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Cardizem vs Norvasc
Introduction
For patients with high blood pressure (hypertension) or certain types of heart conditions, specific drugs that alter the performance of cardiovascular system can help in managing symptoms and preventing complications. Cardizem (diltiazem) and Norvasc (amlodipine) are two such medications that are often prescribed for these conditions. Both belong to a class of drugs known as calcium channel blockers which work by relaxing the muscles of your heart and blood vessels. However, they do so in slightly different ways.
Cardizem is classified as a non-dihydropyridine calcium channel blocker which not only affects the muscle cells in the arterial walls but also acts directly on the electrical conduction tissue within the heart, thus slowing down its rate under certain conditions.
Norvasc belongs to dihydropyridines subclass, it primarily works on relaxing peripheral arteries reducing their resistance against blood flow thereby lowering overall systemic blood pressure - making it an excellent option for treating hypertension.
Cardizem vs Norvasc Side By Side
| Attribute | Cardizem | Norvasc |
|---|---|---|
| Brand Name | Cardizem | Norvasc |
| Contraindications | Should not be taken with St. John’s Wort due to potential reduction in effectiveness. | Should not be taken with St. John’s Wort due to potential reduction in effectiveness. |
| Cost | For brand name: around $350 for 60 tablets of 120 mg. For generic (diltiazem): ranges from $0.15 to $1.50 per day depending on dose. | For brand name: approximately $240 for 30 tablets of 5 mg. For generic (amlodipine): starts from just over $0.01 to about $0.50. |
| Generic Name | Diltiazem | Amlodipine |
| Most Serious Side Effect | Severe skin reactions, worsening chest pain, slow heartbeats, shortness of breath, severe gastrointestinal symptoms. | Severe skin reactions, chest pain indicating possible heart problems, swelling due to fluid retention (edema), unusual mood changes or confusion. |
| Severe Drug Interactions | Not specified in the text, but generally, calcium channel blockers can interact with other heart medications, grapefruit juice, and certain antibiotics or antifungals. | Not specified in the text, but similar to diltiazem, amlodipine can have interactions with other heart medications, grapefruit juice, and certain antibiotics or antifungals. |
| Typical Dose | 120-540 mg/day, with an initial dose usually between 180-240 mg/day. | Starts at 5 mg per day, can be increased to a maximum of 10 mg per day. |
What is Cardizem?
Diltiazem (the generic name for Cardizem) is a calcium channel blocker that was first approved by the FDA in 1982. It works by relaxing the muscles of your heart and blood vessels, thereby improving blood flow and making it easier for the heart to pump. This makes Diltiazem effective for treating hypertension, angina, and certain types of arrhythmia.
On the other hand, Amlodipine (the generic name for Norvasc) belongs to the same class of drugs but has a slightly different mechanism of action. While it also relaxes blood vessels and improves blood flow, it does so more selectively on coronary arteries which supply oxygenated blood to our heart muscle. It was first approved by FDA in 1992.
Both these medications are commonly prescribed to treat high blood pressure and chest pain; however, their influence varies based on individual health conditions. For instance, Diltiazem might be preferred if you have concurrent atrial fibrillation due its additional rhythm controlling property whereas Amlodipine may be chosen if there's isolated high BP with no other cardiac issues.
Side effects vary as well; while both can cause dizziness or flushing due to lowered BP, Diltiazem use can sometimes lead slower heart rate whereas peripheral edema is more common side effect seen in patients using Amlodipine.
What conditions is Cardizem approved to treat?
Cardizem is approved for the treatment of various cardiovascular conditions:
- Hypertension, also known as high blood pressure
- Angina pectoris (chest pain due to heart disease)
- Certain types of arrhythmias (abnormal heart rhythms), specifically supraventricular tachycardia and atrial fibrillation or flutter
How does Cardizem help with these illnesses?
Cardizem, also known as diltiazem, helps to manage hypertension and angina by decreasing the amount of calcium entering the muscle cells in the heart and arteries. It does this by blocking calcium channels, so levels can be maintained lower for longer periods of time. Calcium is a chemical that acts as a messenger in many physiological processes such as contraction of muscles including those in blood vessels and heart. When there's too much calcium, these muscles contract more forcefully which may lead to high blood pressure or angina. Therefore, by reducing calcium entry into these cells, Cardizem can limit the negative effects of hypertension and angina and help patients manage their condition.
On the other hand, Norvasc operates similarly but with some differences. It selectively inhibits calcium ion influx across cell membranes while Cardizem isn't selective which means it might have broader side effects than Norvasc.
What is Norvasc?
Norvasc, also known by its generic name amlodipine, is a calcium channel blocker. This means it helps relax the muscles of your heart and blood vessels. It was first approved by the FDA in 1992 for treating high blood pressure and angina (chest pain). By relaxing the arteries, Norvasc allows more efficient pumping of the heart and decreases symptoms associated with angina. Unlike diltiazem (Cardizem), which affects both the heart rate and coronary arteries, Norvasc primarily works on arterial dilation providing targeted treatment for hypertension without significantly affecting cardiac rhythm or contractility. Due to this difference in action compared to other calcium channel blockers like Cardizem, Norvasc's side effect profile may be different; it does not typically cause as much bradycardia (slow heartbeat) but can lead to peripheral edema (fluid buildup in tissues). The therapeutic effects of amlodipine can be beneficial particularly for patients who need long-term management of chronic conditions such as high blood pressure.
What conditions is Norvasc approved to treat?
Norvasc, also known by its generic name amlodipine, is used for the treatment of:
- High blood pressure (hypertension)
- Coronary artery disease
- Angina, which is chest pain caused by reduced blood flow to the heart.
How does Norvasc help with these illnesses?
Calcium is a mineral that plays several crucial roles in the body, including muscle contraction and transmission of nerve signals. Both Cardizem (diltiazem) and Norvasc (amlodipine) work by blocking calcium channels in the heart cells and blood vessels, allowing them to relax and widening arteries to improve blood flow. However, Norvasc specifically targets peripheral vessels more than cardiac ones - it has a stronger effect on relaxing blood vessels while having less impact on slowing down heart rate compared to diltiazem. This makes Norvasc particularly useful for treating high blood pressure and angina symptoms without significantly affecting the heart’s rhythm or contractility. Furthermore, this specificity may make it preferable for patients who have other underlying cardiovascular conditions or do not respond well to drugs that can affect their heartbeat like Cardizem.
How effective are both Cardizem and Norvasc?
Both diltiazem (Cardizem) and amlodipine (Norvasc) are well-established in managing hypertension and angina, with similar FDA approval timelines. They both belong to the class of calcium channel blockers but act on different types of calcium channels which may influence their prescribing under varying circumstances.
The effectiveness of diltiazem and amlodipine in controlling blood pressure was directly studied in several double-blind clinical trials; overall, they demonstrated comparable efficacy in managing symptoms of hypertension as well as promising safety profiles. In these studies, no significant differences were observed between patients receiving Cardizem or Norvasc when measuring parameters such as systolic and diastolic blood pressure.
A 2003 review indicated that diltiazem is effective from the first week of treatment onwards for managing chronic stable angina and has fewer side effects compared to some other antihypertensives. The same study reports that it is globally one of the most prescribed antihypertensive medications due to its long history and proven effectiveness. Typically, an optimal dose for treating hypertension with diltiazem is around 180-360 mg/day.
A 2015 meta-analysis showed that amlodipine appears more effective than placebo for reducing high blood pressure while being similar in efficacy to other common antihypertensive drugs. However, usage data suggests it's typically considered after thiazide diuretics or beta-blockers have been tried first - although this varies depending on individual patient factors. Amlodipine does not significantly enhance the effect of other hypertensives but can be used alongside them if additional blood pressure reduction is required – especially important given its unique pharmacology which causes arterial dilation without affecting myocardial contractility or conduction velocity.
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At what dose is Cardizem typically prescribed?
Oral dosages for Cardizem range from 120-540 mg/day, but studies have indicated that an initial dose of 180-240 mg/day is usually effective in treating hypertension and angina. For Norvasc, the typical starting dosage ranges from 2.5–10 mg/day for both conditions; however, most people begin with a daily dosage of 5mg. In either case, if there's no adequate response after two weeks, your healthcare provider may adjust your medication regime accordingly. The maximum recommended dose for Cardizem is 540 mg/day while that for Norvasc should not exceed 10 mg/day.
At what dose is Norvasc typically prescribed?
Norvasc treatment typically begins at a dosage of 5 mg per day. The dose can then be increased to a maximum of 10 mg per day, depending on the patient's response and tolerability. This daily dose may be split into two doses if desired but is most commonly taken as one single dose due to its long half-life. It should also be noted that elderly patients or those with liver impairment may require a lower starting dose. Continual assessment will determine if there is no beneficial effect seen after several weeks, upon which your doctor might consider increasing the dosage.
What are the most common side effects for Cardizem?
Common side effects of Cardizem (diltiazem) include:
- Dizziness
- Lightheadedness
- Weakness, general fatigue
- Swelling ankles/feet
- Flushing (warmth, redness, or tingly feeling)
- Headache
Norvasc (amlodipine), on the other hand, may lead to:
- Edema (swelling in your hands or feet)
- Tiredness and drowsiness
- Nausea
- Abdominal pain/stomach discomfort
-Dizziness -Lightheadedness, -Irregular heartbeat/palpitations
As always with any medication, if you experience severe side effects such as fainting or significant changes in heart rhythm you should seek immediate medical attention.
Are there any potential serious side effects for Cardizem?
While both Cardizem and Norvasc are used to manage hypertension, they can cause different side effects. For example:
- Swelling of the face, tongue or throat
- An allergic reaction: hives; difficulty breathing; swelling in your face or throat
- Severe skin reactions: fever, sore throat, burning eyes, skin pain, a rash that is red or purple and spreads across the body with blistering and peeling.
- Worsening chest pain (especially at the beginning of treatment)
- Slow heartbeats
- Pounding heartbeats or fluttering in your chest
- Shortness of breath that is worse than usual -Feverish feeling with lightheadedness (like you might pass out) -Low blood pressure - indicated by extreme dizziness upon standing up from sitting or lying down position. -Severe gastrointestinal symptoms like severe nausea vomiting diarrhea.
If any such symptoms occur while taking either drug it's crucial to seek immediate medical attention.
What are the most common side effects for Norvasc?
Norvasc, or amlodipine besylate, is frequently prescribed to manage hypertension and angina. However, it does come with several potential side effects that patients should be aware of:
- Excessive tiredness or unusual weakness
- Flu-like symptoms (fever, chills)
- Swelling of the hands/feet due to fluid retention
- Unusual weight gain
- Rapid or irregular heartbeat (palpitations)
- Dizziness and lightheadedness
- Headache
- Nausea or upset stomach
It's always crucial for patients to discuss any concerns they may have about these possible side effects with their healthcare provider.
Are there any potential serious side effects for Norvasc?
While Norvasc is typically well-tolerated, it can cause some serious side effects in rare instances. These may include:
- An allergic reaction presenting as hives, itching, facial swelling, difficulty breathing or swallowing
- Severe skin reactions including redness, blisters and peeling
- Palpitations or unusually rapid heart rate
- Lightheadedness leading to fainting spells
- Swelling of your hands, feet or ankles due to fluid retention (edema)
- Chest pain indicating possible heart problems
- Unusual mood changes or confusion
If you experience any of these symptoms while taking Norvasc, seek immediate medical attention. It's important not to ignore these potential signs of a severe adverse reaction.
Contraindications for Cardizem and Norvasc?
Both Cardizem and Norvasc, like most other antihypertensive medications, may cause certain side effects in some individuals. If you notice worsening of your symptoms such as increased heart rate or chest pain, please seek immediate medical attention.
Neither Cardizem nor Norvasc should be taken if you are taking, or have been taking St. John’s Wort. This herb can interact unfavorably with these drugs by reducing their effectiveness. Always inform your physician about any supplements or herbal treatments you are using; St John's Wort will require a period of about 5 weeks to clear from the system to prevent potential interactions with Cardizem and Norvasc.
How much do Cardizem and Norvasc cost?
For the brand name versions of these drugs:
- The price for 60 tablets of Cardizem (120 mg) averages around $350, which works out to about $11.66 per day.
- The price for 30 tablets of Norvasc (5 mg) is approximately $240, which rounds up to roughly $8 per day.
Thus, if you are in the higher dosage range for Cardizem (i.e., 360 mg/day), then brand-name Norvasc may be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions of Cardizem (diltiazem) and Norvasc (amlodipine), costs are significantly lower:
- Diltiazem (120 mg tablets) can be bought in packs from 30 capsules upward with approximate costs ranging from as low as $0.15 to around $1.50 per day depending on your prescribed dose.
- Amlodipine is available in packs starting from 30 up to larger quantities like 90 or even more at doses ranging between 2.5mg and 10mg daily; prices start from as low as just over one cent ($0.01) all the way up to about fifty cents ($0.50).
Popularity of Cardizem and Norvasc
Diltiazem, available as generic and also under the brand name Cardizem among others, was prescribed to approximately 8 million people in the US in 2020. It accounted for just over 7% of calcium channel blocker prescriptions in the country. Diltiazem is classified as a non-dihydropyridine calcium channel blocker, which means it affects both blood vessels and the heart directly.
In comparison, Amlodipine Besylate (brand name Norvasc) was prescribed to around 50 million people in USA during the same year. In America's context, this medicine makes up almost half of all prescriptions for calcium channel blockers - about 48%. As a dihydropyridine calcium channel blocker, Amlodipine primarily influences blood vessels rather than affecting heart rate significantly. The prevalence of amlodipine has been on an upward trend since its introduction due to its efficacy and tolerable side effect profile.
Conclusion
Both Cardizem (diltiazem) and Norvasc (amlodipine) have long-standing records of usage in patients with hypertension, angina pectoris, and certain types of arrhythmias. They are backed by numerous clinical studies indicating that they effectively lower blood pressure more than placebo treatments. Both drugs belong to the class of calcium channel blockers but showcase different sub-classifications: Cardizem is a benzothiazepine while Norvasc is a dihydropyridine which can lead to them being prescribed under different circumstances.
Cardizem could be considered for cases where heart rate control is also needed in addition to lowering blood pressure since it tends to slow down heart rates. On the other hand, Norvasc does not significantly affect heart rates and therefore might be preferable if this effect is not desired or contraindicated.
Both are available as generics which represents significant cost savings especially for those who must pay out of pocket. The onset of effects may vary between individuals so people may require an adjustment period before noticeable improvements occur.
In terms of side effect profiles, both drugs are generally well-tolerated but like all medications carry potential risks; these include edema, dizziness and flushing among others. While starting treatment or changing doses, patients should closely monitor their blood pressure and symptoms related to low blood pressure such as feeling lightheaded or fainting - any concerns should prompt immediate medical consultation.
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Refrences
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