Nifedipine (Procardia, Adalat, Procardia XL, Adalat CC)

Category:

• Miscellaneous

Description:

• Antihypertensive, antianginal (calcium channel blocker)

Indications:

• Vasospastic (Prinzmetal’s or variant) angina

• Chronic stable angina

• Hypertension

Contraindications:

• Use of sustained-release preparations in patients with severe obstructive coronary artery disease or recent MI

• Hypertensive emergencies

Precautions:

• Pregnancy category C; has been used in pregnant women; compatible with breast feeding

Adverse Reactions (Side Effects):

• CNS: anxiety, asthenia, depression, dizziness, headache, insomnia, somnolence, tremor

• CV: bradycardia, dysrhythmia, hypotension, palpitations, peripheral edema, syncope, tachycardia

• GI: abdominal cramps, constipation, diarrhea, flatulence, dry mouth, nausea, vomiting

• GU: Nocturia, polyuria

• SKIN: hair loss, pruritus, rash, urticaria

• MISC: cough, epistaxis, flushing, muscle cramps, nasal congestion, sexual dysfunction, shortness of breath, sweating, tinnitus, weight gain

Dosage:

Administered orally (capsule, sustained release tablet)

• Adult:   

  • PO 10mg 3 times daily initially, usual range 10-20mg 3 times daily; doses > 120 mg/day are rarely necessary

  • PO XL 30-60mg daily, titration to doses >90 mg/day not recommended

• Child: 

  • Hypertensive urgencies: 

    • PO 0.25-.5 mg/kg/dose

Special Considerations:

•  Administer Adalat CC on an empty stomach

•  Do not crush or chew sustained release dosage formes

•  Procardia XL tablets may appear in stool, this is no cause for concern