Diltiazem relieves capecitabine-induced chest pain

Diltiazem relieves capecitabine-induced chest pain
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.

(HealthDay)—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 without significant 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 . 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.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Towards renal artery stenosis treatment

16 hours ago

Renal artery stenting to open blockages in the kidney arteries may benefit patients who have historically been excluded from modern clinical trials, according to new recommendations for renal artery stenosis e-published in ...

New technologies help people with heart disease

21 hours ago

People taking part in cardiac rehabilitation exercise programmes are likely to maintain healthy behaviours for longer with text message and web-based support, according to recent research from the University of Auckland.

A novel pathway for prevention of heart attack and stroke

Aug 21, 2014

A recent Finnish study could pave the way for preventing brain and cardiac ischemia induced by atherosclerosis. Finnish researchers have found that the low-expression variant of fatty acid-binding protein 4 (FABP4), which ...

User comments