Diltiazem Relieves Capecitabine-Induced Chest Pain

Prophylaxis with diltiazem prevents chest pain, allowing patients to tolerate capecitabine

FRIDAY, Nov. 16 (HealthDay News) -- Secondary prophylaxis with diltiazem may offer cancer patients relief from capecitabine-induced chest pain and dyspnea and allow them to tolerate capecitabine treatment, according to a study published in the Dec. 1 issue of The American Journal of Cardiology.

Andrew P. Ambrosy, M.D., of the Stanford University School of Medicine in California, and colleagues conducted a small trial involving five patients with primary colorectal adenocarcinoma or anal squamous cell carcinoma without significant coronary artery disease who started on a two-weeks-on, one-week-off capecitabine dosing regimen. After experiencing chest pain and/or dyspnea at rest or with exertion, patients were started on diltiazem.

The researchers found that, in some cases, at initial presentation, acute electrocardiographic findings were suggestive of ischemia. One patient exhibited troponin elevation which was consistent with acute ST-segment elevation myocardial infarction. After discontinuing capecitabine treatment, all five patients had immediate and sustained relief of their chest pain. They were able to tolerate capecitabine treatment after initiating diltiazem and were able to complete multiple subsequent cycles of capecitabine. However, one patient continued to experience milder and less frequent chest pain with heavy exertion, even after diltiazem initiation.

"In patients without ongoing ischemia, in whom capecitabine is clinically indicated (i.e., no alternatives with comparable efficacy and safety), we recommend starting diltiazem, prescribing sublingual nitroglycerin as needed for acute events, and continuing capecitabine therapy with close follow-up," the authors write.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2012 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events