HyperCard tablets for Cats

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Hypercard tablets are used to treat primary hypertrophic cardiomyopathy in cats. This is a condition which results in the heart becoming abnormally large and thickened. If patients are left untreated, the heart muscle gradually declines and the affected cat goes into heart failure. Hypercard acts to slow the heart down and allows the muscle to relax more. Blood vessels are opened up slightly, especially those supplying the heart. This improves the circulation of blood to the heart muscle, and makes it easier to pump blood around the body, reducing the work load on the heart muscle. Life span and quality of life are improved.

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.

Presentation

1 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. Also contains sodium methyl hydroxybenzoate (E219), microcrystalline cellulose, lactose monohydrate, maize starch, magnesium stearate, polyethylene glycol 4000, povidone (K30), food grade shellac, isopropanol, sucrose, purified water.

A yellow coated biconvex tablet.

Uses

For the therapeutic treatment of feline primary hypertrophic cardiomyopathy.

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 beta-blockers, digitalis or digoxin.

Do not use in pregnant or lactating females.

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 8 weeks.

Cardiac rate should be monitored prior to treatment commencing and at every follow up visit.

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.

In case of accidental ingestion, seek medical advice immediately and show the data sheet to the physician.

Do not break tablets.

Adverse reactions: 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.

Use during pregnancy and lactation: Do not use in pregnant or lactating females. Studies of laboratory animals have shown evidence of teratogenic and embryotoxic effects.

Interactions: 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: 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.

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.

Shelf life of the veterinary medicinal product as packaged for sale: 30 months.

Disposal: Any unused veterinary medical product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

Legal category

POM-V

Packaging quantities

Tablets are located in a pre-formed low density polyethylene base containing 10 tablets and sealed with PC 100 laminate comprising of low density polyethylene and aluminium foil. Once sealed, 3 blisters of 10 tablets (30 tablets) are placed in a cardboard box.