Clinical Pharmacology Details


NIFEDIPINE


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Indications & Dose:

Raynaud’s syndrome 



Angina prophylaxis (not recommended)



Postponement of premature labour



Adult: Initially 20 mg, followed by 10–20 mg 3– 4 times a day, adjusted according to uterine activity


Hiccup in palliative care  



Adult: 10 mg 3 times a day


SR or CC tabs once daily.


Children: PO 0.25-0.5mg/kg/dose every 6-8 hr. SR preparations not recommended

Contraindications:

Use of immediate-release preparations in patients with severe obstructive CAD or recent MI, hypertensive emergencies

Side Effects:

CNS: Anxiety, asthenia, depression, dizziness, fatigue, headache, insomnia, malaise, nervousness, paresthesia, somnolence, tremor


CV: Bradycardia, dysrhythmia, hypotension, palpitations, peripheral edema, syncope, tachycardia


GI: Abdominal cramps, constipation, diarrhea, dry mouth, flatulence, gastric upset, nausea, vomiting


GU: Nocturia, polyuri


SKIN: Hair loss, pruritus, rash, urticaria


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


 

Cautions:

Precautions:

CHF, hypotension, hepatic insufficiency, renal function impairment, aortic stenosis, elderly, children, recent β blocker withdrawal

Interaction:

Drugs


Barbiturates, rifampin, rifabutin: Reduced plasma concentrations of nifedipine


Beta-blockers: Enhanced effects of (B-blockers, hypotension; increased metoprolol and propranolol concentrations; additive negative effects on myocardial contractility


Cimetidine, ranitidine, famotidine: Increased nifedipine concentrations possible


Digitalis glycosides: Increased digitalis levels; increased risk of toxicity


Diltiazem: Increased serum concentrations of nifedipine Doxazosin: Enhanced hypotensive effects


Fentanyl: Severe hypotension or increased fluid volume requirements


Food: Increased absorption of Adalat CC


Grapefruit juice: Increased serum nifedipine concentrations


Histamine H2-antagonists: Increased blood level of nifedipine with cimetidine


Lansaprazole: Increased nifedipine absorption


Magnesium: Potential for transient hypotensive effect


Phenytoin: Increased phenytoin concentration


Quinidine: Reduced blood concentrations of quinidine


Vincristine: Marked increase in vincristine half-life, clinical significance unknown.


 

Warnings:

Adverse Effects:

Lactations:

Has been used for tocolysis and as an antihypertensive agent in pregnant women; compatible with breast feeding

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: