• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is nifedipine?
Nifedipine is in a class of drugs called calcium channel blockers. Nifedipine relaxes (widens) your blood vessels (veins and arteries), which makes it easier for the heart to pump and reduces its workload. Nifedipine is used to lower hypertension (high blood pressure) and to treat angina (chest pain). Nifedipine may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of nifedipine?

If you experience any of the following serious side effects, stop taking nifedipine and contact your doctor immediately or seek emergency medical treatment:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• unusually fast or slow heartbeats;

• severe dizziness or fainting;

• psychosis;

• yellowing of the skin or eyes (jaundice); or

• swelling of the legs or ankles.

Other, less serious side effects may be more likely to occur. Continue to take nifedipine and talk to your doctor if you experience

• headache, fatigue, or tiredness;

• flushing;

• insomnia;

• vivid or abnormal dreams;

• nausea or constipation; or

• increased urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take nifedipine?
Take nifedipine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Adalat CC should be taken on an empty stomach. Do not crush, chew, or break any form of nifedipine. Swallow the pills whole. Do not consume grapefruit or grapefruit juice during treatment with nifedipine. Nifedipine can interact with grapefruit and grapefruit juice, and the interaction may have dangerous effects. You should discuss the use of grapefruit and grapefruit juice with your doctor.

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What is the most important information I should know about nifedipine?
Do not stop taking nifedipine without first talking to your doctor, even if you begin to feel better. If you stop taking the medication, your condition could become worse. Do not crush, chew, or break any form of nifedipine. Swallow the pills whole. Do not consume grapefruit or grapefruit juice during treatment with nifedipine. Nifedipine can interact with grapefruit and grapefruit juice, and the interaction may have dangerous effects. You should discuss the use of grapefruit and grapefruit juice with your doctor.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

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What other drugs will affect nifedipine?
Before taking nifedipine, tell your doctor if you are taking any of the following drugs: another heart medication to treat the same or another condition; cimetidine (Tagamet, Tagamet HB); erythromycin (E-Mycin, E.E.S., Eryc, Ery-Tab, others); itraconazole (Sporanox) or ketoconazole (Nizoral); carbamazepine (Tegretol); phenytoin (Dilantin); or rifampin (Rifadin, Rimactane) or rifabutin (Mycobutin). You may not be able to take nifedipine, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Nifedipine has been assigned to pregnancy category C by the FDA. Animal studies have revealed evidence of teratogenicity after doses 30 times the maximum recommended human dose were given, embryotoxicity after doses 3 to 10 times the maximum recommended human dose were given, and small placentas and underdeveloped chorionic villi after doses 2/3 to 2 times the maximum recommended human dose were given (on a per kg basis). Small, controlled, but unblinded studies in humans and cases reports have revealed decreased maternal blood pressure and decreased uterine artery perfusion pressure associated with nifedipine. Uterine blood flow was maintained due to vasodilation in these studies. Perinatal deaths and decreased birth weights have been associated with the use of nifedipine in other human clinical studies, but other antihypertensive agents were also used, making implication of nifedipine alone difficult. Nifedipine should only be given during pregnancy when benefit outweighs risk. Male infertility associated with sperm dysfunction may be caused by nifedipine.

Nifedipine has been used safely in humans for treatment of preeclampsia and preterm labor. Data from the Michigan Medicaid Birth Defects Study failed to reveal an association between the use of nifedipine and congenital abnormalities (written communication, Franz Rosa, MD, Food and Drug Administration, 1994). This study was a retrospective study of 229,101 completed pregnancies between 1985 and 1992, of which 37 were exposed to the drug at any time during pregnancy. Of these pregnancies, two total birth defects and one cardiovascular birth defect were observed. The incidence of these birth defects did not achieve statistical significance. There were no observations of cleft palate, spina bifida, polydactyly, limb reduction, or hypospadias. These data do not support an association between nifedipine and birth defects. In uncontrolled studies of pregnant women with severe hypertension who were given nifedipine, the drug caused a significant reduction in systemic blood pressure without adversely affecting the expected course of pregnancy. While these pregnancies were complicated, no complications or adverse outcomes were attributed to nifedipine. There were no cases of uterine relaxation, although the high Cesarean section rate and the long and variable intervals between antenatal nifedipine administration and delivery made it impossible to assess the impact of the drug on the progress of labor. In a placebo-controlled study of 30 pregnant women with preeclampsia, nifedipine caused significant reductions in maternal systemic blood pressure without causing significant changes in fetal heart rates or the systolic to diastolic ratio of the umbilical artery. A retrospective review of 78 women with first-trimester exposure to calcium channel blockers (CCBs) (44%, or 34 were taking nifedipine) revealed no increase in major malformations compared with a control group matched for maternal age and smoking. This review suggests that CCBs do not represent a major teratogenic risk. A case in which a 36-year-old primipara with primary pulmonary hypertension (PPH), who received nifedipine SL 180 mg per day (with digoxin and heparin) has been reported. Pelvic ultrasonography and fetal heart monitoring were normal until gestation week 36, when oligohydramnios was detected. Labor was induced, and a healthy 2,485 g infant was delivered vaginally. The authors attributed the good outcome in this case and in other cases of PPH to the use of nifedipine. They do acknowledge, however, that the effects of nifedipine on the fetus remain largely unknown. Nifedipine has been used as a tocolytic agent because of its ability to cause uterine relaxation. Some studies have shown it to be as effective as and safer than either terbutaline or magnesium sulfate in the management of preterm labor. The pharmacokinetics of nifedipine have been elucidated in the immediate postpartum period in patients with preeclampsia. Because of the increased plasma clearance of nifedipine in these patients, dosing every three to four hours may be necessary to achieve adequate antihypertensive control. Due to in vitro evidence that nifedipine can arrest sperm motility, the drug has been considered as a male contraceptive device. Male infertility associated with sperm dysfunction may be caused by nifedipine.

Nifedipine is excreted into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Data reveal the milk nifedipine concentrations represent about 5% of a therapeutic dose and pose little risk to a nursing infant. Delaying breast-feeding 3 to 4 hours after a dose significantly decreases the amount of nifedipine to which a nursing infant may potentially be exposed.

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Who should NOT use this medication?

• Known hypersensitivity to nifedipine or any ingredient in the formulation.

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What does my medication look like?
Nifedipine is available with a prescription generically and under the brand names Adalat, Adalat CC, Procardia, and Procardia XL. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Adalat 10 mg--orange, soft-gelatin capsules Adalat 20 m --orange/light brown, soft-gelatin capsules Adalat CC 30 mg--round, pink, film-coated tablets Adalat CC 60 mg--round, salmon-colored, film-coated tablets

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a nifedipine overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

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What should I discuss with my healthcare provider before taking nifedipine?
Before taking nifedipine, tell your doctor if you have kidney disease; liver disease; another disease of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, low blood pressure, or coronary artery disease. You may not be able to take nifedipine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Nifedipine is in the FDA pregnancy category C. This means that it is not known whether nifedipine will be harmful to an unborn baby. Do not take nifedipine without first talking to your doctor if you are pregnant or could become pregnant during treatment.

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Can I stop taking the medication if I feel better?
Even though you may feel better you should not stop taking your high blood pressure medication without first checking with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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