Nifedipine: Difference between revisions

No edit summary
 
(23 intermediate revisions by 6 users not shown)
Line 1: Line 1:
==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 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==
===[[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]]
*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===
===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==
Line 35: Line 85:


==See Also==
==See Also==
[[Raynaud’s disease]]


==Sources==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Drugs]]
[[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

See Also

Raynaud’s disease

References