Nifedipine: Difference between revisions
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==General== | ==General== | ||
*Type: Calcium Channel Blocker, Dihydropyridine | *Type: [[Calcium Channel Blocker]], Dihydropyridine | ||
*Dosage Forms: PO | *Dosage Forms: 10,20; 30,60,90 ER PO | ||
*Common Trade Names: Procardia, Nifediac, Nifedical, Adalat, Afeditab | *Common Trade Names: Procardia, Nifediac, Nifedical, Adalat, Afeditab | ||
==Adult Dosing== | ==Adult Dosing== | ||
===[[Preterm labor]]/Tocolysis=== | ===[[Preterm labor]]/Tocolysis=== | ||
*20mg x1, additional 20mg dose in 90min if ctx persist, followed by 20mg q3-8 hrs | *20mg x1, additional 20mg dose in 90min if ctx persist, followed by 20mg q3-8 hrs PRN ctx | ||
===[[Hypertension]], [[Angina]], [[Pulmonary hypertension]]=== | |||
*30-60mg ER PO daily | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===[[Hypertensive emergency]]=== | |||
*0.25-0.5mg/kg PO q4-6h | |||
*Max: 10mg/dose up to 1-2mg/kg/day | |||
===[[Hypertrophic cardiomyopathy]]=== | |||
*0.6-0.9mg/kg/day PO divided tid-QID | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: Probably safe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: no adjustment | ||
**Pediatric | **Pediatric: no adjustment | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: not defined | ||
**Pediatric | **Pediatric: not defined | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*galactose intolerance (lactose-containing forms) | |||
*hypertensive crisis (IR form) | |||
*hypertension (IR form) | |||
*caution if CHF | |||
*caution if aortic stenosis | |||
*caution if hypotension | |||
*caution if renal impairment | |||
*caution if hepatic impairment | |||
*caution if anesthesia or surgery | |||
*caution if concurrent or recent β-blocker use | |||
*caution if GI stricture, severe (XL form) | |||
*caution if GI hypomotility disorder (XL form) | |||
*caution in elderly patients | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*CHF | *[[CHF]] | ||
*pulmonary edema | *pulmonary edema | ||
*MI | *MI | ||
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===Common=== | ===Common=== | ||
*peripheral edema | |||
*headache | |||
*dizziness | |||
*flushing | |||
*fatigue/weakness | |||
*nausea | |||
*constipation | |||
*muscle cramps | |||
*nervousness | |||
*palpitations | |||
*dyspnea | |||
*nasal congestion | |||
*hypotension, transient | |||
*eczematous eruptions (chronic use, elderly patients) | |||
==Pharmacology== | ==Pharmacology== | ||
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==See Also== | ==See Also== | ||
[[Raynaud’s disease]] | |||
== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | |||
[[Category: | [[Category:Cardiology]] | ||
Latest revision as of 23:51, 22 September 2019
General
- Type: Calcium Channel Blocker, Dihydropyridine
- Dosage Forms: 10,20; 30,60,90 ER PO
- Common Trade Names: Procardia, Nifediac, Nifedical, Adalat, Afeditab
Adult Dosing
Preterm labor/Tocolysis
- 20mg x1, additional 20mg dose in 90min if ctx persist, followed by 20mg q3-8 hrs PRN ctx
Hypertension, Angina, Pulmonary hypertension
- 30-60mg ER PO daily
Pediatric Dosing
Hypertensive emergency
- 0.25-0.5mg/kg PO q4-6h
- Max: 10mg/dose up to 1-2mg/kg/day
Hypertrophic cardiomyopathy
- 0.6-0.9mg/kg/day PO divided tid-QID
Special Populations
- Pregnancy Rating: C
- Lactation: Probably safe
- Renal Dosing
- Adult: no adjustment
- Pediatric: no adjustment
- Hepatic Dosing
- Adult: not defined
- Pediatric: not defined
Contraindications
- Allergy to class/drug
- galactose intolerance (lactose-containing forms)
- hypertensive crisis (IR form)
- hypertension (IR form)
- caution if CHF
- caution if aortic stenosis
- caution if hypotension
- caution if renal impairment
- caution if hepatic impairment
- caution if anesthesia or surgery
- caution if concurrent or recent β-blocker use
- caution if GI stricture, severe (XL form)
- caution if GI hypomotility disorder (XL form)
- caution in elderly patients
Adverse Reactions
Serious
- CHF
- pulmonary edema
- MI
- arrhythmias
- hypotension, severe
- cholestasis
- allergic hepatitis
- angioedema
- anaphylaxis
- Stevens-Johnson syndrome
- exfoliative dermatitis
- toxic epidermal necrolysis
- exanthematous pustulosis, acute generalized
- GI obstruction (XL form)
- GI ulcer (XL form)
Common
- peripheral edema
- headache
- dizziness
- flushing
- fatigue/weakness
- nausea
- constipation
- muscle cramps
- nervousness
- palpitations
- dyspnea
- nasal congestion
- hypotension, transient
- eczematous eruptions (chronic use, elderly patients)
Pharmacology
- Half-life: 2h, 7h (ER)
- Metabolism: liver, CYP450: 3A4 substrate
- Excretion: urine 60-80% (<0.1% unchanged), bile/feces 20%
- Mechanism of Action: inhibits calcium ion influx into vascular smooth muscle and myocardium