Page 115 - 2026 SMOG

DILTIAZEM (CARDIZEM)
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Atrial Fibrillation or Atrial Flutter, Atrial Tachyarrhythmias, Rate Control
Rate Control Note: Very limited data available for infants,
Note: For rate control in hemodynamically children, and adolescents
stable patients. Do not use in patients with • IV
preexcitation associated with an accessory ˚ Initial bolus: 0.25mg/kg over 5min (max:
pathway, as this can lead to ventricular 20mg/dose [average adult dose]) followed
arrhythmias by a continuous IV infusion. Dose
• IV should be individualized based on patient
˚ Bolus dose: 0.25mg/kg over 2min response.
(average dose: 20mg). If rate control is
Continuous infusion (titrated to effect):
insufficient after 15min, a repeat bolus ˚ 0.05–0.15mg/kg/hr
dose of 0.35mg/kg over 2min may be
given (average dose: 25mg). Patients who
respond after 1 or 2 bolus doses can be
started on a continuous infusion
˚ Continuous infusion following bolus(es):
Initial: 5–10mg/hr. Infusion rate may be
increased in 5mg/hr increments according
to ventricular response, up to a max of
15mg/hr.
Supraventricular Tachycardia
(Alternative Agent)
Note: For hemodynamically stable patients,
if vagal maneuvers and/or adenosine are
unsuccessful
• IV
˚ Bolus dose: 0.25mg/kg (actual body
weight) over 2min (average dose: 20mg).
If rate control is insufficient after 15min, a
repeat bolus dose of 0.35mg/kg over 2min
may be given (average dose: 25mg). If
bolus(es) do not terminate the arrhythmia,
consider alternative therapy.

2026 Standard Medical Operating Guidelines (SMOG) • 107