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nifedipine
Adalat, Adalat CC, Adalat XL†, Adalat PA†, Adipine MR§, Apo-Nifed†, Cardilate MR§, Coracten§, Hypolar Retard 20§, Nifedotard 20 MR§, Nifelease§, Nifensar XL§, Novo-Nifedin†, Nu-Nifed†, Procardia, Procardia XL, Tensipine MR§, Unipine XL§

Pregnancy Risk Category C

How supplied
Tablets (extended-release):
30 mg, 60 mg, 90 mg
Capsules:
10 mg, 20 mg

Action
Unknown. Thought to inhibit calcium ion influx across cardiac and smooth-muscle cells, decreasing contractility and oxygen demand. Also may dilate coronary arteries and arterioles.

Indications & dosage
Vasospastic angina (Prinzmetal's or variant angina), classic chronic stable angina pectoris
--
Adults:
initially 10 mg P.O. t.i.d. Usual effective dosage range is 10 to 20 mg t.i.d. Some patients may require up to 30 mg q.i.d. Maximum daily dose is 180 mg.
Hypertension
--
Adults:
30 or 60 mg P.O. (extended-release form) once daily. Adjusted over 7 to 14 days. Doses larger than 90 mg (for Adalat CC) and 120 mg (for Procardia XL) aren't recommended.

Adverse reactions
CNS:
dizziness, light-headedness, headache, weakness, syncope, nervousness.
CV:
peripheral edema, hypotension, palpitations, heart failure, MI, pulmonary edema, flushing.
EENT:
nasal congestion.
GI:
nausea, diarrhea, constipation, abdominal discomfort.
Hepatic:
increased serum levels of alkaline phosphate, LD, AST, and ALT.
Metabolic:
hypokalemia.
Musculoskeletal:
muscle cramps.
Respiratory:
dyspnea, cough.
Skin:
rash, pruritus.

Interactions
Drug-drug.
Cimetidine, ranitidine: decreased nifedipine metabolism. Dosage may be adjusted.
Digoxin:
may cause elevated digoxin levels. Monitor closely.
Fentanyl:
severe hypotension may occur. Monitor closely.
Propranolol, other beta blockers,:
may cause hypotension and heart failure. Use together cautiously.
Phenytoin:
may reduce phenytoin metabolism. Monitor closely.
Drug-food.
Grapefruit juice: increased bioavailability of nifedipine. Avoid concomitant use. Monitor patient closely if given together.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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