nifedipine, Adalat, Procardia, Afeditab, Nifediac
Annette (Gbemudu) Ogbru, PharmD, MBA
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Medical and Pharmacy Editor:
GENERIC NAME: nifedipine
BRAND NAMES: Adalat, Procardia, Afeditab, Nifediac
DRUG CLASS AND MECHANISM: Nifedipine belongs to a class of medications called calcium channel blockers (CCBs) that are used to treat angina (heart pain), high blood pressure, and abnormal heart rhythms. Other drugs in the same class include amlodipine (Norvasc), diltiazem (Cardizem LA, Tiazac), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nimodipine (Nimotop), and verapamil (Covera-HS, Veralan PM, Calan). Like other CCBs, nifedipine works by blocking the flow of calcium into the muscle cells surrounding the arteries that supply blood to the heart (coronary arteries) as well as other arteries of the body. Since the inflow of calcium is what causes the muscle cells to contract, blocking the entry of calcium relaxes the muscles and dilates (widens) the arteries. By dilating coronary arteries, nifedipine increases the flow of blood to the heart. This treats and prevents angina which occurs when the flow of blood to the heart is not adequate to supply the heart with enough oxygen necessary to pump blood. Relaxing the muscles surrounding other arteries of the body lowers blood pressure and thereby reduces the pressure against which the heart must pump blood and function. This reduces the demand of the heart for oxygen--another mechanism by which CCBs treat and prevent angina. In addition, nifedipine slows conduction of the electrical current that travels through the heart that causes the muscle of the heart to contract. This effect can be used to correct abnormally rapid heartbeats.
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules:10 and 20 mg. Tablets: 30, 60, and 90 mg
STORAGE: Tablets should be stored at room temperature 15-25 C (59-77 F). They should be protected from light, moisture, and humidity.
PRESCRIBED FOR: Nifedipine is used for the treatment and prevention of angina resulting from either an increased workload on the heart (as with exercise) or spasm of the coronary arteries. It is used in the treatment of high blood pressure, to treat abnormally fast heart rhythms such as atrial fibrillation, and in the prevention of episodes of rapid heart rhythm originating from the atria of the heart.
It also is used to dilate blood vessels that go into spasm such as those causing Raynaud's phenomenon, a painful condition of the hands caused by spasm of the arteries supplying blood to the hands. Non-FDA approved uses include anal fissures (applied to the fissures), prevention of migraine headaches in adults, ureteral stones (as secondary therapy) and wound healing (applied to the skin).
DOSING: The usual dose for nifedipine capsules is 10 to 20 mg three times daily. It is important to swallow capsules whole. For extended release tablets, the usual dose is 30 or 60 mg once daily. The tablets should be swallowed whole and not bitten or cut in half. Nifedipine can be taken with or without food.
DRUG INTERACTIONS: In rare instances, congestive heart failure has been associated with nifedipine, usually in patients already on a beta blocker, for example, propranolol (Inderal), metoprolol (Lopressor), etc. Excessive lowering of blood pressure (hypotension) during initiation of nifedipine treatment can occur, especially in patients already taking another blood pressure lowering drug.
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