Nifedipine: Difference between revisions
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== References == | == References == | ||
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[[Category:Calcium channel blockers]] | |||
[[Category:Antihypertensives]] | |||
[[Category:Antianginals]] | |||
[[Category:Tocolytics]] | |||
Latest revision as of 10:43, 23 May 2026
Nifedipine
Procardia, Procardia XL, Adalat CC, Afeditab CR
Experience
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Problems
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Effects
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Summary
Classes
Common uses
Hypertension0, Vasospastic (Prinzmetal) angina0, Stable angina0, Severe hypertension in pregnancy (oral)0, Preterm labor (off-label tocolysis)0, Raynaud's phenomenon0
Pharmacy
Starting dose
ER 30-60 mg PO once daily; immediate-release 10 mg PO TID (now rarely used for hypertension due to reflex tachycardia)
Preparations
10, 20 mg IR capsules; 30, 60, 90 mg ER tablets
US FDA Max
120 mg/d (ER); IR not for chronic hypertension
Pharmacology
Routes
Oral; sublingual IR is discouraged (uncontrolled BP drops, MI reports)
Onset
IR 20 minutes; ER ~6 hours
Duration
IR 4-8 hours; ER 24 hours
Half-life
2-5 hours (IR); ER formulations extend functional duration via osmotic/matrix release[1]
Bioavailability
~50% IR (extensive first-pass via CYP3A4); ER products release-rate-limited[1]
Pregnancy
Oral nifedipine is one of the preferred agents for severe hypertension in pregnancy and for tocolysis in preterm labor.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Nifedipine is a dihydropyridine calcium channel blocker that selectively inhibits L-type voltage-gated calcium channels in vascular smooth muscle, producing peripheral and coronary arterial vasodilation; cardiac myocyte and AV nodal effects are minimal compared with non-dihydropyridines like diltiazem and verapamil.0 Immediate-release nifedipine's rapid vasodilation and reflex sympathetic activation drove the early 1990s safety concerns that led to ER-only chronic use; sublingual IR is contraindicated. CYP3A4 substrate with substantial grapefruit/itraconazole interactions[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Procardia XL (nifedipine), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/018612s045lbl.pdf