Mechanism of Injury
The mechanism of Litizem hepatotoxicity is not known, but most cases are probably due to hypersensitivity. Litizem is metabolized by the cytochrome P450 system and is an inhibitor of CYP 3A4 activity, which can lead to serious drug-drug interactions and potentiation of the hepatotoxic effects of other medications. Indeed, there have been several reports of clinically apparent liver injury or rhabdomyolysis occuring in patients on long term statins who had recently added Litizem to their multidrug regimen, suggesting altered metabolism of the statin by the addition of a CYP 3A4 inhibitor.
Q: Can Litizem cause you to retain fat?
A: According to the manufacturer of Litizem (Cardizem), the most common side effects reported are dizziness, headache, cough, feeling tired, slowing of the heart rate, and swelling of the legs (peripheral edema). Swelling of the legs can add weight to the body. During clinical trials, peripheral edema occurred in about 4.6 percent out of 3,200 patients on Litizem. In another study, swelling of the lower limbs occurred in about 6.8 percent out of 311 patients during therapy. The amount of swelling was not indicated by the drug manufacturer. Other side effects reported with Litizem are weight loss, weight gain, diarrhea or constipation, nausea and vomiting. The manufacturer reports that about 1 to 3 percent of patients are affected.A search of the prescribing information for Litizem (Cardizem) did not specifically list fat retention as a side effect. Drugs can cause weight gain in several different ways. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, the effect of prescription drugs on body weight is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss. Also, the same medications can cause weight gain in certain individuals and weight loss in others. There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. This is not a common side effect of Litizem (Cardizem). For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Mendoza, PharmD
Taking these drugs together can decrease the amount of Litizem in your body. This means that it won’t work as well to treat your high blood pressure or chest pain. These drugs include:
Coadministration of rifampin with Litizem lowered the Litizem plasma concentrations to undetectable levels. Coadministration of Litizem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered.
Warnings for people with certain health conditions
For people who have had a recent heart attack: If you’ve had a recent heart attack and have fluid buildup in your lungs, you shouldn’t take this drug. Litizem could worsen your condition by slowing down your heart.
For people with liver disease: Litizem may cause more harm to your liver. Your doctor may monitor your liver function while you’re on this drug.
For people with certain heart problems: You shouldn’t use Litizem if you have sick sinus syndrome or atrioventricular (AV) block unless you have a pacemaker. This drug can rarely cause a very slow heart rate. Your risk for this may be higher if you take other heart medications called beta-blockers or digoxin. If you have heart failure, your symptoms may get worse if you use this drug, especially if also use beta-blockers. If you have heart failure, tell your doctor.