Nifedipine: Difference between revisions
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===[[Preterm labor]]/Tocolysis=== | ===[[Preterm labor]]/Tocolysis=== | ||
*20mg x1, additional 20mg dose in 90min if ctx persist, followed by 20mg q3-8 hrs PRN ctx | *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== | ||
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*caution if hepatic impairment | *caution if hepatic impairment | ||
*caution if anesthesia or surgery | *caution if anesthesia or surgery | ||
*caution if concurrent or recent | *caution if concurrent or recent β-blocker use | ||
*caution if GI stricture, severe (XL form) | *caution if GI stricture, severe (XL form) | ||
*caution if GI hypomotility disorder (XL form) | *caution if GI hypomotility disorder (XL form) | ||
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==See Also== | ==See Also== | ||
[[Raynaud’s disease]] | |||
==References== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[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