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This medication comes with several important safety warnings and contraindications. It is crucial to review these points and discuss any concerns with your healthcare provider to ensure the safe use of this medication.

• Slow Heart Rate or Heart Block: Use of Diltiazem ER may result in or exacerbate heart block, causing a slow heart rate. Symptoms can include weakness, lightheadedness, or fainting. The risk increases if you are taking medications such as digoxin or beta-blockers, or have conditions that already slow your heart rate. Inform your healthcare provider of your complete medical history before starting this medication.

• Worsening Heart Failure: Individuals with existing heart problems may experience aggravated heart failure with Diltiazem ER. Notify your provider if you notice any symptoms like chest pain, breathing difficulties, dizziness, fatigue, swelling in the legs and feet, or bloating. This risk is heightened for those with heart failure or on beta-blockers.

• Severely Low Blood Pressure: This medication can cause a significant drop in blood pressure, leading to dizziness, fatigue, or lightheadedness. Such effects are more common when beginning treatment or increasing dosage. If you experience severe dizziness, sit down slowly and seek medical advice, especially if a fall occurs.

• Liver Problems: Though rare, Diltiazem ER might elevate liver enzyme levels, potentially causing liver issues. Regular liver function tests may be advisable during treatment. Seek immediate medical attention if you experience severe nausea, vomiting, right-sided abdominal pain, fatigue, appetite loss, or jaundice.

• Severe Skin Reactions: In rare instances, Diltiazem ER can lead to serious skin conditions like Stevens-Johnson syndrome or toxic epidermal necrolysis. If you develop symptoms such as a sore throat, fever, fatigue, rash, painful blisters, skin reddening, or peeling, or if you have facial swelling or breathing difficulty, discontinue use and seek urgent medical care.

Contraindications indicate conditions under which this medication should not be used, as it may pose serious health risks. Consult a healthcare provider if any of the following apply to you:

• Sick sinus syndrome without a ventricular pacemaker
• Second- or third-degree AV block without a ventricular pacemaker
• Uncontrolled low blood pressure (systolic below 90 mm Hg)
• Active heart attack with lung congestion

Always consult your healthcare provider to ensure this medication is safe for you, particularly if you have any pre-existing health conditions or are taking other medications.

When taking Cartia XT, it's important to be aware of potential interactions with other medications and substances. Combining Cartia XT with certain drugs can lead to increased effects or side effects. For instance, using it alongside beta-blockers may enhance the effects of both medications, potentially leading to a slower heart rate or lower blood pressure. Similarly, combining Cartia XT with Digoxin can increase digoxin levels in the blood, raising the risk of toxicity.

Other medications that may interact with Cartia XT include:

• Carbamazepine: Concurrent use can elevate carbamazepine levels, increasing the risk of side effects.

• Cyclosporine: Cartia XT may raise cyclosporine levels, necessitating careful monitoring and possible dose adjustments.

• Benzodiazepines: Cartia XT can increase the effects of medications like Midazolam and Triazolam, leading to prolonged sedation.

• Statins: Combining Cartia XT with certain cholesterol-lowering drugs may heighten the risk of muscle-related side effects.

Additionally, substances like alcohol and grapefruit juice can interact with Cartia XT. Alcohol may amplify the medication's blood pressure-lowering effects, causing dizziness or fainting. Grapefruit juice can increase Cartia XT levels in the blood, potentially leading to enhanced side effects.

Always inform your healthcare provider about all medications, supplements, and substances you are using to ensure safe and effective treatment with Cartia XT.