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Diltiazem Hydrochloride is a calcium channel blocker that Bayview compounds to a prescriber's order.
Diltiazem hydrochloride is a nondihydropyridine calcium channel blocker used in the management of cardiovascular conditions, including hypertension and angina pectoris (chronic stable angina and angina due to coronary artery spasm).[1][2] By inhibiting the influx of calcium ions into cardiac and vascular smooth muscle cells during membrane depolarization, diltiazem relaxes blood vessels, leading to a decrease in blood pressure; it also reduces myocardial oxygen demand and dilates the coronary arteries.[1][2]
Diltiazem hydrochloride is also used for rate control in atrial fibrillation or atrial flutter and in paroxysmal supraventricular tachycardia, as it reduces heart rate.[1]
Bayview compounds diltiazem hydrochloride on a prescriber's order.
Diltiazem is available in immediate-release, extended-release, and injectable forms, and extended-release products allow once-daily dosing; pharmacokinetics vary significantly between extended-release brands.[1][2] Common side effects include headache, bradycardia, dizziness, edema, and fatigue.[1][2] Diltiazem inhibits CYP3A4 and can raise levels of other drugs, and it is contraindicated in conditions such as severe hypotension, second- or third-degree AV block or sick sinus syndrome without a pacemaker, and acute myocardial infarction.[1]
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
For prescribers
Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
It is a compounded, prescription medication applied to the anal area. Diltiazem is a calcium channel blocker, and used this way it relaxes the ring of muscle around the anus. Providers most often prescribe it for anal fissures, small tears in the skin of the anal canal that cause sharp pain and bleeding with bowel movements. Bayview compounds it at 2% strength as an ointment and as a gel.
Pain often eases within the first week or two, but healing takes longer. Chronic fissures are usually treated for six to eight weeks, and prescribers generally direct patients to finish the full course even after the pain improves, since stopping early is a common reason a fissure returns. Supportive care such as fiber, fluids, and sitz baths is usually part of the plan. If your symptoms are not improving after several weeks of use, contact your provider.
Compounded diltiazem starts at $92 for 30 g. The price varies with the base, the quantity (30, 45, or 60 g), and whether the prescription is a plain 2% preparation or a combination with lidocaine. Compounded preparations are cash-priced and are generally eligible for HSA and FSA cards. Call us at 401-284-4505 with the preparation and quantity your prescriber ordered and we will quote it before we make it.
No. Diltiazem is prescription-only in every form. Oral diltiazem tablets and capsules are FDA-approved for blood pressure and chest pain, but there is no FDA-approved topical or rectal diltiazem product in the United States and nothing equivalent is sold over the counter. The 2% ointment and gel used for anal fissures exist only as compounded preparations, and a valid prescription is required.
All three are applied to the anal area, and all three are compounded, since none is available as an FDA-approved topical product in the United States. The 2023 clinical practice guideline from the American Society of Colon and Rectal Surgeons reports that topical calcium channel blockers such as diltiazem and nifedipine heal chronic fissures about as well as topical nitroglycerin while causing fewer side effects such as headache, and that either class may be used first-line. Which one suits a particular person is your prescriber's decision.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
