Pharmacokinetics of oral diltiazem and five of its metabolites in patients with chronic renal failure

Abstract

The pharmacokinetics of oral diltiazem were studied in 10 patients with chronic renal failure not requiring dialysis and in five healthy volunteers after a single dose of 120 mg. We found that patients with chronic renal failure had lower amounts of unchanged diltiazem and of its main metabolite (MA) in urine and a trend to have slightly higher values of plasma concentration. Since the terminal elimination phase is not affected by chronic renal failure we conclude that this trend is probably the result of alterations in the volume of distribution of diltiazem in these patients.

Diltiazem-induced Transient Complete Atrioventricular Block in an Elderly Patient with Acute on Chronic Renal Failure

“…However, it is important to emphasize that these results were derived from the administration of a single oral dose of short-acting diltiazem in a small sample of individuals with severe renal impairment. Later investigations [6] showed that patients with chronic renal failure had increased plasma levels of diltiazem and its 5 main metabolites as compared with non-renal failure patients. …”