Nifedipine - Revision history

Zeki at 03:01, 5 September 2024

2024-09-05T03:01:47Z

← Older revision		Revision as of 23:01, 4 September 2024
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	'''Drug class: [[:Category: Calcium-channel Blocker, CCB \| Calcium-channel Blocker, CCB]]		'''Drug class: [[:Category: Calcium-channel Blocker, CCB \| Calcium-channel Blocker, CCB]]

	'''Nifedipine'''（中文：[[硝苯地平]]） is a dihydropyridine calcium-channel blocker. It is used in the management of hypertension and angina.		'''Nifedipine (ADALAT)'''（中文：[[硝苯地平]]） is a dihydropyridine calcium-channel blocker. It is used in the management of hypertension and angina.

	==Pronunciation==		==Pronunciation==

Zeki at 02:39, 5 September 2024

2024-09-05T02:39:36Z

← Older revision		Revision as of 22:39, 4 September 2024
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	[[Category: Drugs]] [[Category: Calcium-channel Blocker, CCB]]		[[Category: Drugs]][[Category: Calcium-channel Blocker, CCB]]
	'''Nifedipine'''~~(中文:~~[[硝苯地平]]) is a dihydropyridine calcium-channel blocker. It is used in the management of hypertension and angina.
			[[:Category: Cardiovascular Drug \| '''Cardiovascular Drug''']]

			'''Drug class: [[:Category: Calcium-channel Blocker, CCB \| Calcium-channel Blocker, CCB]]

			'''Nifedipine'''（中文：[[硝苯地平]]） is a dihydropyridine calcium-channel blocker. It is used in the management of hypertension and angina.

	==Pronunciation==		==Pronunciation==

Helen: /* Side Effects */

2022-08-22T06:25:48Z

Side Effects

← Older revision		Revision as of 02:25, 22 August 2022
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	\|Flushing		\|Flushing
	\|-		\|-
	\|'''Gastro-intestinal disorders		\| rowspan="2" \|'''Gastro-intestinal disorders
	\|UnCommon		\|UnCommon
	\|Abdominal pain, nausea, constipation		\|Abdominal pain, nausea, constipation
	\|-		\|-
	\|
	\|Very rare		\|Very rare
	\|Gum hyperplasia		\|Gum hyperplasia

Helen at 03:23, 8 August 2022

2022-08-08T03:23:41Z

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	{\| class="wikitable"		{\| class="wikitable"
			!style="text-align: left"\| HA Code:
			\|NIFE03
			\|-
	!style="text-align: left"\| Generic Name:		!style="text-align: left"\| Generic Name:
	\|Nifedipine		\|Nifedipine

Helen at 03:22, 8 August 2022

2022-08-08T03:22:55Z

← Older revision		Revision as of 23:22, 7 August 2022
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	'''Pregnancy''': avoid		'''Pregnancy''': avoid

			== FAQ ==
			==== How should I take the tablet? ====
			Swallow the tablet whole with a drink of water. Do not crush the tablet.

			==== What should I avoid while taking? ====
			Avoid eating grapefruit or drinking grapefruit juice while taking amlodipine.
			Grapefruit juice can increase felodipine in your body and make side effects worse, such as flushing or getting headaches.

			====What happen if I miss a dose?====
			If you forget to take a dose and you usually take nifedipine twice a day – take it as soon as you remember unless it is less than 4 hours until your next dose. In this case leave out the missed dose and take your next dose at the usual time.
			Never take 2 doses to make up for a forgotten one.

Helen: /* Drug Management */

2022-08-08T03:21:40Z

Drug Management

← Older revision		Revision as of 23:21, 7 August 2022
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	<u>Additional interactions</u>		<u>Additional interactions</u>

	The simultaneous administration of nifedipine and digoxin may lead to reduced digoxin clearance and, hence, an increase in the plasma concentrations of digoxin. The patient should therefore be checked for symptoms of digoxin overdosage as a precaution and, if necessary, the glycoside dose should be reduced taking account of the plasma concentration of digoxin.		The simultaneous administration of nifedipine and digoxin may lead to reduced digoxin clearance and, hence, an increase in the plasma concentrations of digoxin. The patient should therefore be checked for symptoms of digoxin overdosage as a precaution and, if necessary, the glycoside dose should be reduced taking account of the plasma concentration of digoxin.

Helen: /* Drug Management */

2022-08-08T03:21:20Z

Drug Management

← Older revision		Revision as of 23:21, 7 August 2022
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	'''Drug Interaction:		'''Drug Interaction:

	Nifedipine (~~Adalat Retard~~) tablets have ~~extended~~-~~release properties~~, ~~so they absorb~~ in the ~~body slowly over time~~ and ~~can take up to 4 hours to reach its “peak” effect~~.		Nifedipine is metabolized in the liver by cytochrome P450 3A4 (CYP3A4). Drugs that are known to either inhibit or to induce this enzyme system may therefore alter the first pass (after oral administration) or the clearance of nifedipine.

			The extent as well as the duration of interactions should be taken into account when administering nifedipine together with the following drugs:

			'''Rifampicin''' : Rifampicin strongly induces the cytochrome P450 3A4 system. Upon coadministration with rifampicin, the bioavailability of nifedipine is distinctly reduced and thus its efficacy weakened. The use of nifedipine in combination with rifampicin is therefore contraindicated

			''Interactions leading to increased plasma concentration of nifedipine

			CYP3A4 enzyme inhibitors have been shown to cause an increase in nifedipine plasma concentrations.
			In case of clinically significant adverse events due to elevated nifedipine exposure when combined with strong CYP3A4 inhibitors, adjustment of nifedipine dose and/or discontinuation of the CYP3A4 inhibitor should be considered.

			Examples:

			- Cimetidine

			- Erythromycin

			- Itraconazole

			- Ketoconazole

			- Certain flavonoids present in grapefruit juice

			Nifedipine tablets should not be taken together with grapefruit juice.

			''Interactions leading to decreased plasma concentration of nifedipine

			Enzyme inducers of the cytochrome P450 3A4 system have been shown to cause a decrease in plasma concentrations of nifedipine.
			In case of lack of efficacy due to decreased nifedipine exposure when combined with potent inducers of CYP3A4, adjustment of nifedipine dose and/or discontinuation of the CYP3A4 inducer should be considered.

			Examples:

			- Phenytoin

			- Carbamazepine

			- Rifampicin

			- Barbiturates

			- Hypericum perforatum (Saint John's wort)

			<u>Additional interactions</u>
			The simultaneous administration of nifedipine and digoxin may lead to reduced digoxin clearance and, hence, an increase in the plasma concentrations of digoxin. The patient should therefore be checked for symptoms of digoxin overdosage as a precaution and, if necessary, the glycoside dose should be reduced taking account of the plasma concentration of digoxin.

			'''Contraindication:

			Cardiac outflow obstruction

			*Significant cardiac valvular obstruction (e.g. aortic stenosis)
			*Uncontrolled heart failure
			*Unstable angina
			*Within 1 month of myocardial infarction

			'''Pregnancy''': avoid

Helen: /* Pharmacokinetics */

2022-08-08T03:18:32Z

Pharmacokinetics

← Older revision		Revision as of 23:18, 7 August 2022
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	'''How long does nifedipine take to work?		'''How long does nifedipine take to work?

	~~Following administration of felodipine~~, ~~a reduction~~ in ~~blood pressure generally occurs within 2~~ to 5 hours~~. During chronic administration, substantial blood pressure control lasts for '''24 hours'''~~.		Nifedipine (Adalat Retard) tablets have extended-release properties, so they absorb in the body slowly over time and can take up to 4 hours to reach its “peak” effect.

	==Drug Management==		==Drug Management==

Helen at 03:17, 8 August 2022

2022-08-08T03:17:48Z

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	*BY MOUTH		*BY MOUTH
	*Adult: 10 mg twice daily, adjusted according to response to 40 mg twice daily.		*Adult: 10 mg twice daily, adjusted according to response to 40 mg twice daily.

			==Side Effects==
			The following definitions of frequencies are used:

			Very common ≥ 1/10

			Common ≥ 1/100 to < 1/10

			Uncommon ≥ 1/1,000 to < 1/100

			Rare ≥ 1/10,000 to < 1/1,000

			Very rare < 1/10,000

			{\| class="wikitable"
			!style="text-align: left"\| System Organ Class
			!Frequency
			!Adverse reactions
			\|-
			\|'''Nervous system disorder
			\|Common
			\|Headache
			\|-
			\|'''Cardiac disorders
			\|UnCommon
			\|Tachycardia, palpitations
			\|-
			\|'''Vascular disorders
			\|Common
			\|Flushing
			\|-
			\|'''Gastro-intestinal disorders
			\|UnCommon
			\|Abdominal pain, nausea, constipation
			\|-
			\|
			\|Very rare
			\|Gum hyperplasia
			\|-
			\|'''General disorders
			\|Common
			\|Peripheral oedema
			\|}

			==Pharmacokinetics==
			<u>Absorption</u>

			After oral administration nifedipine is rapidly and almost completely absorbed. The systemic availability of orally administered nifedipine is 45 – 56% owing to a first pass effect. Maximum plasma and serum concentrations are reached at 1.5 to 4.2 hours with nifedipine. Simultaneous food intake leads to delayed, but not reduced absorption.

			<u>Distribution</u>

			Nifedipine is about 95% bound to plasma protein (albumin).

			<u>Metabolism</u>

			After oral administration, nifedipine is metabolized in the gut wall and in the liver.

			Nifedipine is excreted in the form of its metabolites predominantly via the kidney and about 5 – 15% via the bile in the faeces.

			<u>Elimination</u>

			The terminal elimination half-life is 6 – 11 hours because of delayed absorption. No accumulation of the substance after the usual dose was reported during long-term treatment.


			'''How long does nifedipine take to work?

			Following administration of felodipine, a reduction in blood pressure generally occurs within 2 to 5 hours. During chronic administration, substantial blood pressure control lasts for '''24 hours'''.

			==Drug Management==
			'''Drug Interaction:

			Nifedipine (Adalat Retard) tablets have extended-release properties, so they absorb in the body slowly over time and can take up to 4 hours to reach its “peak” effect.

Helen at 03:14, 8 August 2022

2022-08-08T03:14:29Z

← Older revision		Revision as of 23:14, 7 August 2022
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	== Route of Administration: ==		== Route of Administration: ==
	Nifedipine is given orally in a sustained-release formulation.		Nifedipine is given orally in a sustained-release formulation.

			==Dosage==
			'''Agina
			*BY MOUTH
			*Adult: 10 mg twice daily, adjusted according to response to 40 mg twice daily.
			'''Hypertension
			*BY MOUTH
			*Adult: 10 mg twice daily, adjusted according to response to 40 mg twice daily.