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Hypercard side effects can include lethargy and anorexia, though these
tend to pass in a few days as the patient gets used to the medication. A
few cats will show vomiting or constipation, and possibly skin
reactions and rashes. In a few cats the heart rate slows down too much
and the blood pressure gets too low, so medication has to be stopped. Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication. Introduction 
Company name: Dechra Veterinary Products Limited
Address: (A business unit of Dechra Pharmaceuticals PLC)
Sansaw Business Park
Hadnall, Shrewsbury
Shropshire SY4 4AS
Telephone: 01939 211200
Fax: 01939 211201
Email: info@dechra-uk.com
Website: www.dechra.com
Presentation
Yellow coated biconvex tablets. Each tablet contains:
Active substance: Diltiazem 9.20 mg (equivalent to 10 mg of Diltiazem hydrochloride)
Excipients: Tartrazine (E102) 0.11 mg, Titanium dioxide (E171) 1.1 mg
Uses
Hypercard® 10 mg is indicated for the therapeutic treatment of feline primary hypertrophic cardiomyopathy. Diltiazem hydrochloride is a benzothiazepine derivative which acts as a calcium channel blocker and exerts its effect by selectively inhibiting the inward movement of calcium ions across the cell membrane into vascular smooth muscle cells and myocardial cells.
Dosage and administration
For oral administration.
1 tablet per cat (weighing 3.0-6.25 kg body weight) every eight hours (equivalent to 1.6-3.3 mg diltiazem hydrochloride per kg every 8 hours).
Treatment should be given for the life of the animal.
Contraindications, warnings, etc
Do not use in animals suffering from AV block (2nd or 3rd), hypotension or sick sinus syndrome.
Diltiazem should not be given to animals suffering from hepatic disease.
Do not use in animals suffering from renal disease.
Do not use in cats less than 12 months old.
Do not use in cats weighing less than 3 kg.
Do not use in animals that are hypersensitive to diltiazem.
Do not use in cats with severe bradycardia or arterial hypotension.
Do not use in conjunction with β blockers, digitalis or digoxin.
Do not use in pregnant or lactating females.
Adverse reactions: If you notice any serious effects or other effects not mentioned in the data sheet, please inform your veterinary surgeon.
Some lethargy can occur at the beginning of treatment.
Diltiazem may cause gastrointestinal problems, e.g. constipation, vomiting and anorexia.
Rashes, skin reactions and erythema are potential side effects of diltiazem.
Bradycardia, dyspnoea, hypotension and conduction abnormalities may occasionally occur. In such cases treatment should be suspended.
Special precautions for use in animals: Hepatic failure may increase the plasma concentration of diltiazem.
Monitor glucose levels carefully in diabetic animals.
Use with caution in cats suffering from congestive heart failure.
Cats with possible pre-existing thyroid problems or hyperthyroidism should be treated for this first and then be reassessed, prior to commencing treatment with diltiazem.
Clinical examination to assess the effectiveness of treatment should be performed after eight weeks.
Cardiac rate should be monitored prior to treatment commencing and at every follow up visit.
Use during pregnancy, lactation or lay: Do not use in pregnant or lactating females. Studies of laboratory animals have shown evidence of teratogenic and embryotoxic effects.
Interactions with other medicinal products: Use with caution in conjunction with other calcium channel blockers, anticonvulsant drugs, immunosuppressant drugs, lithium, neuromuscular blocking agents and aminoglycoside antibiotics.
Concurrent use with cimetidine or any other histamine 2 receptor antagonists may cause an increase in plasma diltiazem concentrations.
Gaseous anaesthetics such as halothane, isoflurane or enflurane have synergistic or additive effects with diltiazem, which may lead to hypotension, depressed myocardial contractile function, slow junctional rhythm and AV block. Therefore, animals treated with Hypercard® 10 mg and undergoing gaseous anaesthesia should be monitored closely.
Overdose: In case of overdose, carry out gastric lavage and dose with activated charcoal.
For bradycardia and heart block, treat with normal saline infusion and vasopressors (atropine, dopamine or isoprenaline).
Observations in humans have indicated that treatment with calcium may be useful in treating toxicity from calcium channel blocker overdose.
Special precautions for the person administering the veterinary medicinal product to animals: Wash hands after use as tartrazine in the colour coating may cause allergic reaction in people who are susceptible.
Do not break tablets.
In case of accidental ingestion, seek medical advice immediately and show the data sheet to the physician.
General precautions: For animal treatment only.
Keep out of the reach and sight of children.
Pharmaceutical precautions
Do not store above 25°C. Keep the blister strips in the outer carton.
Do not use after the expiry date which is stated on the carton and blister after EXP.
Disposal: Dispose of any unused product and empty containers in accordance with guidance from your local waste regulation authority.
Legal category
POM-V
Packaging quantities
30 tablets in a blister pack.
Further information
To be supplied only on veterinary prescription.
Veterinary medicinal product authorised for use in UK and IE.
Manufacturer: Dales Pharmaceuticals, Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2RW.
Marketing authorisation holder (if different from distributor)
Dechra Limited, Dechra House, Jamage Industrial Estate, Talke Pits, Stoke-on-Trent, Staffordshire, ST7 1XW.
Marketing authorisation number
Vm 10434/4060.
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