nifedipine, Adalat, Procardia, Afeditab, Nifediac (cont.)

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Medical and Pharmacy Editor:

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.

Nifedipine interferes with the breakdown of tacrolimus (Prograf) by the liver, which in turn causes elevated blood levels of tacrolimus and may increase the risk of toxicity from tacrolimus.

Nifedipine reduces the blood levels of quinidine (Quinaglute, Quinidex, Quinora) which may reduce the effectiveness of quinidine. Conversely, blood levels of nifedipine are increased by quinidine and may lead to side effects from nifedipine.

Cimetidine (Tagamet) interferes with breakdown by the liver of nifedipine and increases nifedipine blood levels. Therefore, cautious dosing is necessary when both medications are administered concurrently.

Nifedipine should not be taken with grapefruit juice since grapefruit juice (one glass, approximately 200 ml) inhibits the breakdown of nifedipine by the liver and increases the levels of nifedipine in the blood.

PREGNANCY: There are no adequate studies of nifedipine in pregnant women, and in general, it is avoided during pregnancy.

NURSING MOTHERS: Nifedipine is excreted in human breast milk. Generally, nifedipine is avoided in nursing mothers.

SIDE EFFECTS: Side effects of nifedipine are generally mild, and reversible. Most side effects are expected consequences of the dilation of the arteries. The most common side effects include headache, dizziness, flushing, and edema (swelling) of the lower extremities. Less common side effects include dizziness, nausea and constipation.

Reference: FDA Prescribing Information


Last Editorial Review: 4/15/2009



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