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One selection filters the source overview, clinical facts, reports and dose calculator. Literature references are not species-filtered.
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Source overview
Recorded excerpts for one species. Each dose remains a separate source entry; no regimen is selected.
Choose one species to view its source overview. All-species evidence remains available below.
View full clinical evidence and sources ↓Clinical evidence
Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications2
Supraventricular tachyarrhythmias, atrial fibrillation (rate control, adjunct to digoxin), pulmonary hypertension (adjunct)
DogExtra-label (EXTRA_LABEL)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Supraventricular tachyarrhythmias, atrial fibrillation (rate control, adjunct to digoxin), pulmonary hypertension (adjunct) — Extra-label
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Hypertrophic cardiomyopathy (one of the drugs of choice), SVT
CatExtra-label (EXTRA_LABEL)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Hypertrophic cardiomyopathy (one of the drugs of choice), SVT — Extra-label
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens4
This calculator performs arithmetic only on the sourced dosing field shown for each result — it does not verify the field's accuracy, does not select which field to use for a patient, and does not replace a veterinarian's order. Not for clinical use. Confirm every result against the primary source before dispensing.
Choose one species above to view its dose calculator.
Adverse effects140
Bradycardia — Most prominent
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Vomiting, anorexia, GI distress — Most common
CatNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Hypotension, myocardial depression, AV block — Dose-related
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Lethargy, weight loss (with 60 mg SR pellet dose) — ~36% of cats in one study
CatNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
These are counts of spontaneously reported events, not proven adverse effects, causal relationships, or incidence rates.
Bars compare report counts within each species; they do not show incidence.
More reportsFewer reportsDog
- Death5 reports
- Anorexia4 reports
- Lethargy (see also Central nervous system depression in Neurological)4 reports
- Tachycardia4 reports
- Urinary incontinence4 reports
- Abnormal electrocardiogram (ECG)3 reports
- Abnormal radiograph finding3 reports
- Abnormal ultrasound finding3 reports
- Atrial fibrillation3 reports
- Bladder distension3 reports
- Crying3 reports
- Diarrhoea3 reports
Cat
- Death by euthanasia5 reports
- Lack of efficacy - NOS4 reports
- Azotaemia3 reports
- Death3 reports
- Vomiting3 reports
- Abdominal effusion2 reports
- Anaemia NOS2 reports
- Decreased appetite2 reports
- Hyperkalaemia2 reports
- Hyperphosphataemia2 reports
- Hypoalbuminaemia2 reports
- Hypocalcaemia2 reports
Monitoring1
ECG/heart rate, blood pressure, adverse effects
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
Severe hypotension (<90 mmHg systolic), sick sinus syndrome, 2nd/3rd-degree AV block (without pacemaker), acute MI, radiographic pulmonary congestion
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions4
Geriatric patients, heart failure (especially with concurrent beta-blockers), hepatic/renal impairment; give IV push over ≥2 min
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Extended-release ("XR"/"SR"/"CD") formulations are difficult to dose accurately in cats — inconsistent plasma levels can mean ineffective treatment in some cats and toxicity in others; if using SR, stick to specifically studied products/doses (e.g., Dilacor XR 30 mg/cat).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Preferred over verapamil in heart failure patients due to less myocardial depression.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
In dogs with atrial fibrillation, combining with digoxin gives greater rate control than either drug alone.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions6
Beta-blockers — ↑ bradycardia/AV block/CHF risk; diltiazem also ↑ propranolol bioavailability substantially
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Cyclosporine — ↑ cyclosporine levels — monitor/adjust dose
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Digoxin — Conflicting data on interaction — monitor digoxin levels diligently
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Cimetidine — ↑ diltiazem levels
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Quinidine — ↑ quinidine levels
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics5
Bioavailability — ~25% (dog); 50–80% (cat, immediate-release); highly variable by SR formulation
CatNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Protein binding — 70–75%
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Half-life — ~3h (dog, range 2.5–4h); ~2h (cat); ~1.5h (horse)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Metabolism — Extensive hepatic, 2 active metabolites
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Elimination — Hepatic/biliary
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
High-dose rodent studies: increased fetal death/skeletal abnormalities. Human FDA category C. Excreted in milk at levels approximating serum.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 406–408; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 244–246 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references19
References are linked to this drug. Species applicability is not recorded here, so the species filter does not narrow this list. Imported dates do not retain their original precision; confirm dates in the original citation.
- Antiviral Activity of Diltiazem HCl Against Pseudorabies Virus Infection In Vitro.
Study summary not available in the imported record. Open the original citation to review the study.
- Cav1.2 facilitates the binding and internalisation of porcine epidemic diarrhoea virus.
Study summary not available in the imported record. Open the original citation to review the study.
- New-onset atrial fibrillation and flutter in a mechanically ventilated dog with bronchopneumonia.
Study summary not available in the imported record. Open the original citation to review the study.
- Cancer stem cells in meningiomas: novel insights and therapeutic implications.
Study summary not available in the imported record. Open the original citation to review the study.
- Diltiazem inhibits SARS-CoV-2 cell attachment and internalization and decreases the viral infection in mouse lung.
Study summary not available in the imported record. Open the original citation to review the study.
Sources: PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.