Drug Database
DI

diltiazem (Cardizem QD / Dilzem XL / Angiact)

✓ Approved

Mitsubishi Tanabe Pharma Corporation · CACNA1C · Small Molecule

What is diltiazem?

diltiazem is a small molecule developed by Mitsubishi Tanabe Pharma Corporation. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesCardizem QD, Dilzem XL, Angiact
CompanyMitsubishi Tanabe Pharma Corporation
Drug ClassSmall Molecule
Molecular TargetCACNA1C
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Mitsubishi Tanabe Pharma Corporation

Mechanism of Action

Molecular Targets

diltiazem acts on 1 molecular target:

CACNA1Ccalcium voltage-gated channel subunit alpha1 C (CACNL1A1, CACNA1C-IT2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

diltiazem is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Cardiac disordersAngina pectoris✓ Approved
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedEndocrine2026-05-24

Fractionated testosterone gel replacement therapy in clinical practice: A real-world exploratory clinical experience.

Maltese Virginia V, Delbarba Andrea A, Gatta Elisa E, Vetrugno Simone S et al.

Testosterone replacement therapy (TRT) with transdermal gel is widely used in men with hypogonadism. Guidelines recommend once-daily application with monitoring of serum testosterone at peak levels. However, real-world clinical experience suggests that peak-trough fluctuations in some patients, potentially affecting hormonal stability and treatment tolerability. The impact of dose fractionation remains unclear. To compare hormonal profiles and biochemical safety parameters between once-daily and twice-daily (fractionated) testosterone gel administration in hypogonadal men receivingh the same total daily dose. We retrospectively identified hypogonadal men treated with 2% testosterone gel who transitioned from once-daily to twice-daily dosing, maintaining the same total daily dose. Eligible patients had serum total testosterone (TT) measurements available at both peak (3 h post-application) and nadir (pre-dose). Hormonal and laboratory parameters under the two regimens were compared. Twelve patients met inclusion criteria. Fractionated dosing was associated with lower peak TT levels [9.0 (5.3-13.0) vs. 5.7 (3.6-7.1) ng/mL, paired difference - 3.6 ng/mL (95% CI: -4.9 to - 1.8)] and higher nadir TT levels [1.4 (1.1-1.8) vs. 3.2 (2.6-5.4) ng/mL, paired difference 2.6 ng/mL (95% CI: 1.2 to 5.1)], resulting in a reduced difference between peak-to-pre-dose difference within the observed sampling window. The proportion of patients achieving target TT levels at peak increased (33% vs. 83%). Calculated free testosterone showed a similar pattern. No clinically relevant differences were observed in luteinizing hormone, prostate-specific antigen, haematocrit, or haemoglobin. In this real-world cohort, fractionated testosterone gel administration was associated with a higher proportion of patients achieving biochemical targets and with a reduced peak-to-pre-dose difference within the observed sampling window, without short-term biochemical safety signals. These findings should be considered hypothesis-generating.

PMID 42176213
Read full article →
PubMedDiabetes therapy : research, treatment and education of diabetes and related disorders2026-05-24

Efficacy and Safety of Insulin Efsitora Versus Degludec in Adults with Type 2 Diabetes Who Are Insulin-Naïve: Japan Subgroup Analysis of QWINT-2.

Kiyosue Arihiro A, Inoue Mariko M, Takita Yasushi Y, Nasu Risa R et al.

The phase 3 QWINT-2 study demonstrated that once-weekly insulin efsitora alfa (efsitora) was noninferior to once-daily insulin degludec (degludec) in reducing glycated hemoglobin (HbA1c) at week 52 when added to existing noninsulin glucose-lowering agents in adults with type 2 diabetes who were insulin-naïve. A Japan subgroup analysis of QWINT-2 using two dosing algorithms is presented here. Participants from Japan were randomized 1:1 to efsitora or degludec and followed one of two dosing algorithms: a general dosing algorithm or an optional alternative dosing algorithm available for participants anticipated to require less insulin, characterized by a body weight ≤ 60 kg or HbA1c level ≤ 7.5% at baseline. Assessments included changes in HbA1c and fasting blood glucose from weeks 0-52, time spent in target glucose range (TIR) from weeks 48-52, and hypoglycemia from weeks 0-52. In total, 144 participants from Japan were included (efsitora, n = 71; degludec, n = 73). Demographic and baseline characteristics were generally balanced between treatment groups. From weeks 0-52, mean HbA1c decreased from 8.04% to 6.63% with efsitora and from 8.00% to 6.64% with degludec (estimated treatment difference, -0.01%). TIR was similar between efsitora and degludec from weeks 48-52. Rates of combined level 2 or 3 hypoglycemia were low overall (weeks 0-52) and during the initial dosing period (weeks 0-12). Level 3 hypoglycemia was not reported in any participants with efsitora and two participants with degludec. The incidence of adverse events was similar between efsitora and degludec. The efficacy and safety of efsitora were comparable with degludec using the general and alternative dosing algorithms in Japanese participants. Once-weekly efsitora was comparable to once-daily degludec in reducing HbA1c in Japanese participants who were insulin-naïve. The efficacy and safety of efsitora in Japanese participants were consistent with the overall QWINT-2 study population. NCT05362058.

PMID 42177728
Read full article →
PubMedPediatric transplantation2026-05-24

Dosing, Safety, and Tolerability of Extended-Release Tacrolimus in Pediatric and Young Adult Solid Organ Transplant Recipients.

Dang Terry T, Hewlett Jennifer J, McAteer John J, Downes Kevin J KJ

Complicated immunosuppression regimens can contribute to non-adherence in pediatric solid organ transplant (SOT) recipients. Once-daily tacrolimus formulations, such as LCP-tacrolimus (LCPT), may help simplify dosing, but pediatric data on dosing, safety, and early tolerability are limited. We conducted a single center retrospective cohort study of SOT recipients prescribed LCPT from December 2016 to July 2024 at our institution. LCPT:IR-Tac daily dosing ratios were calculated. The frequency of laboratory-associated adverse events (AE) and of new patient-reported adverse events in the first 90 days were collected and compared across pediatric- and adult-aged SOT recipients. Ninety-one SOT recipients were prescribed LCPT at a median age of 16.8 years (range 8.4-24.1) and 75 months after transplant (range 0.25-217). Among 53 patients who were therapeutic on both IR-Tac and LCPT, the median daily dosing ratio of LCPT:IR-Tac was 0.75 (range 0.33-1.5) for pediatric patients and 0.75 (IQR: 0.46-1.33) for adults. Eleven (5 patient-reported and 6 laboratory) AEs were identified, none of which resulted in cessation of LCPT therapy. There were no significant differences in the frequency of AEs between children and adults. LCPT was well tolerated and typically required about a 25% dose reduction compared with IR-tacrolimus, though conversion ratios varied widely. These findings offer practical guidance for LCPT dosing in pediatric transplant care and highlight the need for individualized titration and monitoring.

PMID 42175811
Read full article →
PubMedBMC endocrine disorders2026-05-24

Beyond glycemic control: differential effects of empagliflozin and sitagliptin on insulin sensitivity and a shared increase in adropin in type 2 diabetes.

Taha Otbah Salim OS, Azami Golnaz G, Saed Lotfollah L, Hakhamaneshi Mohammad Saeed MS et al.

Type 2 diabetes mellitus (T2DM) is characterized by metabolic and inflammatory disturbances beyond hyperglycemia. Hepatokines such as adropin have emerged as regulators of insulin resistance and vascular function, yet the comparative metabolic effects of sodium-glucose cotransporter 2 (SGLT2) and dipeptidyl peptidase 4 (DPP-4) inhibitors on adropin remain unclear. This study compared the effects of empagliflozin versus sitagliptin, each added to metformin, on serum adropin, insulin resistance, glycemic control, lipid profile, and inflammation in adults with T2DM. In this single-center, randomized, open-label, parallel-group superiority trial with blinded outcome assessment and blinded statistical analysis, 100 adults with inadequately controlled type 2 diabetes mellitus (HbA1c ≥ 7.5%) receiving stable metformin therapy were allocated in a 1:1 ratio to receive empagliflozin 10 mg once daily or sitagliptin 100 mg once daily for a 12-week intervention period. The co-primary outcomes were changes in circulating adropin concentrations and insulin resistance, assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes included changes in HbA1c, fasting insulin, lipid parameters, body weight, and tumor necrosis factor-α (TNF-α). All analyses were conducted according to the intention-to-treat principle. Ninety‑four participants completed the intervention; all were included in analyses. Serum adropin increased from 291 ± 133 to 362 ± 124 pg/mL with empagliflozin and from 299 ± 98 to 358 ± 126 pg/mL with sitagliptin (time effect: F = 19.67, p < .001). HOMA‑IR declined from 10.08 ± 4.44 to 6.65 ± 2.50 with empagliflozin and from 9.28 ± 2.97 to 7.15 ± 1.80 with sitagliptin (interaction: F = 4.85, p = .032, partial η² = 0.09). HbA1c decreased from 8.10 ± 0.53 to 7.04 ± 1.18 with empagliflozin and from 8.29 ± 0.66 to 7.62 ± 0.68 with sitagliptin (interaction: F = 4.30, p = .043, η² = 0.081). TNF‑α fell from 44.12 ± 21.52 to 30.78 ± 15.93 in empagliflozin and from 43.93 ± 21.33 to 37.65 ± 17.96 in sitagliptin (time effect: F = 37.09, p < .001). Empagliflozin produced greater reductions in fasting insulin (- 3.43 ± 2.34 µIU/mL vs. - 2.13 ± 1.17 µIU/mL, interaction p = .036), triglycerides (- 42.5 ± 23.9 mg/dL vs. - 21.9 ± 14.5 mg/dL, interaction p = .005), and a larger HDL‑C increase (+ 5.8 ± 3.1 mg/dL vs. + 3.3 ± 2.5 mg/dL, interaction p = .017). Body weight and BMI decreased similarly in both groups (time effect p < .001, no interaction). No serious adverse events occurred. Both empagliflozin and sitagliptin improved metabolic and inflammatory markers and were associated with comparable increases in circulating adropin. Empagliflozin conferred broader metabolic benefits, particularly in insulin resistance, glycemic control, and lipid profile. The parallel rise in adropin across treatment groups highlights its potential role as a treatment-responsive biomarker rather than a drug-specific effect. This trial was prospectively registered with the Iranian Registry of Clinical Trials (IRCT ID: IRCT20160625028627N8) on May 27, 2025 (Trial ID: 83720). The complete trial record is accessible at https://irct.behdasht.gov.ir/user/trial/83720/view.

PMID 42177445
Read full article →
PubMedThe journal of pain2026-05-24

Bidirectional Associations Between Daily Sleep and Pain Severity in Adults with Rheumatoid Arthritis: A Daily Diary and Actigraphy Study.

Mu Christina X CX, Stone Katie L KL, Jiang Fei F, Prather Aric A AA et al.

Poor sleep and pain are common in rheumatoid arthritis (RA). This study sought to understand the temporal relationships between multidimensional sleep and pain in daily life among individuals with RA. Participants with RA completed up to four waves of 7-day daily diary and sleep actigraphy spanning two years (n=117, Mean age=58.05 years, 87% female). A sleep health composite captured regularity, satisfaction, alertness, timing, efficiency, and duration. Both individual sleep dimensions and the composite were examined. Average daily pain severity, night pain, morning pain, and morning joint stiffness were assessed. Adjusted models controlled for sociodemographic characteristics, depression, anxiety, fatigue, and frequency of pain medication use in linear mixed-effects models. After adjusting for multiple comparisons, the sleep health composite was not associated with pain or joint stiffness outcomes. Participants with shorter nap duration reported less night pain, and participants with higher sleep efficiency reported less daily pain, night pain, morning pain, and joint stiffness. At the daily level, better sleep health the previous night was associated with less night pain and less morning pain the following day. Better sleep quality, higher sleep efficiency, and longer sleep duration were associated with less pain and joint stiffness. Conversely, less night pain was associated with better sleep health the following night. Specifically, daily pain and night pain were associated with worse sleep quality and efficiency the following night. In sum, night pain shares a bidirectional relationship with the sleep health composite, and notably, sleep quality and efficiency influence pain in daily life. PERSPECTIVE: Among adults with RA, there is bidirectionality between better sleep health and less night pain in daily life. Notably, sleep quality, nap duration, efficiency, and duration are associated with pain in older adults with rheumatoid arthritis.

PMID 42177003
Read full article →
PubMedJournal of research on adolescence : the official journal of the Society for Research on Adolescence2026-05-24

Ethnic-racial discrimination, peer support, and internalizing problems: A two-wave daily diary study of Asian university students in Canada from late adolescence to young adulthood.

Huang Qi Q, Wang Yijie Y, Zheng Yao Y

Developmental changes in daily ethnic-racial discrimination and its influence on mental health among ethnic-racial minority young adults remain understudied. Using two waves (30 days at each wave) of daily diary data from 165 Asian university students in Canada (67% women; Mage = 18.11 years, SD = 0.94 at Wave 1), this study investigated changes in the daily associations between ethnic-racial discrimination and internalizing problems, as well as the moderating role of daily peer support (cultural socialization, preparation for bias, and general social support), during the first and third years of university. Multilevel structural equation modeling showed that, at the within-person level, daily ethnic-racial discrimination was significantly associated with increased internalizing problems on the same day at Wave 1 (B = 1.35, 95% CI [0.99, 1.71]) but not at Wave 2 (B = 0.57, 95% CI [-0.05, 1.19]). Daily peer cultural socialization (B = -0.84, 95% CI [-1.65, -0.03]) and preparation for bias (B = -1.21, 95% CI [-2.09, -0.27]) buffered the association between discrimination and internalizing problems at Wave 1; however, these patterns were not observed at Wave 2. These findings underscore the first year of university as a vulnerable period when daily exposure to ethnic-racial discrimination can compromise mental health among ethnic-racial minority students. Peer cultural socialization and preparation for bias can serve as effective buffers during this time. Higher education institutions should prioritize interventions that foster culturally sensitive peer support systems that help create an inclusive and affirming environment for first-year ethnic-racial minority students.

PMID 42175812
Read full article →

+9996 more articles available with a free account

Sign up free to view all articles →

Ask about diltiazem