Diltiazem MR

[Deano]

Hi,

I'm new to this forum so unsure if I'm posting this in the correct place!

Can anyone tell me if there is much difference between calcicard cr 90mg and tildiem retard 90mg. I normally give the brand the patient usually has but calcicard seems to be unobtainable. If a prescription is written as generic and the patient usually has calcicard, would you supply tildiem instead?

Thanks for any answers,
Dean

[PtitpupUK]

Hi Dean

I can't say in detail I am only a tech, but I was under the impression that it was best for patients to continue treatment with the same brand when several brand of the same diltiazem preparation are available. This is why GPs in the local surgery try and prescribe it by brand. If it's not available though you haven't got much choice really ...

[Deano]

Hi thanks for your reply.

Yes it is best to give the same brand because there may be differences in release profiles. I am however wondering if I should give Tildiem or contact the surgery first. The prescriptions I have seen so far have been written as generic but I usually check that the patient is expecting a certain brand.

[PtitpupUK]

Well, when I was training as a tech, I had a manager who was very into "responsibilities" if you see what I mean... I would say if you give Tildiem and something is not right, the onus falls on you. Or you can explain to the GP and the GP makes the decision, and then you're in the clear.
I don't know if that's the answer you are looking for, it's up to you really, but if there is a difference in the release profile as you say and there is an effect on the patient (would this be likely?) then maybe it's best to protect yourself.

[Shaeeb]

If you have no choice look in to the physico-chemical properties of the various dilitiazem preparations and choose the one with the closest bioavailability and release times. Otherwise contact the Doctor and come to some sort of agreement with regards to the patients medication.

[Sofia]

Diltiazem is one of the preparations for which GPs have been recommended to write it as branded because indeed different release profiles for both.
Always try and give same brand, particularly for those drugs with narrow therapeutic range.
If you can't because of supply problems: Can other chemist do it?
If nobody can't: risk of pat not having it is higher than risk of taking a different brand.
Moving onto next question.

[Web Ferret]

BNF states:

Longer-acting formulations
Note
Different versions of modified-release preparations may not have the same clinical effect. To avoid confusion between these different formulations of diltiazem, prescribers should specify the brand to be dispensed

So get prescriber to brand prescribe an availble product and counsell patient.