Uses of Nifa: - Hypertension (high blood pressure) - Angina (heart-related chest pain) Hypertension, Angina pectoris, Raynaud's syndrome, Stroke prevention Acute MI, cardiogenic shock, acute unstable angina, treatment of anginal attack in chronic stable angina.

Calcium-channel blockers

Nifedipine is an inhibitor of Calcium Channel Blocker that blocks the transmembrane influx of Calcium ions into muscle cells. Nifedipine has selective effects as a dilator of arterial vessels. Nifedipine dilates main coronary and systemic arteries. As a result blood pressure falls and this elicits a sympathetic reflex response causing tachycardia and an increased cardiac output. Pulmonary arterial pressure also falls. Nifedipine has direct negative inotropic effects on cardiac muscles and these effects are seen at higher doses than dose which causes arterial vasodilatation.

How to use Nifedipine: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nifedipine may be taken with or without food, but it is better to take it at a fixed time. Administration: Immediate-release: May be taken with or without food. Avoid grapefruit juice. Retard, GITS & OROS: May be taken with or without food. Avoid grapefruit juice. Swallow whole, do not chew/crush. Adult Dose: Oral Hypertension Adult: Immediate-release: Initially, 5 mg tid. Maintenance: 10-20 mg tid. Extended-release: Initially, 10-40 mg bid, or 20-90 mg once daily. Angina pectoris Adult: Immediate-release: Initially, 10 mg tid. Maintenance: 10-20 mg tid. Extended-release: 10-40 mg bid or 30-60 mg once daily. Raynaud's syndrome Adult: Immediate-release: 5-20 mg tid. Elderly: Dose reduction may be necessary. Hepatic impairment: Dose reduction may be necessary.

Enhanced antihypertensive effects w/ other antihypertensives, aldesleukin, and antipsychotics. Concomitant use w/ fentanyl during surgery caused severe hypotension. May modify insulin and glucose responses. Attenuation of tachycardic effect when used w/ benazerpril. Prothrombin time may be increased w/ coumarin anticoagulants. Increased serum levels w/ CYP3A4 inhibitors (e.g. azole antifungals, cimetidine, erythromycin, HIV-protease inhibitors, nefazodone, fluoxetine, quinupristin/dalfopristin). Potentially Fatal: Decreased bioavailability and efficacy w/ strong CYP3A4 inducers (e.g. rifampicin, phenytoin, carbamazepine).

Acute MI, cardiogenic shock, acute unstable angina, treatment of anginal attack in chronic stable angina.

Common - Ankle swelling - Dizziness - Edema (swelling) - Fatigue - Flushing (sense of warmth in the face, ears, neck and trunk) - Headache - Palpitations >10% Peripheral edema (10-30%),Dizziness (23-27%),Flushing (23-27%),Headache (10-23%),Heartburn (11%),Nausea (11%) 1-10% Muscle cramps (8%),Mood change (7%),Nervousness (7%),Cough (6%),Dyspnea (6%),Palpitations (6%),Wheezing (6%),Hypotension, transient (5%),Urticaria (2%),Pruritus (2%),Constipation (<2%),Chest pain (<2%) Frequency Not Defined Gingival hyperplasia,Agranulocytosis,Erectile dysfunction

There are no adequate and well controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Precaution: Patients w/ hypotension, poor cardiac reserve, heart failure, severe aortic stenosis, DM, underlying severe GI narrowing (extended-release tab). Avoid abrupt withdrawal as it may casue rebound angina. Hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling Discontinue if ischaemic pain follows after admin. Monitoring Parameters Monitor BP, heart rate. Lactation: Drug is distributed into breast milk; manufacturer suggests discontinuing drug or refraining from nursing (however, American Academy of Pediatrics states that drug is safe for nursing)

Protect from strong light, store in a cool place in the original pack

Calcium-channel blockers

Nifedipine prevents Ca ion from entering the slow channels of cardiac and smooth muscles during depolarisation, producing peripheral and coronary vasodilatation. It reduces afterload, peripheral resistance and BP; increases coronary blood flow and causes reflex tachycardia. It has little or no effect on cardiac conduction and rarely has negative inotropic activity.

There are no adequate and well controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.