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Updated 11 February 2013

Nifedipine

Nifedipine is a medication that widens and relaxes blood vessels, and decrease the rate at which the heart beats.

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Nifedipine is the active ingredient of Adalat, Bio-Nifedipine, Cardifen, Cipalat, Nifedelat and Vascard.

General information

Nifedipine is a medication that widens and relaxes blood vessels, and decrease the rate at which the heart beats.

It is used to treat and prevent angina pectoris, chest pain as a result of a lack of oxygen available to the heart muscle. It is of particular use in those patients with asthma who cannot make use of medications such as beta blockers that are often prescribed for angina prevention and treatment.

It is furthermore used for the treatment of high blood pressure.

Nifedipine does not cure any of these conditions, but keep them under control. For nifedipine to be effective, it has to be taken regularly, even if you do not notice any immediate effect - it may take several weeks no notice the full benefit of this medication.

Be aware that, at the start of treatment with this medication, you may feel dizzy, especially when getting up suddenly. Caution is advised.

How does nifedipine work?

Calcium plays an important role in the contraction of heart muscle, as well as smooth muscle in the walls of arteries. Blocking the channels though which calcium enters cells in these muscles, leads to relaxation of these muscles. The result is a reduced workload for the heart, as well as the widening of blood vessels causing high blood pressure to return to normal and safe levels.

Fast facts

Drug schedule: Schedule 3

Available as: Tablets

What does it do? Nifedipine reduces high levels of blood pressure and prevents chest pain

Overdose risk: Medium

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Within 60 minutes.

Duration of action: Up to 24 hours.

Dietary advice: Nifedipine can be taken with or without food; but a low-salt, low-fat diet is advised. It is advised to avoid drinking grapefruit juice, as it may increase the level of nifedipine in your blood, which may lead to additional side effects.

Stopping: Consult you prescriber before discontinuing treatment, as an abrupt withdrawal of treatment may cause a return of symptoms.

Prolonged use: Although no problem is expected with long-term use, your doctor may occasionally request kidney and liver function tests.

Special precautions

Alert your doctor before using this drug if:

  • you have a liver or kidney disease,
  • you have or have had congestive heart failure,
  • you have had a stroke or a heart attack,
  • you have diabetes, or
  • you are taking other medication.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication has not been established for children under the age of 12

Elderly: Caution is advised in the elderly as dosage adjustment may be needed.

Driving and hazardous work : Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol with this medication as the combination may cause a further drop in blood pressure, adding to dizziness. Caution is advised.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Flushing

X

x

Skin rash

X

x

Headache

X

x

Swelling

X

x

Dizziness/ weakness

X

x

Chest pain

X

x

Palpitations

X

x

Frequency in passing urine

X

x

Constipation/ diarrhoea/ abdominal discomfort

X

x

Visual disturbance

X

x

Irregular heartbeat

X

x

Low blood pressure

X

x

Fainting

X

x

Interactions

Drug interactions

ACE inhibitor drugs

Possible decrease in blood pressure

Beta blocking drugs

Increased risk of heart failure

Antidiabetic drugs

Impaired glucose tolerance

Some antifungal drugs

Increased risk of nifedipine toxicity

Cimetidine

Increased risk of nifedipine toxicity

Ciclosporin

Increased risk of nifedipine toxicity

Digoxin

Increased risk of digoxin toxicity

Rifampicin

Reduced effect of nifedipine

Ritonavir

Increased risk of nifedipine toxicity

Theophylline

Increased risk of theophylline toxicity

Food interactions

A low-salt, low-fat diet is advised. Alcohol may cause a drop in blood pressure; and it is advised to avoid drinking grapefruit juice while taking medication as it may increase the level of nifedipine in your blood, which may lead to additional side effects.

Disease interactions

Consult your doctor before using this drug if you have a liver or kidney disease, congestive heart failure, have had a stroke or a heart attack, or if you have diabetes.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults, oral: 10-40mg once a day.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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