Nifedipine

Nifedipine Brand Names

Adalat | Adalat CC | Afeditab CR | Nifediac CC | Nifedical XL | Procardia | Procardia XL

What is Nifedipine

Nifedipine is the prototype of the dihydropyridine class of calcium-channel antagonists.

It is structurally and pharmacologically similar to other dihydropyridines including amlodipine, felodipine, isradipine, and nicardipine.

In general, the dihydropyridine-type calcium-channel antagonists have more prominent effects on vasodilation and coronary flow relative to diltiazem and verapamil. Unlike both diltiazem and verapamil, however, nifedipine has negligible effects on AV nodal conduction.

This difference is attributed to the fact that nifedipine binds to a different site in the calcium channel.

Nifedipine is used in the treatment of Prinzmetal’s angina, hypertension, and other vascular disorders such as Raynaud’s phenomenon†.

Nifedipine is available in immediate-release and extended-release dosage forms. The immediate-release nifedipine dosage forms should only be used to treat patients with chronic stable or vasospastic angina angina; the immediate-release formulation is associated with serious side effects when used to treat patients with hypertension, hypertensive urgency, hypertensive emergency, or coexisting myocardial infarction.

Although its actions were described in 1972, nifedipine was not approved by the FDA until 1981.

Indications

1. achalasia
2. altitude sickness
3. altitude sickness prophylaxis
4. diabetic nephropathy
5. hypertension
6. hypertensive emergency
7. hypertensive urgency
8. migraine prophylaxis
9. premature labor
10. proteinuria
11. singultus (hiccups)
12. variant angina

For the treatment of ischemic heart disease including variant angina (Prinzmetal’s angina) and chronic stable angina pectoris

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. alopecia
4. amblyopia
5. anaphylactoid reactions
6. anemia
7. angina
8. angioedema
9. anxiety
10. arrhythmia exacerbation
11. arthralgia
12. asthenia
13. ataxia
14. atrial fibrillation
15. back pain
16. bezoar
17. blurred vision
18. bradycardia
19. breast enlargement
20. cardiac arrest
21. chest pain (unspecified)
22. chills
23. cholestasis
24. confusion
25. conjunctivitis
26. constipation
27. cough
28. depression
29. diarrhea
30. diplopia
31. dizziness
32. drowsiness
33. dysgeusia
34. dyspepsia
35. dysphagia
36. dyspnea
37. dysuria
38. elevated hepatic enzymes
39. eosinophilia
40. epistaxis
41. eructation
42. erythema multiforme
43. esophagitis
44. exfoliative dermatitis
45. fatigue
46. fever
47. flatulence
48. flushing
49. gastroesophageal reflux
50. GI bleeding
51. GI obstruction
52. gingival hyperplasia
53. gout
54. gynecomastia
55. headache
56. heart failure
57. hematuria
58. hemolytic anemia
59. hepatitis
60. hot flashes
61. hyperglycemia
62. hyperhidrosis
63. hypertonia
64. hypoesthesia
65. hypotension
66. impotence (erectile dysfunction)
67. increased urinary frequency
68. insomnia
69. jaundice
70. lacrimation
71. leukopenia
72. libido decrease
73. lymphadenopathy
74. malaise
75. mastalgia
76. melena
77. migraine
78. muscle cramps
79. myalgia
80. myasthenia
81. myocardial infarction
82. nasal congestion
83. nausea
84. nephrolithiasis
85. nightmares
86. nocturia
87. ocular hemorrhage
88. orthostatic hypotension
89. palpitations
90. paranoia
91. paresthesias
92. pelvic pain
93. peptic ulcer
94. peripheral edema
95. peripheral vasodilation
96. petechiae
97. pharyngitis
98. phlebitis
99. photosensitivity
100. polyuria
101. premature ventricular contractions (PVCs)
102. pruritus
103. purpura
104. pyrosis (heartburn)
105. rash
106. rhinitis
107. sinus tachycardia
108. sinusitis
109. Stevens-Johnson syndrome
110. syncope
111. throat irritation
112. thrombocytopenia
113. tinnitus
114. toxic epidermal necrolysis
115. tremor
116. urticaria
117. vertigo
118. visual impairment
119. vomiting
120. weakness
121. weight gain
122. weight loss
123. wheezing
124. xerostomia

Monitoring Parameters

• blood pressure
• heart rate

Contraindications

• acute myocardial infarction
• aortic stenosis
• bradycardia
• breast-feeding
• cardiogenic shock
• children
• colostomy
• constipation
• coronary artery disease
• diabetes mellitus
• dihydropyridine hypersensitivity
• diverticulitis
• esophageal stricture
• gastric cancer
• gastroesophageal reflux disease (GERD)
• geriatric
• GI obstruction
• heart failure
• hepatic disease
• hiatal hernia
• hypotension
• hypothyroidism
• ileus
• infants
• inflammatory bowel disease
• lactase deficiency
• obesity
• pregnancy
• ventricular dysfunction

Interactions

• Acebutolol
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Pseudoephedrine
• Acrivastine; Pseudoephedrine
• Aldesleukin, IL-2
• Alemtuzumab
• Alfentanil
• Alfuzosin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alprazolam
• Alprostadil
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• Amiodarone
• Amlodipine; Celecoxib
• Amobarbital
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphetamine; Dextroamphetamine Salts
• Amprenavir
• Amyl Nitrite
• Apalutamide
• Apomorphine
• Apraclonidine
• Aprepitant, Fosaprepitant
• Aripiprazole
• Asenapine
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• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Atazanavir
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• Butabarbital
• Cabergoline
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• Carbamazepine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
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• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
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• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
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• Disopyramide
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• Empagliflozin
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• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enflurane
• Enzalutamide
• Ephedrine
• Epirubicin
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• Epoprostenol
• Ergonovine
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• Erythromycin
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• Esmolol
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• Estradiol
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• Ethinyl Estradiol; Ethynodiol Diacetate
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• grapefruit juice
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• Hydrocodone; Ibuprofen
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• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
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• Ibuprofen
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• Isoproterenol
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• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
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• Naproxen; Pseudoephedrine
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• Paliperidone
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• Phenylephrine
• Phenylephrine; Promethazine
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• Quinidine
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