Adalat

Nifedipine is a prescription medication used to treat chest pain. This medication belongs to a group of drugs called calcium channel blockers, which relax blood vessels, making it easier for the heart to pump blood.

Nifedipine comes in an immediate release capsule form and is taken 3 or 4 times a day, with or without food. This medication also comes in an extended release tablet form. It is taken once a day, with or without food.

Common side effects of nifedipine include swelling, headache, flushing, and nausea. Nifedipine can also cause dizziness. Do not drive or operate heavy machinery until you know how this medication will affect you.

Nifedipine is a prescription medication used to treat chest pain.

The extended release form of nifedipine, is a prescription medication used to treat chest pain and high blood pressure.

These medications may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Bayer Corp., Pharmaceutical/Biological Division

• Bayer Healthcare Pharmaceuticals Inc.

• Cheshire Pharm. Systems

• PD-Rx Pharmaceuticals, Inc.

• Quality Care Pharmaceuticals

• Quality Care Products, LLC

• Schering Corporation

Serious side effects have been reported with nifedipine. See the “Drug Precautions” section.

Common side effects of nifedipine include:

• swelling
• headache
• fatigue
• dizziness
• constipation
• nausea
• flushing
• weakness

This is not a complete list of nifedipine side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• beta blockers such as metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), propranolol (Inderal, Inderal LA), and carvedilol (Coreg)
• digoxin (Lanoxin)
• quinidine (Cardioquine, Quinact, Duraquin)
• warfarin (Coumadin, Jantoven)
• cimetidine (Tagamet)
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's wort, and nimodipine (Nimotop)

This is not a complete list of nifedipine drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with nifedipine including:

• congestive heart failure (CHF). Tell your healthcare provider right away if you experience any of the following symptoms of CHF:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing more pillows or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• hypotension. Hypotension, or low blood pressure, may cause you to feel faint or dizzy. Inadequate fluid intake, excessive sweating, diarrhea, or vomiting can lead to an excessive fall in blood pressure, too. Lie down if you feel faint or dizzy. Call your doctor right away.
• chest pain. Use of nifedipine may lead to an increased number or severity of heart attacks, particularly in those with coronary artery disease (when blood vessels to the heart become hardened and narrowed). Tell your healthcare provider right away if you have some or all of the following symptoms of angina:
  • a pressure, squeezing, burning, or tightness in the chest
  • pain in the chest, breastbone area, arms, neck, shoulders, or back
  • nausea
  • fatigue
  • shortness of breath
  • light headedness
  • weakness
• heart attack. Use of nifedipine may lead to an increased number or severity in heart attacks, particularly in those with coronary artery disease (when blood vessels to the heart become hardened and narrowed). Tell your healthcare provider right away or call 911 if you experience any of the following symptoms of a heart attack:
  • chest discomfort (pressure, squeezing, or pain)
  • shortness of breath
  • discomfort in the upper body (arms, shoulder, neck, back)
  • nausea, vomiting, dizziness, lightheadedness, sweating
• beta blocker withdrawal. Decreasing the dose of a beta blocker (see the “Drug Interactions” section for examples of beta blockers) while also taking nifedipine may cause chest pain. Your doctor will determine how to lower your beta blocker medication dose. Do not stop use of beta blockers all at once.
• gastrointestinal (refers to the stomach and bowels) blockage. There have been rare reports of this occurrence in patients with gastrointestinal structure abnormalities after taking the extended release form of nifedipine. Small clumps of partially digested or undigested material can get stuck in the GI tract in very rare cases and may require surgery for removal.
• gastrointestinal ulcers. The extended release form of nifedipine may cause ulcers, which are sores in the stomach or small intestines. Tell your healthcare provider right away if you experience any of the following symptoms of a gastrointestinal ulcer:
  • stomach pain
  • blood in the urine
  • dark, tarry stools

Do not take nifedipine if you:

• are allergic to nifedipine or any of this medication’s ingredients
• have a specific form of high blood pressure called “essential hypertension.” The cause of this type of high blood pressure is unknown.

Grapefruit and grapefruit juice may interact with nifedipine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking nifedipine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• have heart problems
• have kidney problems
• have liver problems
• have gastroinstestinal (stomach and bowel) problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Nifedipine falls into category C. There are no well-controlled studies in pregnant women. Nifedipine should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Low levels of nifedipine is known to cross into breastmilk. No negative effects have been reported thus far, so use of this medication may be continued in nursing mothers.

Take nifedipine exactly as prescribed.

This medication comes in an immediate release capsule form and is taken 3 or 4 times a day, with or without food. Swallow whole, do not chew or crush the capsule or its contents.

This medication also comes in an extended release tablet form and is taken once a day, with or without food. Do not chew or swallow these tablets. These tablets are made with a non-absorbable shell that may be passed into the stools. This is an expected occurrence.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of nifedipine at the same time.

Take nifedipine exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose range for nifedipine is 10 to 60 mg three or four times a day. A total daily dose above 180 mg is not recommended.

The recommended dose range for the extended release form is 30 to 120 mg once a day. A total daily doses above 120 mg is not recommended.

• Dose adjustments may be done based on liver function, kidney function, physical activity level, frequency of chest pains, response to medication, and the use of other medications.

If discontinuation of nifedipine is necessary, the dose should be decreased gradually with close physician supervision.

If you take too much nifedipine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store nifedipine at room temperature between 59° to 77°F (15° to 25°C).
• Protect from moisture and humidity.
• Keep this and all medicines out of the reach of children.