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When considering the use of diltiazem extended-release (ER) beads, it's important to be aware of certain risks associated with this medication:

Heart Rhythm Concerns: Diltiazem can affect the heart's electrical system, potentially leading to slow heart rates or heart block, especially in individuals with existing heart rhythm disorders. Those with conditions like sick sinus syndrome or atrioventricular (AV) block should avoid this medication unless they have a functioning pacemaker.

Low Blood Pressure (Hypotension): This medication may cause a significant drop in blood pressure, leading to symptoms such as dizziness or fainting. Individuals with already low blood pressure should exercise caution.

Heart Failure: Diltiazem has the potential to worsen heart failure symptoms. Patients with heart failure should consult their healthcare provider to determine if this medication is appropriate for them.

Liver Health: In rare cases, diltiazem has been linked to liver injury. Signs of liver problems include fatigue, loss of appetite, nausea, yellowing of the skin or eyes, dark urine, and abdominal pain. If any of these symptoms occur, it's crucial to contact a healthcare professional promptly.

Pregnancy and Breastfeeding: The safety of diltiazem during pregnancy has not been well established. It is known to pass into breast milk, which may affect a nursing infant. Pregnant or breastfeeding individuals should discuss the potential risks and benefits with their healthcare provider.

Kidney Function: Since diltiazem is processed by the kidneys, those with impaired kidney function may experience increased drug levels in their system. Such individuals should use this medication cautiously and under medical supervision.

Surgical Considerations: If you're scheduled for surgery, including dental procedures, inform your healthcare provider that you're taking diltiazem, as it may interact with certain anesthetics.

Always consult with your healthcare provider to ensure that diltiazem ER beads are appropriate for your specific health condition and to discuss any potential risks.

Common side effects:

• dizziness
• lightheadedness
• weakness
• nausea
• flushing
• constipation
• headaches

Less common but important to monitor:

• persistent nausea or vomiting
• fainting
• shortness of breath
• swelling in the ankles or feet
• unusual tiredness
• sudden weight gain
• irregularities in heartbeat
• noticeable mental or mood changes
• unusual dreams
• severe stomach pain
• dark urine
• yellowing of the eyes or skin

Serious side effects:

• rash
• itching or swelling of the face, tongue, or throat
• severe dizziness
• difficulty breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Digoxin
• Fingolimod
• Labetalol

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• azole antifungals (such as Ketoconazole)
• Cimetidine
• macrolide antibiotics (such as Erythromycin)
• rifamycins (such as Rifabutin, Rifampin)
• St. John's wort
• Aprepitant/fosaprepitant
• Buspirone
• Colchicine
• elacestrant
• Flibanserin
• Ivabradine
• lomitapide
• certain benzodiazepines (Triazolam, Midazolam)

Interactions with low risk that usually do not require a change in therapy:

• cough-and-cold products
• diet aids
• NSAIDs (such as Ibuprofen/Naproxen)