Drug Class: Non-Dihydropyridine Calcium Channel Blocker | Form: Immediate-Release Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Herbesser 60mg Tablet? Herbesser 60mg contains Diltiazem Hydrochloride — a non-dihydropyridine calcium channel blocker in an immediate-release formulation requiring three times daily dosing. Unlike the sustained-release capsule formulations, the immediate-release tablet provides faster onset of action — making it particularly useful for patients requiring more flexible dose titration or more frequent dosing intervals for specific cardiac indications. Diltiazem's unique dual action on both blood vessels and the heart's electrical conduction system makes it distinctly valuable for conditions requiring simultaneous vasodilation and heart rate control — particularly hypertension with tachycardia, angina, and certain supraventricular arrhythmias. Always used under strict cardiological supervision with regular heart rate and blood pressure monitoring.
What is Herbesser 60mg Used For?
- Hypertension — high blood pressure management (ہائی بلڈ پریشر)
- Chronic stable angina — prevention of chest pain from reduced coronary blood flow (سینے کے درد کی روک تھام)
- Vasospastic angina — Prinzmetal angina caused by coronary artery spasm (خون کی نالیوں کی اینٹھن سے سینے کا درد)
- Supraventricular tachycardia — rate control in rapid heart rhythm disorders (دل کی تیز دھڑکن کو کنٹرول کرنا)
- Rate control in atrial fibrillation — slowing ventricular response in AF (دل کی بے قاعدہ دھڑکن میں قابو)
- Hypertension with tachycardia — combined blood pressure and heart rate management
How Does it Work? Diltiazem blocks L-type voltage-gated calcium channels in two complementary locations simultaneously. In vascular smooth muscle it prevents calcium entry — causing relaxation and dilation of peripheral and coronary blood vessels, reducing vascular resistance, blood pressure, and improving coronary blood flow. In the heart's sinoatrial and atrioventricular nodes it slows calcium-dependent conduction — reducing heart rate and prolonging the cardiac refractory period. The immediate-release 60mg formulation achieves peak plasma concentrations within 2 to 4 hours of dosing — providing targeted cardiovascular action with the flexibility of three times daily dosing that allows more precise symptom control and dose adjustment than once-daily sustained-release formulations.
Dosage and Administration
⚠️ Never stop suddenly — always reduce dose gradually under cardiologist supervision. Never combine with beta-blockers without strict specialist supervision — dangerous additive cardiac depression risk. Monitor heart rate and blood pressure at every dose adjustment. Swallow tablet whole with water.
| Indication | Usual Adult Dose | Frequency | Notes |
|---|---|---|---|
| Hypertension | 60 – 120mg | Three times daily | Adjusted by cardiologist |
| Chronic stable angina | 60 – 120mg | Three times daily | Titrated to symptom and heart rate response |
| Vasospastic angina | 60 – 90mg | Three times daily | As prescribed by cardiologist |
| Supraventricular tachycardia | 60mg | Three times daily | Under specialist supervision |
| Atrial fibrillation rate control | 60 – 120mg | Three times daily | Strict cardiological monitoring required |
Active Ingredients
| Ingredient | Strength |
|---|---|
| Diltiazem Hydrochloride | 60mg |
Who Should NOT Take Herbesser 60mg?
- Allergy to Diltiazem or any calcium channel blocker
- Severe bradycardia — resting heart rate below 50 beats per minute
- Second or third degree heart block without a functioning pacemaker
- Sick sinus syndrome without a pacemaker
- Severe hypotension — systolic blood pressure below 90mmHg
- Acute myocardial infarction with pulmonary congestion
- Wolff-Parkinson-White syndrome with associated tachyarrhythmias
- Severe liver impairment — Diltiazem extensively hepatically metabolised
- Ventricular tachycardia — Diltiazem contraindicated in wide-complex tachycardias
- Pregnancy and breastfeeding — consult cardiologist before use
- Currently taking intravenous beta-blockers
Side Effects
Common: Slow heart rate (دل کی دھڑکن کا سست ہونا), ankle swelling (ٹخنوں کی سوجن), facial flushing and warmth (گرمی کا احساس), mild headache, mild dizziness especially on standing, mild nausea, mild fatigue, constipation — generally well tolerated at standard doses.
Serious — Stop and seek emergency help immediately: Severely slow heart rate below 50 beats per minute with dizziness or fainting (دل کی دھڑکن بہت سست — فوری ہسپتال جائیں), complete heart block — very slow irregular pulse with loss of consciousness (فوری مدد لیں), significant worsening of heart failure — sudden breathlessness with severe ankle swelling and rapid weight gain (فوری ہسپتال جائیں), severe allergic reaction with swelling of face or throat and difficulty breathing (فوری مدد لیں), severe liver toxicity — yellowing of skin or eyes (یرقان — فوری مدد لیں), significantly low blood pressure with fainting (بے ہوشی — فوری مدد لیں), severe skin reactions including blistering or peeling.
Drug Interactions
| Medicine | Interaction |
|---|---|
| Beta-blockers (Atenolol, Metoprolol, Bisoprolol) | Severely additive cardiac depression — dangerous heart block and bradycardia risk — never combine without strict specialist supervision |
| Digoxin | Diltiazem significantly increases Digoxin blood levels — serious toxicity risk; reduce Digoxin dose and monitor levels closely |
| Simvastatin / Lovastatin | Diltiazem significantly increases statin blood levels — increased myopathy and rhabdomyolysis risk; limit statin dose |
| Cyclosporine | Diltiazem significantly increases Cyclosporine blood levels — nephrotoxicity and toxicity risk |
| Rifampicin | Dramatically reduces Diltiazem blood levels — significantly reduced cardiovascular effectiveness |
| Carbamazepine / Phenytoin | Diltiazem increases their blood levels — increased toxicity risk; monitor closely |
| Midazolam / Triazolam | Diltiazem significantly increases sedative blood levels — excessive sedation risk |
| Other antihypertensives | Additive blood pressure lowering — increased hypotension risk |
| Cimetidine | Increases Diltiazem blood levels — increased side effect risk |
| Alcohol (شراب) | Increases blood pressure lowering and dizziness — avoid excessive consumption |
Storage: Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.
FAQs
Q: What is the difference between Herbesser 60mg immediate-release tablet and Herbesser SR capsules? Herbesser 60mg immediate-release requires three times daily dosing — providing more flexible dose titration and faster onset suitable for acute rate control and careful initiation. Herbesser SR capsules are taken once daily — providing smoother more convenient sustained blood pressure and heart rate control for stable long-term management once optimal dose is established.
Q: Can Herbesser 60mg be taken alongside beta-blockers for better blood pressure control? This combination requires absolute strict specialist cardiological supervision only — both Diltiazem and beta-blockers independently slow cardiac conduction and combining them carries serious risk of dangerous bradycardia, complete heart block, and acute heart failure. Never combine without explicit specialist instruction and extremely close monitoring.
Q: Why does Herbesser 60mg need to be taken three times daily rather than once? The immediate-release formulation is absorbed and eliminated relatively quickly — requiring three times daily dosing to maintain consistent therapeutic Diltiazem blood levels throughout the full 24-hour period. Patients preferring once-daily convenience should discuss switching to the sustained-release capsule formulation with their cardiologist once the optimal dose is established.
Medical Disclaimer: This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.