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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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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 and signs 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.
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.
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 spasms of blood vessels, the cause is unknown. Symptoms and signs 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.
Arrhythmias (Heart Rhythm Disorders)
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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.
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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.
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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, and lasts 1-2 minutes. Less commonly, a febrile seizure may only affect one side of the body.
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Medications & Supplements
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- Drug Interactions
- Calcium Channel Blockers (CCBs)
- amlodipine (Norvasc)
- diltiazem (Cardizem, Cardizem CD, Cardizem LA, Tiazac, Cartia XT, Diltzac, Dilt-CD, and several oth)
- verapamil (Calan, Verelan, Verelan PM [Discontinued: Isoptin, Isoptin SR, Covera-HS])
- felodipine (Plendil)
- nicardipine, Cardene, Cardene SR
- Side Effects of Procardia (nifedipine)
- nimodipine - oral, Nymalize
- isradipine - oral, Dynacirc
- bepridil (Vascor)
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