Medications and Drugs
Pharmacy Author: Annette O. Gbemudu PharmD, MBA
Medical and Pharmacy Editor: Jay W. Marks, MD
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.
PRESCRIPTION: Yes
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.
Generally, nifedipine is avoided in children.
Nifedipine decreases the
elimination of digoxin (Lanoxin) by the kidneys which can increase digoxin blood
levels in the blood and give rise to digoxin toxicity. It is important,
therefore, to monitor blood levels of digoxin in order to avoid toxicity.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Calcium Channel Blockers - Establishes the medication calcium channel blockers (CCBs), which are drugs used for treating high blood pressure, angina, and abnormal heart rhythms like atrial fibrillation.
- High Blood Pressure - Learn about high blood pressure symptoms like headache, dizziness, shortness of breath, blurred vision and more. Causes, and normal blood pressure information is included.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
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