Nifedipine
Calcium Antagonist · Calcium antagonist
Indications
Angina. Hypertension. Raynaud's phenomenon.
Dosage
Adults: Angina: Initially 10 mg three times daily adjusted according to response, usually 10-20 mg three times daily with or after meals. If immediate effect required, bite capsule and allow liquid to remain in the mouth. Hypertension: Initially 10-20 mg twice daily adjusting to response, usually 10-40 mg twice daily. Alternately 1 tab of 30 mg once daily, preferably in empty stomach; the dose, if necessary may be increased to 1 tab of 60 mg once daily. Raynaud's phenomenon: 10 mg three times daily with or after meals; max 20 mg three times daily. Children: Not recommended.
Adverse Effects
Headache, flushes, oedema, dizziness, tachycardia, hypotension, GI upset, vasodilatation, lethargy, paraesthesia, skin reactions, myalgia, tremor, visual disturbances, increased urinary frequency, gingival hyperplasia, gynaecomastia. Rarely hypersensitivity type jaundice, impotence, mood changes. MI, ischaemic pain (discontinue).
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Cardiogenic shock, unstable angina, severe aortic stenosis, within a month of MI. Hepatic impairment, history of GI obstruction, Crohn's disease, Kock pouch, IBS, porphyria, malignant hypertension. Precautions: Poor cardiac reserve. Heart failure, hepatic impairment, severe hypotension, diabetes, dialysis. Elderly.
Interactions
Antihypertensives, cimetidine, quinidine, digoxin, rifampicin, phenytoin, diltiazem, cisapride, erythromycin, azole antifungals, fluoxetine, indinavir, ritonavir, tacrolimus, quinupristin/dalfopristin, nefazodone, grapefruit juice, Beta blockers, carbamazepine, phenobarbital, valproic acid, macrolides, azole antifungals, protease inhibitors, mizolastine, fluoxetine, other inducers or inhibitors of CYP3A4, IV magnesium sulfate.
Advice to Patient
Take with non-fatty meals or without meals. Swallow whole, do not crush or chew sustained release forms. Do not take nifedipine within 1 hour of a high-fat meal or grapefruit. Do not stop taking medication abruptly, gradually decrease the dose, then stop. Contact prescriber if there is chest pain, palpitations, ringing in ears, rapid heartbeat, swelling of extremities, muscle weakness or pain, difficulty in breathing, nervousness, change in mood, rash or change in vision. Do not change the amount of grapefruit in diet without consulting prescriber. Taking low-fat, low-sodium meals, regular exercise, stress reduction, weight reduction are important lifestyle changes to be followed. Avoid caffeine, smoking, alcohol and grapefruit juice during therapy. Constipation may be more of a problem in the elderly. To relieve constipation, increase intake of fluid and dietary fiber. Before…
Pharmacokinetics
Onset of action: Immediate release: Approx. 20 min. Metabolism: Hepatic. Bioavailability: Cap: 40%-77%. ER: 65%-89% relative to immediate release caps. Half-life elimination: Adults: Healthy: 2-5 hrs. Cirrhosis: 7 hrs. Elderly: 7 hrs (extended release tab). Excretion: Urine (60%-80%). Faeces.
Unlicensed Use
Children: ORAL: Hypertensive crisis, acute angina in Kawasaki disease or progeria: 1 mth-18 yr, 250-500 mcg/kg (max 20 mg) as a single dose. Hypertension, angina in Kawasaki disease or progeria: Child 1 mth-12 yr, 200-300 mcg/kg 3 times daily, max. 3 mg/kg daily or 90 mg daily; 12-18 yr, 5-20 mg 3 times daily, max 90 mg daily. Raynaud’s syndrome: 2-18 yr, 2.5-10 mg 2-4 times daily; start with low doses at night and increase gradually to avoid postural hypotension. Persistent hyperinsulinaemic hypoglycaemia: Neonate, 100-200 mcg/kg (max 600 mcg/kg) 4 times daily.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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