Nifedipine effects. Nifedipine: Uses, Side Effects, and Important Precautions
What are the common side effects of nifedipine. How does nifedipine work to prevent angina. When should you seek immediate medical attention while taking nifedipine. What precautions should older adults take with nifedipine.
Understanding Nifedipine: A Calcium Channel Blocker for Angina Prevention
Nifedipine is a medication belonging to the class of calcium channel blockers. Its primary use is in the prevention of certain types of chest pain, known as angina. By relaxing blood vessels, nifedipine allows for improved blood flow throughout the body, which can have significant benefits for patients with angina.
How does nifedipine work to prevent angina attacks? The medication’s mechanism of action involves relaxing and widening blood vessels, which improves blood flow to the heart. This increased blood flow can help reduce the frequency of angina attacks and may allow patients to engage in more physical activity with less discomfort.
Key Benefits of Nifedipine
- Prevents certain types of angina
- Improves exercise tolerance
- Decreases frequency of angina attacks
- Enhances overall blood flow
Is nifedipine used for immediate relief of chest pain? No, it’s important to note that nifedipine is not intended for the immediate treatment of angina attacks. Patients should use other medications, such as sublingual nitroglycerin, for rapid relief of chest pain as directed by their healthcare provider.
Common Side Effects of Nifedipine: What to Expect
While nifedipine can be an effective medication for many patients, it’s not without potential side effects. Understanding these common side effects can help patients better manage their treatment and know when to seek medical advice.
Headaches
Headaches are one of the most common side effects experienced by nifedipine users. How can you manage nifedipine-induced headaches? Here are some tips:
- Rest and stay hydrated
- Limit alcohol consumption
- Use over-the-counter pain relievers like paracetamol
If headaches persist beyond the first week of treatment or become severe, it’s advisable to consult your doctor.
Dizziness
Feeling dizzy is another frequent side effect of nifedipine. What should you do if you experience dizziness while taking nifedipine?
- Stop your current activity and sit or lie down until the sensation passes
- Avoid driving, cycling, or operating machinery when feeling dizzy
- Consult your doctor if dizziness persists for more than a few days
Flushing
Flushing, or a feeling of warmth in the face and body, often occurs when first starting nifedipine treatment. How can you manage flushing symptoms?
- Reduce intake of coffee, tea, and alcohol
- Keep your environment cool and use fans if necessary
- Try cool water sprays or sipping cold drinks
Flushing typically subsides after a few days of treatment. If it persists or causes significant discomfort, contact your healthcare provider.
Heart Palpitations
Some patients may experience a fast, pounding, or irregular heartbeat while taking nifedipine. What steps can you take to manage heart palpitations?
- Take your medication at a time when you can rest during peak symptoms
- Reduce consumption of alcohol, caffeine, and large meals
- Quit smoking if applicable
For patients with a history of heart disease, prolonged or concerning palpitations should be reported to a doctor promptly.
Swollen Legs or Ankles
Edema, or swelling in the legs and ankles, can occur with nifedipine use. How can you alleviate this swelling?
- Elevate your legs when sitting or lying down
- Engage in regular, gentle exercise as approved by your doctor
- Consider wearing compression stockings if recommended by your healthcare provider
Constipation
Constipation is a potential side effect of nifedipine that can be uncomfortable for some patients. What dietary and lifestyle changes can help manage constipation?
- Increase intake of high-fiber foods like fruits, vegetables, and whole grains
- Stay well-hydrated by drinking plenty of water
- Engage in regular physical activity, such as daily walks
- Use laxatives occasionally if needed, but consult your doctor for prolonged use
Recognizing Serious Side Effects: When to Seek Immediate Medical Attention
While serious side effects of nifedipine are rare, occurring in less than 1 in 1,000 people, it’s crucial to be aware of potential warning signs that require immediate medical attention.
Liver Problems
What are the signs of potential liver problems associated with nifedipine use? If you notice yellowing of the whites of your eyes or skin (jaundice), stop taking nifedipine immediately and contact medical services. This discoloration may be less noticeable on darker skin tones, so pay close attention to any changes.
Chest Pain
When should you seek emergency care for chest pain while taking nifedipine? If you experience persistent chest pain that doesn’t subside after a few minutes, or if you have new or worsening chest pain when you already have angina, call emergency services immediately. This could be a sign of a heart attack and requires immediate medical evaluation.
Severe Allergic Reactions
What are the signs of a severe allergic reaction to nifedipine? Watch for symptoms such as:
- Skin rash (itchy, red, swollen, blistered, or peeling)
- Wheezing or difficulty breathing
- Tightness in the chest or throat
- Trouble speaking
- Swelling of the mouth, face, lips, tongue, or throat
If you experience these symptoms, seek emergency medical care immediately, as you may be having a serious allergic reaction (anaphylaxis) that requires prompt treatment.
Special Considerations for Older Adults Taking Nifedipine
Older adults may need to take special precautions when using nifedipine. What factors should older patients consider when prescribed this medication?
- Increased sensitivity to side effects
- Potential interactions with other medications
- Risk of falls due to dizziness or lightheadedness
- Possible need for dose adjustments
Older patients should discuss the risks and benefits of nifedipine treatment with their healthcare provider, ensuring that their medical history and current medication regimen are thoroughly reviewed.
Proper Use and Administration of Nifedipine
To maximize the benefits of nifedipine while minimizing potential side effects, it’s crucial to use the medication as prescribed. What are some key points to remember when taking nifedipine?
- Take nifedipine regularly for it to be effective
- Do not use it to treat acute angina attacks
- Follow your doctor’s instructions regarding dosage and timing
- Do not abruptly stop taking nifedipine without consulting your healthcare provider
- Inform your doctor of all other medications you’re taking to avoid potential interactions
Extended-Release Formulations
Many patients are prescribed extended-release formulations of nifedipine. How should these be taken? Extended-release tablets or capsules should be swallowed whole and not crushed, chewed, or broken. This ensures the medication is released slowly over time as intended.
Monitoring and Follow-Up: Ensuring Safe and Effective Treatment
Regular monitoring is essential for patients taking nifedipine to ensure the medication is working effectively and not causing undue side effects. What should be included in follow-up care for nifedipine users?
- Regular blood pressure checks
- Periodic blood tests to assess liver and kidney function
- Evaluation of side effects and their impact on quality of life
- Assessment of medication efficacy in preventing angina
- Review of other medications and potential interactions
How often should patients follow up with their healthcare provider while taking nifedipine? The frequency of follow-up appointments may vary based on individual patient needs, but typically, patients should have regular check-ups at least every 3-6 months or as recommended by their doctor.
Lifestyle Modifications to Complement Nifedipine Treatment
While nifedipine can be effective in managing angina, combining medication with lifestyle changes can further improve outcomes. What lifestyle modifications can enhance the effectiveness of nifedipine treatment?
- Maintaining a heart-healthy diet low in saturated fats and rich in fruits, vegetables, and whole grains
- Engaging in regular physical activity as approved by your doctor
- Quitting smoking and limiting alcohol consumption
- Managing stress through relaxation techniques or counseling
- Maintaining a healthy weight
- Controlling other risk factors such as high blood pressure, diabetes, and high cholesterol
How can patients safely incorporate exercise into their routine while taking nifedipine? It’s important to start slowly and gradually increase activity levels under the guidance of a healthcare provider. Nifedipine may allow for increased exercise tolerance, but patients should still be mindful of their limits and stop activity if they experience chest pain or shortness of breath.
Dietary Considerations
Are there any specific dietary considerations for patients taking nifedipine? While nifedipine doesn’t have many strict dietary restrictions, patients should be aware that grapefruit and grapefruit juice can interact with the medication, potentially increasing its concentration in the blood. It’s best to avoid or limit grapefruit consumption while taking nifedipine unless otherwise advised by your healthcare provider.
Nifedipine and Pregnancy: Important Considerations
For women of childbearing age, it’s crucial to understand the implications of nifedipine use during pregnancy. What should women know about taking nifedipine if they are pregnant or planning to become pregnant?
- Nifedipine may be used during pregnancy if the potential benefits outweigh the risks
- It’s important to discuss pregnancy plans with your healthcare provider before becoming pregnant
- Some studies suggest nifedipine may be safe during pregnancy, particularly for managing high blood pressure
- The medication can pass into breast milk, so breastfeeding mothers should consult their doctor
How does nifedipine compare to other blood pressure medications for use during pregnancy? While some blood pressure medications are contraindicated during pregnancy, nifedipine is often considered a safer option. However, each case should be evaluated individually by a healthcare professional.
Fertility Considerations
Does nifedipine affect fertility? There is limited evidence suggesting that nifedipine may affect male fertility by reducing sperm motility. Men who are trying to conceive should discuss this potential effect with their doctor to weigh the risks and benefits of treatment.
Drug Interactions: What to Watch Out For
Understanding potential drug interactions is crucial for patients taking nifedipine. What other medications can interact with nifedipine, and how can these interactions affect treatment?
- Other blood pressure medications may enhance the blood pressure-lowering effect of nifedipine
- Certain antibiotics, antifungals, and HIV medications can increase nifedipine levels in the blood
- Some anti-epileptic drugs may reduce the effectiveness of nifedipine
- Nifedipine may increase the concentration of certain statins used to lower cholesterol
How can patients minimize the risk of drug interactions? Always inform your healthcare provider and pharmacist about all medications, supplements, and herbal products you are taking. This includes over-the-counter medications and recreational drugs. Your doctor may need to adjust dosages or recommend alternative treatments to avoid potentially harmful interactions.
Alcohol and Nifedipine
What effect does alcohol have when combined with nifedipine? Alcohol can enhance the blood pressure-lowering effect of nifedipine, potentially leading to dizziness, lightheadedness, and fainting. While moderate alcohol consumption may be permissible for some patients, it’s best to discuss alcohol use with your healthcare provider to determine what’s safe for your individual situation.
Long-Term Use of Nifedipine: What to Expect
For many patients, nifedipine is a long-term medication used to manage chronic conditions. What should patients know about the long-term use of nifedipine?
- Regular monitoring is essential to ensure continued effectiveness and safety
- Some side effects may decrease over time as the body adjusts to the medication
- Dosage adjustments may be necessary as your condition changes
- Long-term use is generally considered safe when properly monitored
- Abrupt discontinuation can lead to worsening of angina symptoms
How often should patients have their nifedipine treatment reviewed? While individual needs may vary, it’s typically recommended to have a comprehensive review of your nifedipine treatment at least annually. This review should include an assessment of the medication’s effectiveness, any side effects, and overall cardiovascular health.
Tolerance and Efficacy
Can patients develop tolerance to nifedipine over time? While some patients may experience a decrease in effectiveness over time, true tolerance to nifedipine is not common. If you feel your medication is becoming less effective, it’s important to discuss this with your healthcare provider. Changes in your condition or other factors may be responsible, and your treatment plan may need adjustment.
By understanding the uses, benefits, potential side effects, and important considerations associated with nifedipine, patients can work closely with their healthcare providers to ensure safe and effective treatment. Regular communication, monitoring, and lifestyle modifications can help maximize the benefits of nifedipine while minimizing risks, leading to improved management of angina and overall cardiovascular health.
Side effects of nifedipine – NHS
Common side effects
These common side effects of nifedipine happen in more than 1 in 100 people. There are things you can do to help cope with them:
Headaches
Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Paracetamol is safe to take with nifedipine.
Headaches should usually go away after the first week of taking nifedipine. Talk to your doctor if they last longer than a week or are severe.
Feeling dizzy
If nifedipine makes you feel dizzy, stop what you’re doing and sit or lie down until you feel better. Do not drive, ride a bike or operate tools or machinery until the dizziness passes. Speak to a doctor if the dizzy feelings last for more than a couple of days.
Flushing
This usually happens when you first start taking nifedipine. Try cutting down on coffee, tea and alcohol. If the flushing is also making you feel hot, it might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks.
The flushing should go away after a few days, so try to carry on taking nifedipine for this time. If it does not go away or is causing you problems, contact your doctor.
A fast, pounding or irregular heartbeat (palpitations)
If this happens regularly after you take your medicine, try to take it at a time when you can sit or lie down while the symptoms are at their worst. It might also help to cut down on alcohol, smoking, caffeine and big meals as these can make the problem worse.
If you have a history of heart disease, and you are having these symptoms for a long time, these symptoms do not improve, or you are concerned, speak to your doctor.
Swollen legs or ankles (oedema)
Try raising your legs when you’re sitting down.
Constipation
Eat plenty of high-fibre foods such as fresh fruit and vegetables and cereals, and drink lots of water. Try to exercise regularly, for example by going for a daily walk or run. It’s OK to occasionally use a laxative.
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.
Serious side effects
Serious side effects after taking nifedipine are rare and happen in less than 1 in 1,000 people.
Stop taking nifedipine and contact 111 straight away if the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin. These can be signs of liver problems.
Go to 111.nhs.uk or call 111.
Immediate action required: Call 999 now if:
- you get chest pain that does not stop after a few minutes, or is new or worse if you already have angina
Chest pain is a possible sign of a heart attack and needs to be checked as soon as possible.
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to nifedipine.
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you’re wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
Other side effects
These are not all the side effects of nifedipine. For a full list, see the leaflet inside your medicine packet.
Information:
You can report any suspected side effect using the Yellow Card safety scheme.
Visit Yellow Card for further information.
Page last reviewed: 18 February 2022
Next review due: 18 February 2025
Nifedipine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
This medication is used to prevent certain types of chest pain (angina). It may allow you to exercise more and decrease the frequency of angina attacks. Nifedipine belongs to a class of medications known as calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily. This medication must be taken regularly to be effective. It should not be used to treat attacks of chest pain when they occur. Use other medications (such as sublingual nitroglycerin) to relieve attacks of chest pain as directed by your doctor. Consult your doctor or pharmacist for details.Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist, as well as other possibly safer forms of nifedipine (such as the long-acting tablets).
How to use nifedipine oral
Take this medication by mouth with or without food as directed by your doctor, usually 3 times daily. Swallow this medication whole. Do not crush, chew, or break the capsule.
The dosage is based on your medical condition and response to treatment. Your doctor may gradually increase your dose. Follow your doctor’s instructions carefully.
Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.
Tell your doctor if your condition worsens (for example, your chest pain worsens or is more frequent).
Side Effects
Dizziness, flushing, weakness, swelling ankles/feet, constipation, and headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: fast/irregular/pounding heartbeat, fainting, vision changes.
Although this medication is effective in preventing chest pain (angina), some people who already have severe heart disease may rarely develop worsening chest pain or a heart attack after starting this medication or increasing the dose. Get medical help right away if you experience: worsening chest pain, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating).
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain heart problems (such as heart failure, aortic stenosis), liver problems, kidney problems.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Older adults may be more sensitive to the side effects of this drug, especially dizziness, constipation, or swelling ankles/feet.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
This medication passes into breast milk. Consult your doctor before breast-feeding.
Interactions
See also the How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Other medications can affect the removal of nifedipine from your body, which may affect how nifedipine works. Examples include apalutamide, cimetidine, enzalutamide, mitotane, quinupristin/dalfopristin, St. John’s wort, rifamycins (such as rifabutin, rifampin), drugs used to treat seizures (such as carbamazepine, phenytoin), among others.
Some products have ingredients that could raise your heart rate or worsen your chest pain. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
Does nifedipine oral interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Do not share this medication with others.
Lab and/or medical tests (such as blood pressure, liver/kidney tests, electrocardiogram) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
nifedipine 10 mg capsule
Color: reddish-brownShape: oblongImprint: IMI 10
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 10 mg capsule
Color: whiteShape: oblongImprint: HP 194
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 20 mg capsule
Color: redShape: oblongImprint: N20
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 10 mg capsule
Color: orangeShape: oblongImprint: N10
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 20 mg capsule
Color: peachShape: oblongImprint: HP 195
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 10 mg capsule
Color: yellowShape: oblongImprint: logo and 497
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 20 mg capsule
Color: red brownShape: oblongImprint: logo and 530
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
nifedipine 10 mg capsule
Color: orangeShape: oblongImprint: PROCARDIA PFIZER 260
This medicine is a reddish-brown, oblong, capsule imprinted with “IMI 10”.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
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💊 Composition of Nifedipine ✅ Use of Nifedipine Save Search for analogues Interaction Description of the active ingredients of the preparation Nifedipine The scientific information provided is general and cannot be used to make decisions. Update date: 2021.02.01 Marketing authorization holder: VALENTA PHARMACEUTICS, PJSC ATX code: C08CA05 (Nifedipine) Active substance: Rec.INN WHO registered Dosage form
Release form, packaging and composition |
I10 | Essential [primary] hypertension |
I20 | Angina pectoris [angina pectoris] |
I20.1 | Angina with documented spasm (Prinzmetal’s angina, variant angina) |
I73. 0 | Raynaud’s syndrome |
Dosage regimen
The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed.
Individual. For oral administration, the initial dose is 10 mg 3-4 times / day. If necessary, the dose is gradually increased to 20 mg 3-4 times / day. In special cases (variant angina pectoris, severe arterial hypertension) for a short time, the dose can be increased to 30 mg 3-4 times / day. For the relief of a hypertensive crisis, as well as an attack of angina pectoris, 10-20 mg (rarely 30 mg) can be used sublingually.
In / in for the relief of an attack of angina pectoris or hypertensive crisis – 5 mg for 4-8 hours.
Intracoronary administration for the relief of acute spasms of the coronary arteries is administered as a bolus of 100-200 mcg. With stenosis of large coronary vessels, the initial dose is 50-100 mcg.
Maximum daily doses: when taken orally – 120 mg, when administered intravenously – 30 mg.
Side effects
From the side of the cardiovascular system: hyperemia of the skin, feeling of warmth, tachycardia, arterial hypotension, peripheral edema; rarely – bradycardia, ventricular tachycardia, asystole, increased angina attacks.
From the digestive system: nausea, heartburn, diarrhea; rarely – deterioration of liver function; in isolated cases – gingival hyperplasia. With prolonged use in high doses, dyspeptic symptoms, increased activity of hepatic transaminases, intrahepatic cholestasis are possible.
From the side of the central nervous system and peripheral nervous system: headache. With prolonged use in high doses, paresthesia, muscle pain, tremor, mild visual disturbances, and sleep disturbances are possible.
On the part of the hematopoietic system: in isolated cases – leukopenia, thrombocytopenia.
From the urinary system: increased daily diuresis. With prolonged use in high doses, impaired renal function is possible.
From the endocrine system: in isolated cases – gynecomastia.
Allergic reactions: skin rash.
Local reactions: when administered intravenously, burning at the injection site is possible.
Within 1 min after intracoronary administration, a negative inotropic effect of nifedipine, an increase in heart rate, and arterial hypotension are possible; these symptoms gradually disappear after 5-15 minutes.
Contraindications
Arterial hypotension (systolic blood pressure below 90 mmHg), collapse, cardiogenic shock, severe heart failure, severe aortic stenosis; hypersensitivity to nifedipine.
Use during pregnancy and lactation
Adequate and well-controlled studies of the safety of nifedipine in pregnancy have not been conducted. The use of nifedipine during pregnancy is not recommended.
Since nifedipine is excreted in breast milk, its use during lactation should be avoided or breast-feeding should be discontinued during treatment.
In experimental studies , embryotoxic, fetotoxic and teratogenic effects of nifedipine were detected.
Use in hepatic dysfunction
In case of liver dysfunction, nifedipine should only be used in a clinical setting under the strict supervision of a physician. In patients with impaired liver function, high doses of nifedipine should be avoided.
Use in patients with impaired renal function
In patients with impaired renal function, nifedipine should only be used in a clinical setting under strict medical supervision. In patients with impaired renal function, high doses of nifedipine should be avoided.
Elderly use
Elderly patients are more likely to have decreased cerebral blood flow due to severe peripheral vasodilation.
Special instructions
Nifedipine should only be used in the clinic under the strict supervision of a physician in acute myocardial infarction, severe cerebrovascular accident, diabetes mellitus, impaired liver and kidney function, in malignant arterial hypertension and hypovolemia, as well as in patients on hemodialysis. In patients with impaired liver and / or kidney function, high doses of nifedipine should be avoided. Elderly patients are more likely to have reduced cerebral blood flow due to severe peripheral vasodilation.
When taken orally, nifedipine can be chewed to speed up the effect.
If chest pain occurs during treatment, nifedipine should be discontinued. Cancel nifedipine should be gradual, because with a sudden discontinuation of the reception (especially after long-term treatment), the development of a withdrawal syndrome is possible.
When intracoronary administration in the presence of stenosis of two vessels, nifedipine should not be injected into a third open vessel due to the danger of a pronounced negative inotropic effect.
During the course of treatment avoid drinking alcohol due to the risk of an excessive decrease in blood pressure.
Influence on the ability to drive vehicles and mechanisms
At the beginning of treatment, driving and other potentially hazardous activities that require quick psychomotor reactions should be avoided. In the course of further treatment, the degree of restriction is determined depending on the individual tolerability of nifedipine.
Drug interactions
When used simultaneously with antihypertensive drugs, diuretics, phenothiazine derivatives, the antihypertensive effect of nifedipine is enhanced.
When used simultaneously with anticholinergics, memory and attention disorders may occur in elderly patients.
When used simultaneously with beta-blockers, severe arterial hypotension may develop; in some cases – the development of heart failure.
When used simultaneously with nitrates, the antianginal effect of nifedipine is enhanced.
When used simultaneously with calcium preparations, the effectiveness of nifedipine decreases due to antagonistic interaction caused by an increase in the concentration of calcium ions in the extracellular fluid.
Cases of development of muscular weakness at simultaneous use with salts of magnesium are described.
When used simultaneously with digoxin, it is possible to slow down the excretion of digoxin from the body and, consequently, increase its concentration in the blood plasma.
When used simultaneously with diltiazem, the antihypertensive effect is enhanced.
With simultaneous use with theophylline, changes in the concentration of theophylline in blood plasma are possible.
Rifampicin induces the activity of liver enzymes, accelerating the metabolism of nifedipine, which leads to a decrease in its effectiveness.
When used simultaneously with phenobarbital, phenytoin, carbamazepine, the concentration of nifedipine in the blood plasma decreases.
There are reports of an increase in plasma concentrations of nifedipine and an increase in its AUC when used simultaneously with fluconazole, itraconazole.
When used simultaneously with fluoxetine, the side effects of nifedipine may be increased.
In some cases, with simultaneous use with quinidine, a decrease in the concentration of quinidine in the blood plasma is possible, and when nifedipine is canceled, a significant increase in the concentration of quinidine is possible, which is accompanied by a prolongation of the QT interval on the ECG.
Cimetidine and, to a lesser extent, ranitidine, increase the plasma concentration of nifedipine and thus enhance its antihypertensive effect.
Ethanol may increase the effects of nifedipine (excessive hypotension), causing dizziness and other adverse reactions.
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- Nifedipine or Moxonidine: which is better?
- Amlodipine or Nifedipine: which is better?
- Captopril or Nifedipine: which is better?
- Summary
- Ask an expert about the topic
The World Health Organization’s global targets for 2010-2030 include a 33% reduction in hypertension. Now with this diagnosis live 1.28 billion people on the planet.
Arterial hypertension leads to the development of diseases of the cardiovascular system, brain, and kidneys. And it is one of the leading causes of death for people around the world.
A large number of drugs have been invented for the treatment of hypertension. Modern classification divides them according to the mechanism of action into 7 groups. The pharmacist talks about the “honored” representative of the group of calcium antagonists Nifedipine: its composition, mechanism of action, application and side effects. Compares with Moxonidine, Amlodipine and Captopril.
Nifedipine: Composition
Nifedipine contains the active ingredient of the same name, which belongs to the first generation slow calcium channel blockers. The drug is produced in tablets, the excipients include lactose (milk sugar). Nifedipine tablets contain 10 mg of the active substance.
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Nifedipine: mechanism of action
The mechanism of action of Nifedipine is “coded” in the name of its group: calcium antagonists or slow calcium channel blockers (CBCC). The drug inhibits the entry of calcium ions through L-channels into smooth muscle cells, including heart cells. A decrease in calcium levels leads to:
- weakening of vascular tone, dilation of coronary and peripheral arteries
- pressure relief
- improve the blood supply to the heart and the supply of oxygen to it
- improve renal blood flow
Nifedipine works at high pressure by dilating and decreasing total peripheral vascular resistance. In this case, the drug has practically no effect on normal blood pressure.
What does nifedipine help with?
Nifedipine, according to the RLS and instructions, is prescribed for the treatment of arterial hypertension and stable angina pectoris, often in combination with other antihypertensive drugs. Nifedipine in hypertensive crisis and for the relief of angina attacks should not be used.
The pharmacist answers popular questions about the drug:
- How long does it take for Nifedipine to work, how quickly does it reduce blood pressure? – The drug begins to act 30 minutes after ingestion.
- How long does Nifedipine last? – The duration of the hypotensive effect is 4-6 hours.
- Nifedipine how to take with high blood pressure? – In case of hypertension, the drug is usually taken twice a day, the maximum single dose is 20 mg. If necessary, the daily dose can be increased to 120 mg. If the patient is taking other antihypertensive drugs in combination, then the dose of nifedipine should be reduced.
- How to take nifedipine: under the tongue or with a drink? – According to the official instructions, the tablets are taken orally and washed down with water. They can not be chewed, divided, crushed and washed down with grapefruit juice.
- Can pregnant women take Nifedipine for high blood pressure? – The drug is prohibited for use during pregnancy up to 20 weeks. After this period, Nifedipine can be considered as a reserve drug, but only in case of severe hypertension in a pregnant woman who is not suitable for other means.
- What is the compatibility between Nifedipine and alcohol? – During treatment, the use of alcohol is not recommended due to the risk of a strong decrease in pressure.
- Why is Nifedipine included in hemorrhoid ointment? – Yes, indeed, there are gels and ointments with the active ingredient nifedipine. For example, Relifipin gel for the treatment of hemorrhoids is registered in the Russian Federation. Here Nifedipine relaxes the muscles of the anal sphincter, reduces pain, improves blood circulation, relieves inflammation.
Nifedipine side effects
Nifedipine often has the following side effects:
- headache, weakness
- tingling in the limbs, movement disorders, difficulty swallowing – with long-term use of high doses of the drug
- palpitations
- edema
- constipation
Nifedipine: overdose
An overdose of the drug leads to a long-term pronounced decrease in pressure and slowing of the heart rate. In a severe case, the patient loses consciousness and may fall into a coma.
Symptoms of an overdose (headache, flushing of the face, slow pulse) should call for emergency help. Antidote for poisoning with Nifedipine are calcium preparations. They also do a gastric lavage and inject activated charcoal. If the pressure cannot be raised, then dopamine is used, with a rare pulse and arrhythmia, atropine is administered intravenously. In life-threatening conditions, a temporary pacemaker is installed.
Nifedipine or Moxonidine: which is better?
Moxonidine is a centrally acting drug. It stimulates imidazoline receptors in the brain, which leads to a decrease in vascular resistance and blood pressure.
For use in the treatment of hypertension only. Moxonidine and Nifedipine have different mechanisms of action and contraindications, so the drugs should not be compared. Only a doctor can choose the optimal antihypertensive therapy for a particular patient. Moxonidine is often prescribed in combination with BKMM.
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Amlodipine or Nifedipine: which is better?
These two drugs are from the same group of calcium antagonists (CAMC). Amlodipine belongs to the second generation of blockers and has a greater affinity for L-channels and fewer side effects.
Amlodipine and Nifedipine have identical contraindications and should not be given after myocardial infarction and in patients with aortic stenosis. Amlodipine is approved for the treatment of arterial hypertension in children over 6 years of age, Nifedipine is indicated only for adults over 18 years of age. The advantage of Amlodipine is in a single dose, while Nifedipine is taken 2-4 times a day.
Preparations with different active substances, despite the fact that they belong to the same group, must not be replaced independently. To do this, you need to consult a doctor.
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Captopril or Nifedipine: which is better?
Captopril is an ACE inhibitor and reduces blood pressure in a different way than nifedipine. The list of indications for use is longer, because due to its mechanism of action, Captopril not only dilates blood vessels, but also reduces the excretion of protein and potassium, and reduces myocardial hypertrophy. It is indicated for acute myocardial infarction, heart failure, diabetic nephropathy, left ventricular hypertrophy.
Captopril reduces blood pressure quickly, so it is used as an ambulance for hypertensive crisis (sublingually). There is no such indication in the instructions for Nifedipine.
For long-term use, the best drug is the one prescribed by the doctor, taking into account the cause and degree of hypertension, the age, condition and history of the individual patient. Modern tactics for the treatment of arterial hypertension, as a rule, consists of a combination of several drugs.
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Summary
- Nifedipine contains the active ingredient of the same name. Nifedipine has only one dosage (10 mg) and one dosage form (tablets).
- The drug inhibits the entry of calcium ions into vascular smooth muscle cells, dilates them and reduces pressure.
- Nifedipine is indicated for the treatment of hypertension and stable angina.