What is Nifedipine?
Nifedipine is an active ingredient used for the treatment of angina, Raynaud’s syndrome and high blood pressure (HBP).
The brand names of Nifedipine in the United States are: Procardia, Adalat, Procardia XL, Nifedical XL.
Nifedipine Mechanism of Action (MOA)
Inhibits the flow of Ca ions to the myocardial and smooth muscle tissue of coronary arteries and peripheral vessels.
Therapeutic indications and benefits of Nifedipine
Chronic stable angina pectoris in combination treatment, vasospastic angina pectoris, Raynaud’s syndrome, High blood pressure.
Posology of Nifedipine
Oral dose:
– Rapid release capsules: Chronic stable angina pectoris in combination treatment, vasospastic angina pectoris and Raynaud’s syndrome: initial 10 mg/8 h, max. 20 mg/8 h.
– Modified release “Retard” tablets: Chronic stable angina pectoris in combined treatment and high blood pressure: initial 20 mg/2 times daily, max. 60 mg/day.
– Prolonged release tablets “OROS”: Chronic stable chest angina in combination treatment and high blood pressure: initial 30 mg/day, max. 120 mg/day. Administer in 1 single dose.
Method of administration and uses of Nifedipine
Oral use:
Administer independently of meals, should not be broken, should be swallowed whole and without chewing with the help of a little liquid.
Food intake slows, but does not reduce, absorption. Avoid grapefruit juice.
Contraindications of Nifedipine
- Hypersensitivity to this active ingredient.
- Cardiovascular shock.
- Concomitance with rifampicin.
- OROS” form: do not use in ileostomy after proctolectomy.
- Nifedipine of rapid release is contraindicated in unstable angina and in case of having suffered a myocardial infarction in the last 4 weeks.
Warnings and precautions with Nifedipine
Liver failure (reduce dose); Renal failure; severe hypotension; manifest heart failure; severe aortic stenosis.
Diabetics; dialysis patients with malignant high blood pressure and irreversible renal failure, or with hypovolemia.
Special control with depressed ventricular function, increased risk of heart failure. Blood pressure monitoring.
In case of suspending treatment, gradually decrease. Not recommended in children and adolescents < 18 years.
In forms of rapid and delayed release, in addition: mild coronary insufficiency, with BPH, severe cerebrovascular disease or advanced age, it is recommended to start with low doses. In “OROS” form, in addition: history of gastrointestinal stenosis.
Liver failure
Caution. Watch closely, a reduction in dose may be necessary.
Kidney failure
Caution.
Interactions with Nifedipine
- Plasma concentration increased by: cytochrome P4503A4 inhibitors (erythromycin, ritonavir, ketoconazole, fluoxetine and nefazodone, quinupristine/dalfopristine, ac. valproico, cimetidine, grapefruit juice), cisapride.
Plasma concentration reduced by: cytochrome P4503A4 inducers (phenobarbital, carbamazepine, phenytoin, rifampicin). - Increases hypotensive effect of: diuretics, ß-blockers, ACEi, angiotensin II receptor antagonists, other calcium antagonists, alpha-adrenergic blockers, PDE5 inhibitors, alpha-methyldopa.
- Increases toxicity of: digoxin.
- Decreases plasma levels of: quinidine.
- Lob: falsely alters spectrophotometric determination of ac. vanillylmandelic in urine.
Pregnancy and Nifedipine
It should not be used during pregnancy unless the woman’s clinical conditions require treatment with this active ingredient, it should be reserved for women with severe high blood pressure who do not respond to standard treatment.
Breastfeeding
Nifedipine is excreted in breast milk. The concentration in milk is almost comparable to the serum concentration in the mother.
For immediate release formulations, it is proposed to delay lactation or milk extraction until 3 to 4 hours after administration of active ingredient to decrease exposure in the baby.
Effects on driving ability
Nifedipine can limit the ability to react. Especially at the beginning of treatment, caution should be exercised when driving automobiles or other vehicles and when operating dangerous machines.
The risk is accentuated if alcoholic beverages are ingested at the same time.
Adverse reactions and side effects of Nifedipine
Headache, dizziness; edema, vasodilatation; constipation; ill feeling.
⭐⭐⭐⭐⭐ VIDEO OF NIFEDIPINE/PROCARDIA (DRUG)
Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).
In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.
Resources:
UNII: I9ZF7L6G2L
ChemIDplus
DrugPortal
PubChem CID: 4485
NCI Thesaurus: C29290