What is Nifedipene?

Nifedipene (brand names Procardia®, Procardia XL®, Adalat CC®, Afeditab CR®, Nifedical XL® and Nifediac CC®) is the generic chemical name for one of a group of drugs called calcium channel blockers.

Why is it prescribed?

Nifedipine is prescribed for high blood pressure and angina (chest pain caused by constricted/blocked arteries), and works by relaxing the walls of the blood vessels, increasing the blood flow and helping the heart receive more oxygen. The mechanism of this drug’s action is to block the flow of calcium ions into the muscles.
Nifedipene also controls electrical impulses that cause muscle contraction, and therefore also helps prevent atrial fibrillation (an irregular, too-rapid beat of the atria of the heart).

Nifedipene is also used “off-label” (http://www.medterms.com/script/main/art.asp?articlekey=4622) to treat Raynaud’s phenomenon (a circulatory problem in hands, feet and sometimes other areas), premature labor, and anal fissures (applied topically). It can also be used to treat migraine headaches.

What is the dosage?

Nifedipene is available in two forms: capsules and long-acting tablets. The capsules come in 10 or 20 mg. dosages, while the extended-release tablets are available in 30, 60 and 90 mg. dosages.

The usual dosage for the capsules is 1020 mg. three times a day; for the tablets, the usual dose is 30 to 60 mg. once daily. Both capsules and tablets should be swallowed whole, not crushed or broken.

Dosage for the capsules should start at the 10 mg. dose three times a day, and be increased gradually over a 714 day period if needed. For the extended-release tablets, dosage should start at 30 mg. daily and increase gradually to the lowest effective dose.

Nifedipine Contraindications

Do not use Nifedipene if you have previously had an allergic reaction to it. Also be sure to tell your doctor of any other allergies you may have to either foods or medicines.

Tell your doctor if you have any of the following conditions, which could affect your reaction to Nifedipene:

• Kidney problems
• Gastrointestinal disorders (including reflux, slow digestion, colon cancer or other diseases of the colon, stomach cancer, history of gastric bypass or colostomy surgery, blockage)
• Liver disease
• Diabetes
• Thyroid problems
• Coronary artery disease/congestive heart failure

Before having surgery, be sure to tell your doctor you are taking this drug. Do not stop taking Nifedipine suddenly or without telling your doctor.

Nifedipine Interactions

Nifedipine may interact with the following drugs. Please let your physician know if you are taking any of these drugs before starting Nifedipine.

• Beta blockers (prescribed for heart arrhythmias and high blood pressure); examples are Inderal® (propranolol), Lopressor® or Toprol® (metoprolol), Tenormin® (atenolol).
• Digoxin (Lanoxin®)
• Tacrolimus (Prograf®)
• Quinidine (Quinidex®, Quiniglute®, Quinora®)
• Cimetadine (Tagamet®)
• Antifungal drugs (Ketoconazole, Fluconazole, Intraconazole)
• Fentanyl (Actiq®, Duragesic®, Fentora®) or other narcotic painkillers.
• Imatinib (Gleevec®)
• Isoniazid (for tuberculosis)
• Rifampin (for tuberculosis)
• Levothyroxine (Synthroid®)
• Nefazodone (Serzone®)
• Antibiotics such as erythromycin or clarithromycin
• Tizanidine (Zanaflex®)
• Phenytoin (for seizures)
• Carbamazepine (for seizures)
• Phenobarbital (for seizures)
• Rifabutin (for mycobacterium avium complex)
• HIV/AIDS medicines
• Cold or allergy medications
• Laxatives
• Non-steroidal anti-inflammatory medications (e.g., ibuprofen or naproxen and others).

Grapefruit juice should also be avoided when taking Nifedipine, as it can increase the blood level of the drug and cause too-low blood pressure.

In addition, caution should be used if you are taking the herbal supplements, such as St. Johns Wort, ginkgo or ginseng.

Nifedipine Side Effects

The following side effects may occur when taking Nifedipine. Be sure to call your doctor if you have any of these serious side effects:

• Allergic reaction (hives, swelling of the face, throat or tongue, or difficulty breathing)
• Chest pain or pressure/angina, pain in arm or shoulder, sweating or nausea
• Severe constipation/cramps, stomach pain, heartburn.
• Coughing blood.
• Faintness
• Shortness of breath
• Pounding heartbeat or tachycardia (fast heartbeat)
• Yellowing of the skin or eyes (jaundice)
• Any numbness or tingling feeling; peripheral neuropathy
• Blurred vision

Less severe side effects can include:

• Headache
• Dizziness (especially when first taking Nifedipine)
• Intestinal effects (diarrhea or mild constipation/pain)
• Nausea
• Insomnia
• Rash or itching
• Leg cramps or joint pain
• Slight redness, warmth or tingling feeling in the skin
• Needing to urinate more than usual