diltiazem / Generic mfg. - LARVOL DELTA

Beyond CYP3A5: Extensive tacrolimus dosing variability in a multi‑ethnic southeast asian kidney transplant population (TTS 2026) - " This was a retrospective, single-centre study of KTRs receiving initial maintenance immunosuppression of TAC, steroids, and either mycophenolate mofetil (MMF) or azathioprine (AZA). Dual-organ recipients and those receiving concomitant diltiazem were excluded... In this Southeast Asian multi-ethnic cohort, CYP3A5 NMs/IMs required higher TAC doses and had more subtherapeutic early TAC levels, but CYP3A5 phenotype did not predict infectious or metabolic toxicities. The wide intra-phenotype dose variability and overlap of doses inter-phenotype suggests that CYP3A5-guided dosing alone is insufficient. This underscores the need for evaluating genetic polymorphisms beyond CYP3A5 and non-genetic factors to improve dosing precision."

Clinical • Cytomegalovirus Infection • Diabetes • Infectious Disease • Metabolic Disorders • Transplantation • CYP3A5

Pharmacokinetic comparison of innovator and generic tacrolimus in kidney transplant patients receiving CYP3A boosters (TTS 2026) - " Twenty-four patients completed all study periods, with a median post-transplant duration of 3.2 (2.4 – 7) years; 20 received CYP3A inhibitor boosting (fluconazole n=8, diltiazem n=8, both n=4). Two generic Tac formulations were bioequivalent to the innovator in stable KTRs, including those receiving CYP3A inhibitor boosting. Booster co-administration did not alter relative formulation performance. These findings support the clinical adoption of generic Tac in settings where cost containment is essential."

Clinical • PK/PD data • Nephrology • Transplantation

SERIAL HEMODYNAMIC PHENOTYPING DURING VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION FOR REFRACTORY VASOPLEGIC SHOCK AFTER MASSIVE DILTIAZEM AND METOPROLOL CO-INGESTION (CHEST 2026) - No abstract available

Critical care

Newly Detected Atrial Flutter After Enclomiphene Dose Escalation in a Patient With Prior Mitral Valve Repair and Chronic Immune Thrombocytopenia: A Case Report. (PubMed, Cureus) - "Rate control was achieved with metoprolol and diltiazem. Anticoagulation was deferred because of severe thrombocytopenia, and high-dose prednisone was initiated to raise the platelet count before planned anticoagulation and elective cardioversion...Formal causality assessment using the Naranjo scale placed the association in the possible category only. The case is presented for two reasons: as an illustration of how a hormonal agent should be weighed against a pre-existing structural substrate rather than assumed to be causal, and as an example of the difficulty of balancing thromboembolic and bleeding risk when atrial flutter coexists with severe ITP."

Journal • Cardiovascular • Endocrine Disorders • Heart Failure • Hematological Disorders • Immune Thrombocytopenic Purpura • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Thrombocytopenic Purpura

BRAVE-HCM: The Therapeutic Value of Mavacamten in Hypertrophic Cardiomyopathy With Mid-to-Apical Left Ventricular Obstruction (clinicaltrials.gov) - P4 | N=132 | Enrolling by invitation | Sponsor: Second Affiliated Hospital, Zhejiang University, School of Medicine | Not yet recruiting ➔ Enrolling by invitation | Trial primary completion date: Jul 2026 ➔ Nov 2026

Enrollment open • Real-world evidence • Trial primary completion date • Cardiomyopathy • Cardiovascular • Hypertrophic Cardiomyopathy

ReCAST AF: Flecainide Safety in Patients With Coronary Artery Disease and Atrial Fibrillation (clinicaltrials.gov) - P4 | N=988 | Recruiting | Sponsor: Universitaire Ziekenhuizen KU Leuven | Not yet recruiting ➔ Recruiting

Enrollment open • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease

Randomized Trial Comparing Diltiazem and Metoprolol For Atrial Fibrillation Rate Control (clinicaltrials.gov) - P4 | N=69 | Terminated | Sponsor: CAMC Health System | N=150 ➔ 69 | Unknown status ➔ Terminated; Low enrollment and PI retired.

Enrollment change • Trial termination • Atrial Fibrillation • Cardiovascular

Acute Inferior Myocardial Infarction with Anomalous Origin of the Right Coronary Artery, Myocardial Bridging and Fibro-Lipid Plaque. (PubMed, Catheter Cardiovasc Interv) - "An abnormal origin of the right coronary artery (RCA) from the left coronary sinus was discovered by emergency coronary angiography, along with mild stenosis in the mid-RCA segment that persisted even after intracoronary nitroglycerin was administered...The patient experienced total symptom alleviation and an uneventful recovery after receiving dual antiplatelet therapy, intense lipid-lowering treatment, diltiazem for myocardial bridging, and stringent risk factor control. For long-term risk reduction, a multidisciplinary evaluation is planned for surgical of the coronary abnormality. In addition to highlighting the significance of tailored management approaches for congenital coronary anomalies combined with acquired vulnerable plaques, this case underscores the crucial role of multimodality imaging, particularly IVUS, in accurate etiological diagnosis and treatment decision-making for young patients with acute myocardial infarction (AMI) caused by complex coronary..."

Journal • Cardiovascular • Myocardial Infarction • Pain

Oral urea as a safety strategy in complex syndrome of inappropriate antidiuretic hormone secretion - Challenges posed by polypharmacy and institutionalization (PubMed, Nutr Hosp) - "this case highlights oral urea as a safe, effective, and cost-effective therapeutic option for SIADH when fluid restriction is not feasible and vaptans are unsuitable, particularly in frail older adults with polypharmacy and complex social circumstances."

Journal • Cardiovascular • Geriatric Disorders • Heart Failure • Hepatology

Safety and Clinical Outcomes Associated with Concomitant Diltiazem and Direct Oral Anticoagulant Therapy: A Systematic Review and Meta-Analysis (AHA 2026) - "Abstract is embargoed at this time."

Clinical data • Retrospective data • Review

Swallowing-Induced Supraventricular Tachycardia Associated With Reflux Esophagitis (ACG 2026) - "The patient was started on flecainide, metoprolol succinate, and diltiazem and discharged with mobile cardiac outpatient telemetry (MCOT). Figure: Figure 1. Mobile cardiac outpatient telemetry demonstrating initiation of paroxysmal supraventricular tachycardia (197 beats/min) temporally associated with swallowing, supporting the diagnosis of swallowing-induced supraventricular tachycardia."

Barrett Esophagus • Cardiovascular • CNS Disorders • Coronary Artery Disease • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Infectious Disease • Pulmonary Disease • Ventricular Tachycardia

A Rare Presentation of Distal Esophageal Adenocarcinoma With Malignant Carotid Sinus Syndrome (ACG 2026) - "Atrial fibrillation with RVR was noted, with conversion to sinus rhythm after IV diltiazem and digoxin. Distal esophageal adenocarcinoma can metastasize to cervical nodes, and cause CS compression with even minor positional changes inducing reproducible bradycardia, asystole, or syncope. In patients with known malignancy, position-dependent hemodynamic collapse should prompt consideration of cervical mass effect."

Atrial Fibrillation • Breast Cancer • Esophageal Adenocarcinoma • Esophageal Cancer • Esophageal Squamous Cell Carcinoma • Hematological Malignancies • Hypotension • Lymphoma • Oncology • Pulmonary Disease • Solid Tumor • Squamous Cell Carcinoma

A Broken Heart Before Colonoscopy: Bowel Preparation-Associated Atrial Fibrillation With Rapid Ventricular Response Complicated by Atypical Takotsubo Cardiomyopathy (ACG 2026) - "She received IV diltiazem, developed bradycardia requiring atropine, and remained hypotensive after 2 L crystalloid...She stabilized, pressors were weaned, acidosis resolved, and she was discharged on atorvastatin, apixaban, and metoprolol with cardiology follow-up...Clinicians should ensure adequate periprocedural hydration and pursue cardiac evaluation in symptomatic patients, recognizing that troponin and ST changes do not indicate obstructive coronary disease in this context. Figure: Takotsubo Cardiomyopathy Figure: Combined ECGs ( Atrial fibrillation and sinus rhythm)"

Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Metabolic Disorders

Lateral Internal Sphincterotomy versus Topical 2% Diltiazem for Chronic Anal Fissure: A Systematic Review and Meta-Analysis (ACG 2026) - "Eight studies comprising 750 patients (366 LIS, 384 diltiazem) were included. LIS was associated with a significantly higher risk of postoperative flatus incontinence (RR 6.01, 95% CI 1.34â26.97). Healing rates favored LIS at 2 weeks (RR 42.53, 95% CI 14.95â120.99), 4 weeks (RR 1.93, 95% CI 1.15â3.22), and 6 weeks (RR 1.31, 95% CI 1.19â1.44)."

Retrospective data • Review • Gastrointestinal Disorder

Luhong formula attenuates cardiomyocyte hypoxia/reoxygenation injury in vitro through SLC7A11-mediated ferroptosis. (PubMed, Immunobiology) - "H9c2 cells were subjected to H/R injury and treated with LHF extract, diltiazem (positive control), or Fer-1 (ferroptosis inhibitor)...These findings provide preliminary evidence for a potential regulatory effect of LHF on SLC7A11 protein stability, although direct measurements of protein half-life and detailed ubiquitin topology require further investigation. These findings suggest that LHF inhibits H/R-induced ferroptosis in H9c2 cells, at least in part, through the SLC7A11/GPX4 pathway, which may contribute to its cardioprotective effect."

Journal • Preclinical • Cardiovascular • Myocardial Ischemia • Reperfusion Injury • Targeted Protein Degradation • GPX4 • SLC7A11

Effect of amiodarone, diltiazem, or both to achieve strict heart rate control in dogs with atrial fibrillation. (PubMed, J Vet Intern Med) - "Monotherapy with amiodarone or diltiazem or combination therapy of amiodarone/diltiazem did not achieve SHRC in most dogs in this study."

Clinical • Journal • Atrial Fibrillation • Cardiovascular

A novel CACNA1S variant associated with diltiazem-related worsening of hypokalemic periodic paralysis: a case report. (PubMed, Neurol Sci) - "The p.(Met1366Arg) variant is located in the S6 segment of CaV1.1, outside the canonical S4 arginine residues implicated in most cases of CACNA1S-related HypoPP; nevertheless, strong intrafamilial segregation evidence supports its pathogenicity. Furthermore, its proximity to the diltiazem-binding site raises the possibility of altered drug-channel interactions. The observed diltiazem-associated worsening of HypoPP may be variant-specific rather than a class effect of LTCCBs. Nevertheless, careful monitoring may be warranted when prescribing these agents to patients with HypoPP."

Journal • Cardiovascular • CACNA1S • CAV1

PERVADE-ED: PERceptions of Diltiazem Versus ADEnosine for Treatment of Supraventricular Tachycardia in the Emergency Department (clinicaltrials.gov) - P=N/A | N=100 | Recruiting | Sponsor: University of Iowa | N=20 ➔ 100

Enrollment change • Cardiovascular • Ventricular Tachycardia

Perioperative Management of New-Onset Atrial Fibrillation with Rapid Ventricular Response in a Patient with Small Bowel Obstruction Requiring Urgent Surgery (ASA 2026) - "A diltiazem infusion was initiated and achieved partial rate control to the 130s with improved blood pressure (~120 mmHg)...Intraoperatively, persistent atrial fibrillation with hemodynamic instability required vasoactive support and synchronized cardioversion, resulting in improved rhythm and perfusion. This case highlights perioperative management challenges in unstable tachyarrhythmias requiring urgent non-cardiac surgery."

Clinical • Surgery • Atrial Fibrillation • Cardiovascular • Hypotension

Management of Supraventricular Tachycardia in the Peripartum Stage (ASA 2026) - "A 19-year-old primigravida at 35 weeks, 6 days with gestational hypertension and pregnancy-induced supraventricular tachycardia previously controlled by flecainide and diltiazem was admitted for close monitoring and potential delivery after an exacerbation by an upper respiratory infection. Intraoperative management of patient hemodynamics with diltiazem drip was overall uneventful, and the patient had an ordinary postpartum course. The patient was discharged with close obstetric and cardiology follow-up."

Cardiomyopathy • Cardiovascular • Hypertension • Infectious Disease • Obstetrics • Respiratory Diseases • Ventricular Tachycardia

Potentially inappropriate prescribing in Iranian elderly population: a nationwide claims-based analysis. (PubMed, BMJ Open) - "In this nationwide claims-based study, about 5% of elderly Iranians were exposed to PIPs, particularly chronic benzodiazepine use, excessive anticholinergic burden and high-risk cardiovascular and antithrombotic combinations. Our findings provide concrete targets for claims-based surveillance and interventions to improve prescribing safety in Iran's ageing population."

Journal • Observational data • Retrospective data • Cardiovascular

Non-dihydropyridine Calcium Channel Blockers in Atrial Fibrillation with Mildly Reduced Ejection Fraction: Caution is Still AdvisedReplyBrazilian Atrial Fibrillation Guidelines - 20252016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology... (PubMed, Arq Bras Cardiol) - No abstract available

Clinical guideline • Journal • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction

A Clinical Trial of MK-4082 in Healthy Participants (MK-4082-005) (clinicaltrials.gov) - P1 | N=28 | Recruiting | Sponsor: Merck Sharp & Dohme LLC | Not yet recruiting ➔ Recruiting | N=18 ➔ 28

Enrollment change • Enrollment open

Severe Diltiazem Poisoning Managed With CytoSorb Hemoadsorption and Supportive Therapies: A Case Report. (PubMed, Crit Care Explor) - "Retrospective analysis demonstrated elevated diltiazem concentrations with delayed, capacity-limited elimination. This case supports considering hemoadsorption in unstable patients with severe diltiazem poisoning despite conventional measures and highlights the need for systematic pharmacokinetic evaluation in future studies."

Journal • Hypotension • Metabolic Disorders

The Many ECG Faces of Wolff-Parkinson-White Syndrome. (PubMed, JACC Case Rep) - "WPW can present without classic features of pre-excitation on initial ECG; comprehensive serial ECG analysis is crucial to accurately diagnose WPW. Ventricular tachycardia should be considered in the differential diagnosis of WPW, as ECG cannot reliably differentiate between antidromic WPW and ventricular tachycardia."

Journal • Atrial Fibrillation • Cardiovascular • CNS Disorders • Infectious Disease • Movement Disorders • Pneumonia • Respiratory Diseases • Ventricular Tachycardia