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- What is nifedipine?
- Why is nifedipine prescribed to patients?
- Do I need a prescription for nifedipine?
- Is nifedipine available as a generic drug?
- What are the side effects of nifedipine?
- What is the dosage for nifedipine?
- Which drugs or supplements interact with nifedipine?
- Is nifedipine safe to use during pregnancy or while breastfeeding?
- What else should I know about nifedipine?
What is nifedipine?
Why is nifedipine prescribed to patients?
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:
What are the side effects of nifedipine?
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:
Less common side effects include:
Uncommon side effects include:
What is the dosage for nifedipine?
- The usual dose for nifedipine capsules for treating angina is 10 to 20 mg three times daily. Up to 20 to 30 mg every 6-8 hours daily may be required. The dose should not exceed 180 mg daily. For extended release tablets, the usual dose is 30 or 60 mg once daily. The maximum dose is 120 mg daily.
- Hypertension is treated with 30-60 mg daily using extended release tablets. The maximum dose is 90 mg/day (Adalat CC) or 120 mg/day (Procardia XL).
- Nifedipine can be taken with or without food.
- The tablets and capsules should be swallowed whole and not bitten or cut in half.
Which drugs or supplements interact with nifedipine?
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.
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.
Is nifedipine safe to use during pregnancy or while breastfeeding?
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What else should I know about nifedipine?
What preparations of nifedipine are available?
Capsules: 10 and 20 mg. Tablets: 30, 60, and 90 mg
How should I keep nifedipine stored?
Tablets should be stored at room temperature 15 C to 25 C (59 F to 77 F). They should be protected from light, moisture, and humidity.
How does nifedipine work?
Other drugs in the same class as nifedipine 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.
When was nifedipine approved by the FDA?
The FDA approved nifedipine in December 1981.
Nifedipine (Adalat, Procardia, Afeditab, Nifediac) is in the drug class of calcium channel blockers (CCBs). Nifedipine (Adalat, Procardia, Afeditab, Nifediac) is prescribed for the treatment of angina, high blood pressure, and abnormal heart rhythms such as atrial fibrillation. Off label uses of nifedipine (Adalat, Procardia, Afeditab, Nifediac) Raynaud's phenomenon, anal fissures, and prevention of migraine headaches. Side effects, warnings and precautions, drug interactions, and safety during pregnancy information should be reviewed prior to taking this medication.
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Related Disease Conditions
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
An anal fissure is a small tear or cut in the skin lining of the anus. Pain and/or rectal bleeding during bowel movements are common symptoms of anal fissures. Treatment includes increasing liquid intake, using stool softeners, prescription medications, and surgery.
Interstitial Cystitis (IC) and Painful Bladder Syndrome (PBS)
Interstitial cystitis (IC)/painful bladder syndrome (PBS) is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Kidney Stones (nephrolithiasis)
Kidney stones are solid masses of crystalline material that form in the kidneys. Symptoms of kidney stones can include pain, nausea, vomiting, and even fever and chills. Kidney stones are diagnosed via CT scans and specialized X-rays. Treatment of kidney stones involves drinking lots of fluids and taking over-the-counter pain medications to medical intervention including prescription medications, lithotripsy, and sometimes even surgery.
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Esophageal achalasia is a disease of the esophagus that mainly affects young adults. Achalasia makes it difficult to swallow, can cause chest pain, and may lead to regurgitation. Here we discuss achalasia symptoms, surgery, treatment, and causes. Learn the definition of achalasia and what you can do to treat the disease.
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Abnormal Heart Rhythms (Heart Rhythm Disorders)
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
Febrile seizures, or convulsions caused by fever, can be frightening in small children or infants. However, in general, febrile seizures are harmless. Febrile seizure is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure. Some of the features of a febrile seizure include: losing consciousness, shaking, moving limbs on both sides of the body, lasts 1-2 minutes. Less commonly, a febrile seizure may only affect one side of the body.
Treatment & Diagnosis
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Medications & Supplements
- nicardipine, Cardene, Cardene SR
- diltiazem (Cardizem, Cardizem CD, Cardizem LA, Tiazac, Cartia XT, Diltzac, Dilt-CD, and several oth)
- amlodipine (Norvasc)
- verapamil (Calan, Verelan, Verelan PM [Discontinued: Isoptin, Isoptin SR, Covera-HS])
- felodipine (Plendil)
- bepridil (Vascor)
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Calcium Channel Blockers (CCBs)
- Drug Interactions
- isradipine - oral, Dynacirc
- nimodipine - oral, Nymalize
- High Blood Pressure Drugs (Hypertension)
- Side Effects of Procardia (nifedipine)
Prevention & Wellness
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