Tildiem retard/diltiazem question

[LucyBoo21]

Hi, My cardiologist has taken me off bisoprolol and put me on tildiem retard due to me still getting angina pain on walking despite having two stents.

I've also been referred for a stress echocardiogram on 24 April to see if I have another narrowing. He doesn't want to do an angiogram/CT unless absolutely necessary as I've had alot of radiation in the past 6 months.

I've been on tildiem retard for 4 days now, it has improved my pain on walking (yay!) but instead I'm now getting more palpitations, a fast heart rate if I walk up the stairs and feelings of angina coming in waves but never fully coming on.

Has anyone else experienced this? I spoke to the pharmacist yesterday and they were a bit concerned but said give it a couple of week to see if things settle down.

I'm not convinced the stress echocardiogram is going to show a narrowing. I had one before which was clear and then 18 months later had a 99% blockage in my LAD artery.

[Hidden]

hello

I’ve had diltiazem twice and didn’t work for me for my angina, I felt it made it worse / different.

4 days is early and if you can bear it give it at least two weeks just like the pharmacist says - that’s the advice I got too. This was second time round. I had to stop.

First time round I had it for 7months but I knew little about my condition then.

It looks like it’s made a little difference (I’d love to be able to walk without angina) so fingers crossed if works for you. Maybe a different dose might be the answer.

But I’m sure you know if things get weird / increase, make the call!

Good luck.

[LucyBoo21 in reply to Hidden]

Thank you 🙂

I honestly couldn't believe it when I walked quickly to work, I was waiting for the pain to come and it didn't! That was great but the other symptoms are so much more intrusive as it's all throughout the day.

I will stick with it though, I'm seeing my GP on Monday for another problem so I'll mention it then to see what his opinion is.

[maggy12]

Hi Lucy I take Diltiazen & Apixaban for Mitral Valve disease, I dont really get angina but it seems to help with my symptons.

[Nep05]

I have a diagnosis of coronary artery spasm. Prior to that diagnosis I was started on bisoprolol (and isosorbide mononitrate) in 2019 when it was thought I had blocked arteries. The bisoprolol floored me and soon came off it.

An urgent angiogram showed my arteries were pretty much ok and the bisoprolol was replaced with diltiazem which I persevered with for over 2 years despite it making no difference to my angina. It gave me horrendous oedema in feet and lower legs and I eventually took myself off it in 2021. The 2019 cardiologist had discharged me back to GP and there was next to no GP/clinician contact during covid.

I then managed a referral to a specialist team dealing with INOCA where I received my vasospasm diagnosis last year. They prescribed another calcium channel blocker, Verapramil, to replace the Diltiazem. My experience was no better so I was changed to yet another CCB, Nifedipine, and told to allow up to 4 weeks for effects to settle. The pharmacy had trouble sourcing Nifedipine so I never actually took it. By this time I’d had enough, realised that as I now have a diagnosis I’m more in control and aware of my angina triggers and that they are best helped by the isosorbide mononitrate and GTN spray.

I’ll be avoiding all calcium channel blockers in the future. Even if they had helped with my angina the painful oedema side effect was just too awful for me. It restricted my mobility and diuretics had limited effect. My feet and ankles are a whole lot better but have not fully recovered and I do regret sticking with Diltiazem for over 2 years on account of those effects.

That’s just my experience and I’ve no doubt CCBs are beneficial for many of patients taking them.