diltiazem and enalapril

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Teczem, |diltiazem and enalapril
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diltiazem and enalapril

Generic Name: diltiazem and enalapril (dil TYE a zem and e NAL a pril)
Brand Names: Teczem

What is diltiazem and enalapril?

Diltiazem is in a class of drugs called calcium channel blockers. Diltiazem relaxes (widens) your blood vessels (veins and arteries), which makes it easier for your heart to pump and reduces its workload.

Enalapril is in a class of drugs called angiotensin-converting-enzyme inhibitors (ACE inhibitors). Enalapril prevents the constriction (narrowing) of blood vessels (veins and arteries).

The combination, diltiazem and enalapril, is used to lower blood pressure and to prevent and treat heart failure.

Diltiazem and enalapril may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about diltiazem and enalapril?

Do not take diltiazem and enalapril if you are pregnant or planning a pregnancy. When used during the second and third trimesters of pregnancy, ACE inhibitors (enalapril) can cause injury and even death to the developing fetus. Notify your doctor immediately if you think you might be pregnant. Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse. Use caution when driving, operating machinery, or performing other hazardous activities. Diltiazem and enalapril may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position.

Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with diltiazem and enalapril. Maintain proper fluid intake to prevent dehydration and related adverse effects.

Do not break, crush, or chew this medication. Swallow the pills whole.

What should I discuss with my healthcare provider before taking diltiazem and enalapril?

Before taking diltiazem and enalapril, tell your doctor if you

  • have liver disease;
  • have kidney disease;

  • have diabetes;

  • have a collagen vascular disorder;

  • have another disease of the heart or blood vessels, such as sick sinus syndrome, aortic stenosis, congestive heart failure, heart block, or low blood pressure; or

  • are taking salt substitutes, potassium supplements (e.g., K-Dur, Klor-Con), or a potassium-sparing diuretic such as amiloride (Midamor), triamterene (Dyrenium, Dyazide, Maxzide), or spironolactone (Aldactone).

You may not be able to take diltiazem and enalapril, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Diltiazem and enalapril is in the FDA pregnancy category D. This means that diltiazem and enalapril is known to be harmful to an unborn baby. When used during the second and third trimesters of pregnancy, ACE inhibitors (enalapril) can cause injury and even death of the developing fetus. Do not take this medication without first talking to your doctor if you are pregnant or planning a pregnancy. It is not known whether diltiazem and enalapril passes into breast milk. Do not use diltiazem and enalapril without first talking to your doctor if you are breast-feeding a baby.

How should I take diltiazem and enalapril?

Take diltiazem and enalapril exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Do not break, crush, or chew this medication. Swallow the pills whole.

Do not be alarmed if you see what looks like a tablet in your stool. The tablets are made to release from an outer shell which is then eliminated in the stool.

Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse. Store diltiazem and enalapril at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a diltiazem and enalapril overdose are not known, but might include extreme dizziness, weakness, fainting, fatigue, chest pain, shortness of breath, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

What should I avoid while taking diltiazem and enalapril?

Use caution when driving, operating machinery, or performing other hazardous activities. Diltiazem and enalapril may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position. Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while you are taking diltiazem and enalapril.

Do not use salt substitutes or potassium supplements while taking diltiazem and enalapril, except under the supervision of your doctor.

Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with diltiazem and enalapril. Maintain proper fluid intake to prevent dehydration and related side effects.

Diltiazem and enalapril side effects

If you experience any of the following serious side effects, stop taking diltiazem and enalapril and call your doctor immediately or seek emergency medical treatment:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • jaundice (yellowing of your skin or eyes);

  • unusually fast or slow heartbeats;

  • difficulty breathing;

  • abnormal behavior or psychosis;

  • swelling of your legs or ankles;

  • little or no urine;

  • chest pain; or

  • severe dizziness or fainting.

Other, less serious side effects may be more likely to occur. Continue to take diltiazem and enalapril and talk to your doctor if you experience

  • mild dizziness or lightheadedness;

  • headache;

  • dry, tickling cough;

  • flushing (redness);

  • insomnia and vivid dreams;

  • numbness or tingling in the hands, feet, arms, or legs;

  • nausea, constipation, or diarrhea;

  • weakness or fatigue; or

  • a rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diltiazem and enalapril?

Before taking diltiazem and enalapril, tell your doctor if you are taking any of the following drugs:

  • a potassium supplement such as K-Dur, Klor-Con, and others;

  • salt substitutes that contain potassium;

  • any of the diuretics (water pills) triamterene (Dyrenium, Maxzide, Dyazide), spironolactone (Aldactone), and amiloride (Midamor);

  • any other diuretic (water pill), such as hydrochlorothiazide (HCTZ, Hydrodiuril, others), furosemide (Lasix), bumetanide (Bumex), indapamide (Lozol), and others;

  • a beta-blocker such as atenolol (Tenormin), acebutolol (Sectral), metoprolol (Lopressor, Toprol XL), propranolol (Inderal), carvedilol (Coreg), and others;

  • digoxin (Lanoxin, Lanoxicaps);

  • lithium (Lithobid, Eskalith, others);

  • cyclosporine (Sandimmune, Neoral);

  • cimetidine (Tagamet, Tagamet HB) or ranitidine (Zantac, Zantac-75); or

  • carbamazepine (Tegretol).

You may not be able to take diltiazem and enalapril, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with diltiazem and enalapril or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about diltiazem and enalapril written for health professionals that you may read.

What to the pills look like?

Diltiazem and enalapril is available with a prescription under the brand name Teczem Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. The following product strengths are listed as enalapril/diltiazem:

  • Teczem 5/180 mg-gold, capsule-shaped, film-coated tablets

  • Remember, keep this and all other medicines out of the reach of children. Never share your medicines with others and only use this medication for the condition prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.06. Revision Date: 2/13/04 4:06:40 PM.



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