| name | Nifedipine |
| Classification | Calcium Channel Blocker, Antianginal |
| Pharmacokinetics | | absorption | Rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations usually occurring within 30-60 minutes. | | distribution | Widely distributed throughout the body, with high concentrations in the heart, brain, and kidneys. | | metabolism | Metabolized primarily in the liver, primarily via the CYP3A4 pathway. Extensive first-pass metabolism occurs. | | excretion | Excreted primarily by the kidneys, with a significant portion as metabolites. Renal impairment can affect clearance. |
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| suggested dosage | | oral | Initial dose typically starts at 10-20 mg every 6-8 hours, titrated up to maintain angina control, as tolerated, maximum daily dose 60mg. Specific requirements will depend on the patient's response. Always follow the prescriber's guidelines and instructions. | | note | Dosage adjustments are often necessary based on patient response, age, and co-existing conditions. |
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| indications | | 1 | Treatment of angina pectoris (chronic stable angina) | | 2 | Treatment of hypertension | | 3 | Prevention of migraine headaches |
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| Safety in pregnancy | | category | C (US FDA). Animal studies have shown adverse effects on the fetus. No adequate and well-controlled studies in pregnant women are available. The potential risks and benefits should be carefully considered. | | note | Nifedipine should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. |
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| Safety in breastfeeding | | status | Unknown. Nifedipine is likely to be present in breast milk. The potential effects on the infant should be considered in relation to the potential benefits for the mother. | | note | Caution is advised, and alternative therapies should be considered whenever possible. |
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| side effects | | 1 | Headache | | 2 | Dizziness | | 3 | Peripheral edema | | 4 | Flushing | | 5 | Hypotension | | 6 | Constipation | | 7 | Palpitations | | 8 | Gingival hyperplasia (rare) |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to nifedipine or other calcium channel blockers | | 2 | Severe hypotension | | 3 | Severe left ventricular dysfunction | | 4 | Symptomatic second- or third-degree atrioventricular block | | 5 | Uncontrolled heart failure |
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| interactions | | 1 | Grapefruit juice, which can increase nifedipine levels | | 2 | CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) | | 3 | CYP3A4 inducers (e.g., rifampin) | | 4 | Other antihypertensive medications | | 5 | Certain antidepressants | | 6 | Other medications | | 7 | alcohol |
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| warnings and precautions | | 1 | Monitor blood pressure closely, especially in the first few days of treatment and with dosage changes. | | 2 | Patients with hepatic or renal impairment should be carefully monitored for side effects. | | 3 | Caution is necessary in patients with pre-existing cardiac conditions. | | 4 | Avoid sudden discontinuation of medication | | 5 | Can cause dizziness or lightheadedness, exercise caution in activities requiring alertness. |
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| additional informations | Nifedipine, in sustained-release formulations, tends to have fewer side effects and is more suited for long-term therapy. Consult with a healthcare provider to determine the most appropriate dosage and regimen based on individual circumstances. This information is for general knowledge and does not constitute medical advice. |
| patient specific notes | For a 25-year-old male weighing 70 kg, the dosage and overall management should be tailored to the specific needs by a healthcare professional. The information provided here should not be used to self-treat. |
| last updated | 2024-07-20 |
