Diltiazem is a nondihydropyridine (non-DHP) member of the class of drugs known as calcium channel blockers, used in the treatment of hypertension, angina pectoris, and some types of arrhythmia. It is a benzothiazepine, which differentiates it from the other classes of non-DHP calcium channel blockers such as the phenylalkylamines. It is also an effective preventive medication for migraine. It is a class 3 antianginal drug, and a class IV antiarrhythmic.It incites minimal reflex sympathetic changes. It is based upon a 1,4-thiazepine ring. Diltiazem is metabolized by and acts as an inhibitor of the CYP3A4 enzyme. Diltiazem is a potent vasodilator, increasing blood flow and variably decreasing the heart rate via strong depression of A-V node conduction. Its pharmacological activity is somewhat similar to verapamil. It is a potent vasodilator of coronary and peripheral vessels, which reduces peripheral resistance and afterload.
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