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Tildiem (diltiazem) is a calcium channel blocker used to treat angina (chest pain).

This product is very similar to Cardizem, as it contains the same active ingredient, but Tildiem comes in a lower dose of 60 mg per tablet while Cardizem tends to start at 120 mg doses and goes up to 300 mg. While Cardizem is often used to treat high blood pressure as well as angina, Tildiem is largely restricted to treating angina.

Tildiem is sometimes used off-label to manage high blood pressure, however, as well as treating tardive dyskinesia, Raynaud's syndrome, and preventing heart attacks. If taking Tildiem to treat these conditions doctor instructions should be followed.

Taking Tildiem

As mentioned above, Tildiem comes in tablets of 60 mg each. Tablets may be taken with or without food or drink as desired, but grapefruit juice should be avoided.

In otherwise healthy adults treatment is typically:

  • Take one tablet (60 mg) three times per day (total of 180 mg per day).
  • If insufficient, dosage may be increased to two tablets three times per day (total of 360 mg per day); or
  • Two tablets four times per day (total of 480 mg per day).

Patients who are elderly, who have other medical conditions, or are taking other medications that may interfere with Tildiem are usually started on lower doses:

  • Take one tablet (60 mg) twice per day.

Use in patients under 18 years of age is not recommended.

Tildiem, like all calcium channel blockers, is a vasodilator that widens blood vessels and allows blood to flow easier. This action often prevents angina from developing, but angina may still occur even if the medication is working. If angina does not decrease in frequency or worsens while taking Tildiem, speak with a doctor.

If the occasional angina is still experienced, another prescription for a fast-acting rescue treatment may also be given. Tildiem will do little to abort a current angina episode.

Other Considerations

Patients should avoid use of Tildiem if they:

  • Have a slow heartbeat (less than 50 beats per minute)
  • Have a heart arrhythmia and no pacemaker
  • Have heart failure
  • Are pregnant or breastfeeding

Patients who have the following are at increased risk of side effects and may be started on a lower dose of Tildiem:

  • Left ventricular failure
  • Atrioventricular block
  • Kidney or liver impairment

Medications known to interact with Tildiem include:

  • Digoxin
  • Cimitidine
  • Azole antifungals
  • Macrolide antibiotics
  • Benzodiapines
  • Rifamycins
  • St. John's wort
  • Aprepitant
  • Buspirone
  • Ivabradine
  • Cold or flu medications
  • NSAIDs

All calcium channel blockers will lower blood pressure and slow heart rate, regardless of what they're taken to treat. Any medical condition or medications that reduce blood pressure and/or influence heart rate have the potential to cause serious complications and should be brought to the attention of the prescribing doctor. Likewise double-check with a doctor or pharmacist before mixing any other medications with Tildiem, including over-the-counter varieties.


60mg diltiazem  Buy Cardizem 90 Tablets - $36.28
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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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