nifedipine oral tablets

Nifedipine Oral: Uses, side effects, cautions, and doses

How does Nifedipine work

Nifedipine works by reducing peripheral vascular resistance, which is a measure of the pressure exerted against the flow of blood in the peripheral blood vessels. As such, Nifedipine is able to reduce the overall pressure exerted against the flow of blood in the vessels. By doing so, it reduces the blood pressure of the individual.

This action of Nifedipine is possible because it inhibits the entry of calcium into excitable cells. That is why the class to which Nifedipine belongs is known as the Calcium channel blockers.

Chemical Structure of Nifedipine:

Which class of medication does Nifedipine belong to

Nifedipine belongs to a class of drugs called calcium channel blockers.

Sub-class

There are a number of subclasses under the calcium channel blocker class and Nifedipine belongs to the Dihydropyridine subclass.

What are the medicinal forms of Nifedipine available on the market

The commonly available forms of Nifedipine are:

·      Tablets (Immediate release and slow release) 

·      on-request oral suspensions

·      Paste

·      Spray

What are some of the brands of Nifedipine available

A few of the very popular brands of Nifedipine available on the market are:

  • Nifecard XL, 
  • Nifedi-Denk, 
  • Cardiopin

Indications and dose: How should nifedipine be taken and what should it be taken for

Nifedipine can be used to treat the under-listed conditions with their respective treatment doses. Note that the dose for treatment may vary based on a number of factors including some patient-specific factors, other health conditions that the patient may have, and some other important factors that your pharmacist or doctor may consider.

  •  Hypertension (including hypertensive emergencies), Prinzmetal’s Angina and Chronic stable angina  

Initially, 5 mg once daily, the dose is individualized and may be increased after 1-2 weeks, Maximum is 10mg daily 

  • Used as a tocolytic agent for the management of preterm labor: This means that Nifedipine can be used to delay delivery in cases where there is the need to.
  • Used in the management of anal fissures and acute thrombosed hemorrhoid (nifedipine paste to be applied at the rectum twice daily)

Should I take Nifedipine before or after meals?

Nifedipine may be taken with or without food, thus you can take it before, during, or after meals. 

Contraindications: When should I not take Nifedipine?

If you have any of the following conditions, you should not routinely take Nifedipine. Do well to talk to your pharmacist or doctor if you are on Nifedipine treatment and develop any of such conditions.

  •  Cardiogenic shock
  • Significant aortic stenosis 
  •  Unstable angina 
  • Severe hypotension

Cautions: When should I be cautious taking Nifedipine?

If you happen to have any of the following conditions, you have to be cautious when taking Nifedipine. You are therefore advised to speak to your pharmacist or doctor before taking Nifedipine if you have any of the following conditions.

  • Postural hypotension
  • Heart failure
  • Worsening ischemic pain

Interactions: What are some of the interactions that Nifedipine has?

Nifedipine is able to cause an

·      Increase in serum concentration of simvastatin when taken together

·      Increase in systemic plasma concentration with immunosuppressants

·      Decrease in plasma concentration with CYP4503A4 inducers.

What are some of the side effects or adverse effects of Nifedipine

If you are taking Nifedipine, then here are some potential side effects of nifedipine that you should be aware of: 

  • Peripheral edema
  • Thrombocytopenia
  • Bradycardia
  • GI disturbances
  • Headache
  • Arthralgia
  • Myalgia
  • Constipation
  • Diarrhea
  • Vision disturbances
  • Elevated hepatic enzymes
  • Pulmonary edema

Pregnancy: Can I take Nifedipine if I am pregnant?

Nifedipine in pregnancy is rated as Category C which means it can be used with caution in pregnancy if the potential benefits for the woman and fetus far outweigh the risks that it poses to them.

The manufacturer advises avoiding, but the risk to the fetus should be balanced against the risk of uncontrolled maternal hypertension 

Breastfeeding: Can a lactating mother take Nifedipine?

The manufacturer of Nifedipine advises avoiding it during breastfeeding as the medication is distributed into breastmilk. 

However, the American Association of Pediatrics states that the medicine is safe for nursing and hence a lactating mother should consult her pharmacist or doctor before taking Nifedipine.

Hepatic impairment: How should people with liver problems take Nifedipine?

Nifedipine in liver impaired patients should be initiated at a low dose and titrate upwards slowly while monitoring for any side effects or toxicity.

What should I monitor when taking Nifedipine?

Once you are put on Nifedipine, you will need to regularly:

  • Monitor pulse or heart rate, 
  • Monitor your blood pressure
  • Monitor your weight and the resolution or development of peripheral edema

Other Medications in Class

Other medicines which belong to the same class as Nifedipine include: 

WRITTEN AND EDITED RESPECTIVELY BY:

Dr. Asantewaa Owusu-Agyei, PharmD

Dr. Asantewaa Owusu-Agyei is a practicing pharmacist at the Korle-Bu Teaching Hospital. She loves to read medical journals relating to infectious diseases and also enjoys watching medical movies.

Dr. Ehoneah Obed is a registered pharmacist and a member of the Pharmaceutical Society of Ghana. He has a Doctor of Pharmacy degree from Kwame Nkrumah University of Science and Technology and has experience working in a Tertiary hospital as well as various community pharmacies. He is also a software engineer interested in healthcare technologies.

His love for helping others motivates him to create content on an array of topics mostly relating to the health of people and also software engineering content.

He is knowledgeable in digital marketing, content marketing, and a host of other skills that make him versatile enough to uplift any team he joins.

Chief Editor at Wapomu.com

MPSGH, MRPharmS, MPhil.

Isaiah Amoo is a practicing community pharmacist in good standing with the Pharmacy Council of Ghana who has meaningful experience in academia and industrial pharmacy. He is a member of the Royal Pharmaceutical Society, England, UK and currently pursuing his overseas pharmacy assessment programme (MSc) at Aston University, UK. He had his MPhil degree in Pharmaceutical Chemistry at Kwame Nkrumah University of Science and Technology. He has about 5 years’ experience as a community Pharmacist and has also taught in academic institutions like KNUST, Kumasi Technical University, Royal Ann College of Health, and G-Health Consult. He likes to spend time reading medical research articles and loves sharing his knowledge with others.

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