Roy Says:
Rick, thank you so much for posting those eye-opening details! You've helped to eliminate much confusion for me :) In case this helps anyone there are professional write ups available as Rick has stated for: Cardizem CD, Dilacor XR, Cardizem LA. Hope this helps!
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Rick Says:
Glad to help, Roy. I guess I should mention that the other common brand-name variety of extended release diltiazem is Tiazac, which has an intermediate peak absorption time -- longer than Dilacor XR, but shorter than Cardizem CD or LA (at least for regular Tiazac -- I'm not sure what the difference is between that and Tiazac XC). The last extended release version I know of is a twice-a-day formulation (I believe -- not sure -- that the brand name is Cardizem SR, and I'm not sure it's even made anymore). The question of whether this myriad of different formulations actually elicit significantly different responses in practice would depend on the physician you ask. No doubt some aren't even aware that there are differences between the various extended-release versions.
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Rick Says:
No difference. Diltiazem is really just short for Diltiazem HCL (HCL=hydrochloride). So the HCL really applies to all the various generic and branded forms of diltiazem, whether specifically listed or not.
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Tommy Says:
So then, is there any difference between Diltiazem CD and Diltiazem HCL ER?
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Rick Says:
The only way to get a definitive answer to that is to ask the pharmacy whether or not what they are calling diltiazem ER is equivalent to the brand Cardizem CD. And there's always a chance they'll give you the wrong answer, as I once verified by checking the capsule I got against an online pill identifier. But usually the answer will be right.
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Lanette Says:
First, I must state that I appreciate the question as it is what I just queried. Second, I appreciate the detailed answers given. Directly to the point: I just checked my blood pressure. It is extremely high: 230/120. I checked it because I'm having chest pain. Fortunately, I have a nice supply of Nitrostat from the hospital's pharmacy, not a commercial one. In late August of last year, I was prescribed Cardizem CD 120 mg once a day. I was given the correct medication at the hospital along with 1 refill. I went back to the hospital to obtain a refill. (Yes, I just took Nitro again.) Recently I paid in advance for concierge doctor services. He prescribed Cardizem CD 120. Walgren's filled it with Diltiazem ER 120 MG. Obviously, it isn't working. I have found that it is a battle to get medication that actually works, because of generic substitutions that are the only ones allowed by WellCare my Medicare Prescription drug coverage or so I am told by Walgreen's. Generics don't work.
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Lanette Says:
First, I must state that I appreciate the question as it is what I just queried. Second, I appreciate the detailed answers given. Directly to the point: I just checked my blood pressure. It is extremely high: 230/120. I checked it because I'm having chest pain. Fortunately, I have a nice supply of Nitrostat from the hospital's pharmacy, not a commercial one. In late August of last year, I was prescribed Cardizem CD 120 mg once a day. I was given the correct medication at the hospital along with 1 refill. I went back to the hospital to obtain a refill. (Yes, I just took Nitro again.) Recently I paid in advance for concierge doctor services. He prescribed Cardizem CD 120. Walgreen's filled it with Diltiazem ER 120 MG (mfg: TEVAU green capsule marked BVF 120). Obviously, it isn't working. I have found that it is a battle to get medication that actually works, because of generic substitutions that are the only ones allowed by WellCare my Medicare Prescription drug coverage or so I am told by Walgreen's. pharmacists. MANY generics don't work effectively.
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Rick Says:
Lanette, I assume your diltiazem prescription is for reasons other than blood pressure alone, right? E.g., chest pains perhaps? And that you are taking other blood pressure meds, too? I ask because, as you pointed out, 230/120 is extremely high. Frankly, for blood pressure lowering alone diltiazem is probably weaker than many BP meds, and 120 mg is a fairly low dose. Aside from the substitution issues, I hope all is going well! BTW, while I don't think generics are always as potent (and in the case of diltiazem may be the wrong version sometimes), I am OK with most of those i've used. E.g., I have long used Teva as my generic for Klonopin and it is every bit as effective as the original, at least for the reason I'm taking it. OTOH, I know Teva was directly implicated by a testing Lab for problems (a different extended-release mechanism ) with its versions of certain forms of the anti-depressant Wellbutrin (bupropion). (I'm assuming this was corrected, but don't know.) BTW I have a friend with very high blood pressure who keeps it very well controlled mostly generics, but she takes five different BP meds, mostly at high doses (fortunately with minimal side effects except possibly congestion and possibly declined olfactory function).
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vera Says:
does any one know if you just stop taking tiazac xc or do you have to wean off?
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Rick Says:
Generally it's only beta blockers which require weaning off of, not calcium channel blockers like tiazac/diltiazem. Despite that, unless you're taking it SOLEY for MILD high blood pressue, I wouldn't depend on anyone on the internet for your answer -- ask your doctor. In fact, that's the best advice regardless. A call should suffice.
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vera Says:
Thank you so much rick.
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Janet Says:
Can anyone tell me the difference between Diltiazem ER 180 MG Caps XR and Diltiazem ER 180 MG Caps CD. Walgreens pharmacy changed my prescription to the CD from the XR saying there is no difference. I want to be sure before I take the CD. Does anyone no the difference. Thanks
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Janet Says:
Can anyone tell me the difference between Diltiazem ER 180 MG Caps XR and Diltiazem ER 180 MG Caps CD. Walgreens pharmacy changed my prescription to the CD from the XR saying there is difference. I want to be sure before I take the CD. Does anyone know the difference. Thanks
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Rick Says:
I'm surprised they would tell you there's no difference. Take a look at diltiazem in the blood pressure section of Walgreens' own list of value generics:
https://webapp.walgreens.com/MYWCARDWeb/pdf/Value-PricedGenericsList.pdf
You'll see they have a footnote under it that says **Generic for Dilacor XR only, with the only underlined. This is different -- and cheaper than -- the CD, so I'm guessing they ran out of the XR and are making a substitution at the same price. They are similar in that they are both extended-release versions of diltiazem. But I assume that the product they are giving you is generic for Cardizem CD, which has a different release mechanism than Dilacor XR. Actually, CD may be a little better in that it releases the medicine more gradually over a longer time period. Also, the CD's release is not affected by food, whereas XR will dump out faster if it is taken less than an hour before a meal, particularly a high fat meal. If you seach the net for Cardizem CD and Dilacor XR you can find this info and more details. You might not notice much or any difference between the two, but I'd suggest you talk to Walgreens and/or your doctor if you're concerned. Again, it's the same basic compound but using a different kind of timed-release method.
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Leonard Byrne Says:
I have been taking Diltiazem XR 240 mg/24. It has coated beads. Now the drug Co. has sent Diltiazem CD cap 240ER24H. I have taken the CD years ago and it made my jittery. Switch to XR and it has not been a problem I am having the same problem again.HELP
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Roy Says:
Leonard,
Are you working with the same drug company that has been sending you the XR (which was not a problem)? If it's the same company then I would recommend letting them know that the CD does not react well in your body, but the XR is fine - maybe they would be able to send you the correct medication. Can I get the manufacturer name(s)?
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Betty Says:
Thanks for the info on difference between diltazemCD/diltazem ER.I was started on 300mg CD(TEVA) added two 60 mg ER cap(MYLAN) for total dose of 420mg daily with no problems. Rx changed to Diliazem 420mg daily for one cap instead of three. Received oblong white tablet -Diltazem hydrochloride extended release tablets.(Watson). After a month on these tablets, I have started to hear whistling noise while exhaling.. Has anyone experienced this . Would taking med with food cause this. I was not aware that med should be taken on empty stomach or 1 hr before or 2 hr after meal until now. I did notice that after taking the original meds/dosage for 2 days, the whistling stopped.( I had a few caps left over).I've had resp symptoms before with Toprol? Lisinopril HCTZ, allergic rash with alide, carvedilol.and swelling of feet and ankles with amlodipine. Was okay with the diltazem until the oblong white tablet by Watson.
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Most Recent Replies:
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Dennis Eccleston Says:
Re: Verwon (# 1) 
I use the drug daily and found a problem with 240mg XR in a single dose. It took several hours to activate and the effect fell after 16hours. However splitting the product which is a combination of uncoated and single coated medication worked perfectly. However doctors tend to leave off the suffix and the pharmacy supplied CD which is a blend of uncoated, single coated and double coated. CD might last a bit longer but it didn't work for me as the medications were out of phase for twice daily dosing. Only XR twice daily works for me to control a fast pulse.
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Joan Says:
Why is there no medical person or pharmacist answering these questions?
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Ruth Says:
Can I take Diltiazem at night before bedtime instead of the morning? I am changing medication from Nifedipine to Diltiazem. I always took the Nifedipine before bedtime.
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Gbrooklyn Says:
Are there any side effects from taking Cardizem (diltiazem) 240mg ER 2x a day? I have noticed a loss or reduction of libido. Could it be the Cardizem or other drugs I am prescribed (Cozaar and Eliquis)?
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SAMMY Says:
Is diltiazem a blood thinner? I am having some teeth cut out and they told to stop my blood thinners.
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Kathllen Says:
I think the sum pharma bought out the pharma that was liked and are peddling the one we don't like as the same!?
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kumarr Says:
I have taken 120 mg dilitiazem and have hip and thigh pain. does any body experience that too.
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Nina Says:
I have been taking diltiazem 24hr ER 120 MG cap. Just received a new prescription that my Dr called in to our mail order pharmacy and what I got was diltiazem HCL ER (dilt-xr)caps 120mg are these the same thing? Thanks!
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