Nifedipine: Drug information

For additional information see "Nifedipine: Patient drug information" and "Nifedipine: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table

Brand Names: US

Procardia XL;
Procardia [DSC]

Brand Names: Canada

Adalat XL;
AG-Nifedipine ER;
DOM-NIFEdipine;
JAMP-Nifedipine ER;
M-Nifedipine ER;
MYLAN-NIFEdipine;
PMS-NIFEdipine ER;
PMSC-Nifedipine ER;
PRO-Nifedipine ER

Pharmacologic Category

Antianginal Agent;
Antihypertensive;
Calcium Channel Blocker;
Calcium Channel Blocker, Dihydropyridine

Dosing: Adult

Dosage guidance:

Safety: The use of IR sublingual nifedipine is not recommended for any indication due to safety concerns.

Dosage form information: When switching from IR (oral administration) to ER formulations, use same total daily dose.

Anal fissure

Anal fissure (off-label use):

Note: Administered topically as a local vasodilator in conjunction with supportive measures. Ointment and gel are not commercially available and must be prepared by a licensed compounding facility (Ref).

Peri-anal: 0.2% to 0.3% ointment or gel: After cleansing, apply around fissure(s) 2 to 4 times daily for 4 weeks (Ref).

Angina

Angina:

Chronic stable angina (alternative agent):

Note: A beta-blocker is the preferred initial therapy; if there are ongoing symptoms on beta-blocker therapy, a long-acting dihydropyridine calcium channel blocker (eg, ER nifedipine) may be added; ER nifedipine may also be used as an alternative therapy if there are contraindications or unacceptable adverse effects with beta-blockade (Ref). Use of immediate-release nifedipine (oral or sublingual) is not recommended due to increased adverse effects (hypotension and reflex tachycardia), particularly in absence of a beta-blocker.

Oral: Extended release: Initial: 30 or 60 mg once daily; increase as needed to effective antianginal dose over 1 to 2 weeks. Doses >90 mg/day are rarely needed; maximum: 120 mg/day.

Vasospastic angina:

Note: May be used alone or in combination with nitrates (Ref). Use of immediate-release nifedipine (oral or sublingual) is not recommended due to increased adverse effects (hypotension and reflex tachycardia).

Oral: Extended release: Initial: 30 or 60 mg once daily; increase as needed to effective antianginal dose over 1 to 2 weeks. Doses >90 mg/day are rarely needed; maximum: 120 mg/day.

High-altitude pulmonary edema

High-altitude pulmonary edema (adjunctive therapy) (off-label use):

Prevention: Note: May use as an adjunct to gradual ascent in high-risk individuals (eg, history of high-altitude pulmonary edema) (Ref).

Oral: Extended release: 30 mg every 12 hours starting 24 hours prior to ascent; continue for 4 to 5 days after reaching maximal altitude; can extend for up to 7 days in individuals who ascend faster than recommended (Ref).

Treatment: Note: Adjunctive to nonpharmacologic measures (eg, oxygen supplementation, portable hyperbaric chamber, gradual descent) or as monotherapy if nonpharmacologic measures are not possible (Ref).

Oral: Extended release: 30 mg every 12 hours; continue until descent is complete, symptoms resolve, and oxygenation is normal for the altitude (Ref).

Hypertension, chronic

Hypertension, chronic:

Note: For patients who warrant combination therapy (BP >20/10 mm Hg above goal or suboptimal response to initial monotherapy), may use in combination with another appropriate agent (eg, angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, thiazide diuretic) (Ref). IR nifedipine (oral or sublingual) should not be used for acute BP lowering due to risk of hypotension and ischemic complications. However, may consider extended release for severe asymptomatic hypertension (eg, to lower BP over hours) if there is concern that severe BP elevation will precipitate an acute cardiovascular event, such as in patients with known aortic or intracranial aneurysms (Ref).

Oral: Extended release: Initial: 30 or 60 mg once daily; evaluate response after ~2 to 4 weeks and titrate dose as needed up to 90 mg once daily; if additional blood pressure control is needed, consider combination therapy. Patients with severe asymptomatic hypertension and no signs of acute end organ damage should be evaluated for medication adjustment within 1 week (Ref).

Hypertensive emergency in pregnancy or postpartum

Hypertensive emergency in pregnancy or postpartum (including acute-onset severe hypertension in preeclampsia/eclampsia) (off-label use):

Note: For acute-onset, severe, persistent hypertension (eg, systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg) (Ref).

Oral: Extended release: Note: Consider for use in less acute settings when slower BP reduction (eg, within 60 minutes versus 5 to 10 minutes) is sufficient (Ref).

Initial: 30 mg; repeat 30 mg after 1 to 2 hours if target BP is not achieved; if systolic or diastolic BP remains above threshold after the second dose, another class of agents should be considered (Ref).

Oral: Immediate release (alternative agent): Note: Generally reserved for use when IV access is not available. Some experts avoid use of immediate-release formulations unless immediate BP lowering is warranted (eg, <30 minutes), as it may be associated with precipitous drops in BP (Ref). Do not puncture capsule or administer sublingually.

Initial: 10 mg once; if systolic or diastolic BP remains above target at 20 minutes, give a second dose of 10 or 20 mg orally depending on initial response. Reassess BP again 20 minutes after the second dose; if not at target, give a third dose of 10 or 20 mg depending on previous response. If target BP is not achieved 20 minutes after the third dose, another class of agents should be considered; maximum cumulative dose: 50 mg/treatment episode or 180 mg/day (Ref).

Pulmonary arterial hypertension, group 1

Pulmonary arterial hypertension, group 1 (off-label use):

Note: Only used for group 1 pulmonary arterial hypertension patients with a positive vasoreactivity test and under the care of a pulmonary hypertension specialist (Ref).

Oral: Extended release: Initial: 30 mg once daily; titrate gradually, with close hemodynamic monitoring; reported dose range: 120 to 240 mg/day (Ref)

Raynaud phenomenon

Raynaud phenomenon (off-label use):

Oral: Extended release: Initial: 30 mg once daily; if needed, may increase dose gradually, usually once every 4 weeks, but not more frequently than once every 7 to 10 days; monitor blood pressure closely with each dose increase; usual effective dose: 30 to 120 mg/day (Ref).

Oral: Immediate release: Note: Only for short-term use in hospitalized patients with severe digital ischemia. Initial: 10 mg 3 times daily; may titrate by 10 mg increments as needed based on response and tolerability, up to 30 mg 3 times daily; transition to an ER formulation for maintenance therapy (Ref).

Tocolysis

Tocolysis (off-label use):

Oral: Immediate release: Initial: 20 to 30 mg as a loading dose, followed by 10 to 20 mg every 3 to 8 hours for up to 48 hours; maximum dose: 180 mg/day (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: Mild to severe impairment: No dosage adjustment necessary (systemic clearance minimally affected by kidney dysfunction); however, use of lower initial doses and more frequent monitoring is recommended in severe impairment (eg, CrCl <30 mL/minute) as these patients are more sensitive to nifedipine's BP lowering effects (Ref).

Hemodialysis, intermittent (thrice weekly): Not significantly dialyzed (Ref): No supplemental dose or dosage adjustment necessary; however, use of lower initial doses and more frequent monitoring is recommended as these patients are more sensitive to nifedipine's BP lowering effects (Ref).

Peritoneal dialysis: Not significantly dialyzed: No dosage adjustment necessary (Ref); however, use of lower initial doses and more frequent monitoring is recommended as these patients are more sensitive to nifedipine's BP lowering effects (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in manufacturer's labeling (has not been studied); use with caution. Clearance of nifedipine is reduced in cirrhotic patients, which may lead to increased systemic exposure; monitor closely for adverse effects/toxicity and consider dose adjustments.

Dosing: Older Adult

Note: Avoid immediate-release formulation (Ref).

Refer to adult dosing. In the management of hypertension, consider lower initial doses and titrate to response (Ref).

Dosing: Pediatric

(For additional information see "Nifedipine: Pediatric drug information")

Hypertension, severe

Hypertension, severe: Limited data available:

Note: Use should be under the supervision of a specialist experienced in the management of pediatric hypertension in the inpatient tertiary setting and used only after other alternatives have been shown to be ineffective. Current pediatric blood pressure guidelines do not recommend nifedipine for the management of acute severe hypertension, as other safe and effective alternatives are available for use in the pediatric population (eg, hydralazine, isradipine) (Ref). If treatment with nifedipine is deemed appropriate and necessary, then administration should occur in the inpatient setting where blood pressure and other hemodynamic parameters can be closely monitored.

Children and Adolescents: Immediate release: Oral: 0.04 to 0.25 mg/kg/dose; maximum single dose: 10 mg/dose; may repeat if needed every 4 to 6 hours; monitor carefully; maximum daily dose: 1 to 2 mg/kg/day (Ref).

Hypertension, chronic

Hypertension, chronic: Limited data available: Children and Adolescents (able to swallow whole tablet): Extended release: Oral: Initial: 0.2 to 0.5 mg/kg/day once daily or divided in 2 doses every 12 hours; do not exceed initial adult daily dose of 30 to 60 mg/day; titrate dose to effect; maximum daily dose: 3 mg/kg/day up to 120 mg/day (Ref); some centers use a higher maximum dose: 3 mg/kg/day up to 180 mg/day (Ref). Note: In adults, doses are usually titrated upward over 7 to 14 days; may increase over 3 days if clinically necessary (Ref).

High altitude pulmonary edema, treatment

High altitude pulmonary edema, treatment: Limited data available: Note: Reserve treatment with NIFEdipine for unsatisfactory response to oxygen and/or altitude descent:

Children and Adolescents:

Immediate release: Oral: 0.5 mg/kg/dose every 8 hours; maximum dose: 20 mg/dose (Ref).

Extended release (preferred if weight allows): Oral: 1.5 mg/kg/day once daily or divided in 2 doses per day; do not exceed adult dose of 30 mg every 12 hours. Note: Smallest extended-release dosage form available is 30 mg (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in manufacturer's labeling (has not been studied); the pharmacokinetics of nifedipine are not significantly influenced by the degree of renal impairment (only trace amounts of unchanged drug are found in urine). Based on experience in adult dialysis patients, supplemental doses are not necessary with hemodialysis or peritoneal dialysis; however, more frequent monitoring may be necessary.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in manufacturer's labeling (has not been studied); use with caution. Clearance of nifedipine is reduced in cirrhotic adult patients, which may lead to increased systemic exposure; monitor closely for adverse effects/toxicity and consider dose adjustments.

Adverse Reactions (Significant): Considerations

Angina/Myocardial infarction

Exacerbation of angina pectoris and/or acute myocardial infarction (MI) have occurred with initiation or dosage titration of immediate release (IR) (orally or sublingually) nifedipine. Hypotension and reflex tachycardia may occur resulting in angina and/or MI in patients with coronary heart disease, especially in the absence of concurrent beta-blockade. Use of IR nifedipine has been associated with increased mortality in patients with coronary heart disease. In patients with unstable angina/non–ST-elevation myocardial infarction (STEMI), the use of IR nifedipine is not recommended in the absence of a beta-blocker and is contraindicated in patients with STEMI. Effects may be reversible upon discontinuation (Ref).

Mechanism: Dose-related; related to the pharmacologic action. Hypotension due to calcium channel blocking properties may cause a reflex increase in sympathetic activity, leading to ischemic effects. In addition, the IR nature of nifedipine may cause more marked fluctuations in hemodynamics compared to extended release (ER) formulations (Ref).

Onset: Varied; increase in mortality observed after 2 weeks (Muller 1984). However, hemodynamic effects (ie, decrease in blood pressure, increase in heart rate, ECG changes) observed as quickly as after 1 dose (Ref).

Risk factors:

• Acute MI (Ref)

• Coronary heart disease (Ref)

• Refractory angina (Ref)

Hypotension/syncope

Symptomatic hypotension with or without syncope may occur when using the immediate release (IR) formulation. The use of IR nifedipine (sublingually or orally) in hypertensive emergencies and urgencies is neither safe or effective and is associated with increased risk of adverse events such as acute myocardial infarction, cerebrovascular ischemia, fetal distress, and death when used to treat hypertension (Ref). IR nifedipine may be warranted for acute treatment in pregnant or postpartum women based on guidelines (Ref). Although hypotension should be reversible upon discontinuation, effects may be initially severe and resistant to treatment (Ref).

Mechanism: Dose-related; related to the pharmacologic action. Inhibits calcium channels in peripheral smooth muscle leading to vasodilation. IR nifedipine, compared to extended release (ER) nifedipine has a much faster rate of increase in plasma levels, leading to more adverse reactions (Ref).

Onset: Rapid; hemodynamic effects (ie, decrease in blood pressure, increase in heart rate) observed as quickly as after one dose (Ref).

Risk factors:

• Older patients (age 60 to 83 years) (Ref)

Peripheral edema

Peripheral edema is a common adverse reaction of calcium channel blockers, characterized by ankle and leg swelling independent of fluid retention (Ref). It is a bothersome adverse reaction for patients and may lead to discontinuation (Ref). Peripheral edema can be expected to subside within several days following intervention.

Mechanism: Dose- and time-related; related to the pharmacologic action. Calcium channel blocker-mediated peripheral edema is caused by arteriolar vasodilation that subsequently leads to increased hydrostatic pressure in the precapillary circulation and fluid movement from the capillary vasculature to the interstitial space (Ref). In addition, impaired postural vasoconstriction may contribute (Ref).

Onset: Varied; has been reported between 4 weeks to >6 months after initiation (Ref).

Risk factors:

• Dose-related (ie, higher doses) (Ref); however, may develop more frequently and at lower doses in patients with impaired postural autoregulation (eg, diabetes, arterial disease) (Ref).

• Duration-related (>6 months) (Ref)

• Dihydropyridine calcium channel blockers (DHPs) versus non-DHPs (Ref)

• Lipophilic DHPs (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Incidence may include data with concomitant beta-blocker therapy. ER = extended release; IR = immediate release.

>10%:

Cardiovascular: Flushing (IR: 25%; ER: <3%), peripheral edema (4% to 30%) (table 1)Peripheral Edema

**Nifedipine: Adverse Reaction: Peripheral Edema**
Drug (Nifedipine)	Placebo	Dose	Dosage Form	Number of Patients (Nifedipine)	Number of Patients (Placebo)
30%	N/A	180 mg per day	ER tablets	N/A	N/A
10%	N/A	N/A	ER tablets	N/A	N/A
13%	N/A	120 mg per day or more	IR capsules	N/A	N/A
7%	1%	N/A	IR capsules	226	235
4%	N/A	less than 60 mg per day	IR capsules	N/A	N/A

Gastrointestinal: Heartburn (IR: ≤11%), nausea (IR: ≤11%; ER: 3%)

Nervous system: Dizziness (IR: 27%), headache (16% to 23%)

Neuromuscular & skeletal: Asthenia (IR: 12%; ER: <3%)

1% to 10%:

Cardiovascular: Acute myocardial infarction (4%), cardiac failure (2%), palpitations (≤7%), transient hypotension (5%)

Dermatologic: Dermatitis (IR), diaphoresis, pruritus, skin rash (ER), urticaria

Gastrointestinal: Abdominal cramps (IR), abdominal pain (ER), constipation (≤3%), diarrhea, dyspepsia (ER), flatulence, xerostomia (ER)

Genitourinary: Impotence (ER), sexual difficulty (IR)

Nervous system: Balance impairment (IR), chills (IR), drowsiness (ER), fatigue (ER: 6%), insomnia (ER), jitteriness (IR), mood changes (IR: ≤7%), nervousness (≤7%), pain (ER), paresthesia (ER), shakiness (IR), sleep disturbance (IR)

Neuromuscular & skeletal: Arthralgia (ER), joint stiffness (IR), lower limb cramp (ER), muscle cramps (IR: ≤8%), tremor (IR: ≤8%; ER: <1%)

Ophthalmic: Blurred vision (IR)

Renal: Polyuria (ER: <3%; IR: <1%)

Respiratory: Chest congestion (IR), cough (IR: ≤6%; ER: <1%), dyspnea, nasal congestion (IR), pleuritic chest pain (ER), pulmonary edema (2%), wheezing (IR: ≤6%)

Miscellaneous: Fever, inflammation (IR)

<1%:

Cardiovascular: Cardiac arrhythmia, cardiac conduction disorder, erythromelalgia, exacerbation of angina pectoris, facial edema, hypotension (may be severe hypotension), syncope, tachycardia, ventricular arrhythmia

Dermatologic: Alopecia, exfoliative dermatitis

Endocrine & metabolic: Decreased libido, gout, gynecomastia, hot flash, weight gain

Gastrointestinal: Dysgeusia, eructation, gastroesophageal reflux disease, gastrointestinal hemorrhage, gastrointestinal irritation, gingival hyperplasia, melena, vomiting

Genitourinary: Dysuria, hematuria, mastalgia, nocturia

Hematologic & oncologic: Anemia, leukopenia, purpuric disease, thrombocytopenia

Hepatic: Hepatitis (allergic)

Hypersensitivity: Angioedema

Nervous system: Anxiety, ataxia, depression, hypertonia, hypoesthesia, malaise, migraine, nightmares, paranoid ideation, rigors, vertigo

Neuromuscular & skeletal: Arthritis (with positive ANA), back pain, myalgia

Ophthalmic: Abnormal lacrimation, periorbital edema, transient blindness (at peak of plasma level; can be unilateral), visual disturbance

Otic: Tinnitus

Respiratory: Epistaxis, sinusitis, upper respiratory tract infection

Frequency not defined:

Endocrine & metabolic: Increased lactate dehydrogenase

Gastrointestinal: Cholecystitis

Hepatic: Increased serum alanine aminotransferase, increased serum alkaline phosphatase, increased serum aspartate aminotransferase

Neuromuscular & skeletal: Increased creatine phosphokinase in blood specimen

Postmarketing:

Dermatologic: Acute generalized exanthematous pustulosis (Roujeau 1991, Tripathy 2009), bullous skin disease (Morimoto 2021), erythema multiforme (Bewley 1993), psoriasis (Song 2021), skin photosensitivity (Seggev 1996; Thomas 1986; Zenarola 1991), Stevens-Johnson syndrome (Stern 1989), toxic epidermal necrolysis

Gastrointestinal: Bezoar formation, gastrointestinal obstruction (Juurlink 2014), gastrointestinal ulcer (Lavy 1999)

Hematologic & oncologic: Malignant neoplasm of lip (Friedman 2012), positive direct Coombs test

Contraindications

Hypersensitivity to nifedipine or any component of the formulation.

Note: Considered contraindicated in patients with ST-elevation myocardial infarction (STEMI) (ACCF/AHA [O'Gara 2013]); avoid use (Elkayam 1990; FDA 2015).

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to other dihydropyridine calcium antagonists; severe hypotension; cardiovascular shock; concomitant use with rifampicin; breast-feeding; pregnancy or women of childbearing potential. Note: SOGC guidelines recommend nifedipine as a preferred agent for maternal hypertension (SOGC [Magee 2022]). Extended release only: Kock pouch (ileostomy after proctocolectomy); moderate or severe hepatic impairment; severe gastrointestinal obstructive disorders. Immediate release only: Acute myocardial infarction.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Hypotension/syncope: IR nifedipine should not be used for acute BP reduction.

Disease-related concerns:

• Aortic stenosis: Use with extreme caution in patients with severe aortic stenosis; may reduce coronary perfusion resulting in myocardial ischemia.

• GI strictures: Alterations in GI anatomy (eg, severe GI narrowing, history of GI cancer, obstruction, bowel resection, gastric bypass, vertical banded gastroplasty) and underlying hypomotility disorders have led to bezoar formation with extended release forms.

• Heart failure: The American College of Cardiology/American Heart Association heart failure guidelines recommend to avoid use in patients with heart failure due to lack of benefit and/or worse outcomes with calcium channel blockers in general (FDA 2015).

• Hepatic impairment: Use with caution in patients with hepatic impairment. Clearance of nifedipine is reduced in cirrhotic patients leading to increased systemic exposure; monitor closely for adverse effects/toxicity and consider dose adjustments.

• Hypertrophic cardiomyopathy (HCM) with outflow tract obstruction: Use with caution in patients with HCM and outflow tract obstruction since reduction in afterload may worsen symptoms associated with this condition.

Dosage form specific issues:

• Extended release formulation: Consists of drug within a nondeformable matrix; following drug release/absorption, the matrix/shell is expelled in the stool. The use of nondeformable products in patients with known stricture/narrowing of the GI tract (eg, severe gastrointestinal narrowing, colon cancer, obstruction, bowel resection, gastric bypass, vertical banded gastroplasty) has been associated with symptoms of obstruction (pharmacobezoar).

• Immediate release formulation: Immediate release formulations should not be used to manage primary hypertension, adequate studies to evaluate outcomes have not been conducted.

• Lactose: Adalat CC tablets contain lactose; do not use with galactose intolerance, congenital lactase deficiency, or glucose-galactose malabsorption syndromes.

Other warnings/precautions:

• Surgery: Use with caution before major surgery. Cardiopulmonary bypass, intraoperative blood loss or vasodilating anesthesia may result in severe hypotension and/or increased fluid requirements. Consider withdrawing nifedipine (>36 hours) before surgery if possible.

• Withdrawal: Abrupt withdrawal may cause rebound angina in patients with coronary artery disease.

Warnings: Additional Pediatric Considerations

The "bite and swallow" method of administering immediate-release nifedipine is not recommended; variability of dose supplied via this method may lead to an overdose and result in significant side effects (eg, hypotension) in pediatric patients (Flynn 2003). An extemporaneous solution should be compounded to provide the most accurate dosing (see "Extemporaneous Preparations").

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Procardia: 10 mg [DSC]

Generic: 10 mg, 20 mg

Tablet Extended Release 24 Hour, Oral:

Procardia XL: 30 mg, 60 mg, 90 mg

Generic: 30 mg, 60 mg, 90 mg

Generic Equivalent Available: US

Yes

Pricing: US

Capsules (NIFEdipine Oral)

10 mg (per each): $0.46 - $1.29

20 mg (per each): $0.99 - $2.30

Tablet, 24-hour (NIFEdipine ER Oral)

30 mg (per each): $0.41 - $1.39

60 mg (per each): $0.54 - $2.48

90 mg (per each): $0.67 - $3.03

Tablet, 24-hour (NIFEdipine ER Osmotic Release Oral)

30 mg (per each): $1.10 - $1.39

60 mg (per each): $1.83 - $3.50

90 mg (per each): $2.31 - $2.91

Tablet, 24-hour (Procardia XL Oral)

30 mg (per each): $7.93

60 mg (per each): $13.72

90 mg (per each): $15.83

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: 5 mg, 10 mg

Tablet Extended Release 24 Hour, Oral:

Adalat XL: 20 mg [DSC], 30 mg, 60 mg [DSC]

Generic: 30 mg, 60 mg

Administration: Adult

Oral:

Immediate release: In general, may be administered with or without food.

Extended release: Tablets should be swallowed whole; do not crush, split, or chew.

Adalat CC, Afeditab CR: Administer on an empty stomach (per manufacturer). Other extended release products may not have this recommendation; consult product labeling.

Bariatric surgery: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. IR capsule formulation is available. If safety and efficacy of nifedipine can be effectively monitored, no change in formulation or administration is required after bariatric surgery; however, selection of IR formulation or alternative therapy is advised for cardiovascular and other high-risk labeled and off-label indications.

Administration: Pediatric

Oral:

Immediate release: In general, administer with or without food. If using extemporaneously compounded oral suspension, use calibrated device to accurately measure dose.

Extended release: Tablets should be swallowed whole; do not crush, break, chew, or divide.

Use: Labeled Indications

Angina: Management of chronic stable or vasospastic angina.

Hypertension, chronic: Management of hypertension (ER products only).

Use: Off-Label: Adult

Anal fissure; High-altitude pulmonary edema; Hypertensive emergency in pregnancy or postpartum (including acute-onset severe hypertension in preeclampsia/eclampsia); Pulmonary arterial hypertension, group 1; Raynaud phenomenon; Tocolysis

Medication Safety Issues

Sound-alike/look-alike issues:

NIFEdipine may be confused with niCARdipine, niMODipine, nisoldipine

Procardia XL may be confused with Cartia XT

Older Adult: High-Risk Medication:

Beers Criteria: Nifedipine (immediate release) is identified as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) due to its potential to cause hypotension and risk for precipitating myocardial ischemia (Beers Criteria [AGS 2023]).

Nifedipine is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) with severe symptomatic aortic stenosis (O’Mahony 2023).

International issues:

Depin [India] may be confused with Depen brand name for penicillamine [US]; Depon brand name for acetaminophen [Greece]; Dipen brand name for diltiazem [Greece]

Nipin [Italy and Singapore] may be confused with Nipent brand name for pentostatin [US, Canada, and multiple international markets]

Metabolism/Transport Effects

Substrate of CYP2D6 (minor), CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Alcohol (Ethyl): May increase the serum concentration of NIFEdipine. Risk C: Monitor therapy

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Atosiban: Calcium Channel Blockers may enhance the adverse/toxic effect of Atosiban. Specifically, there may be an increased risk for pulmonary edema and/or dyspnea. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Beta-Blockers: NIFEdipine may enhance the hypotensive effect of Beta-Blockers. NIFEdipine may enhance the negative inotropic effect of Beta-Blockers. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Calcium Salts: May diminish the therapeutic effect of Calcium Channel Blockers. Risk C: Monitor therapy

Cimetidine: May increase the serum concentration of Calcium Channel Blockers. Risk C: Monitor therapy

Cladribine: Inhibitors of Equilibrative Nucleoside (ENT1) and Concentrative Nucleoside (CNT3) Transport Proteins may increase the serum concentration of Cladribine. Management: Avoid concomitant use of ENT1 or CNT3 inhibitors during the 4 to 5 day oral cladribine treatment cycles whenever possible. If combined, consider an ENT1 or CNT3 inhibitor dose reduction and separation in the timing of administration. Risk D: Consider therapy modification

Clofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Clopidogrel: Calcium Channel Blockers may diminish the therapeutic effect of Clopidogrel. Risk C: Monitor therapy

CycloSPORINE (Systemic): Calcium Channel Blockers (Dihydropyridine) may increase the serum concentration of CycloSPORINE (Systemic). CycloSPORINE (Systemic) may increase the serum concentration of Calcium Channel Blockers (Dihydropyridine). Risk C: Monitor therapy

CYP3A4 Inducers (Moderate): May decrease the serum concentration of NIFEdipine. Risk C: Monitor therapy

CYP3A4 Inducers (Strong): May decrease the serum concentration of NIFEdipine. Management: Avoid coadministration of nifedipine with strong CYP3A4 inducers when possible and if combined, monitor patients closely for clinical signs of diminished nifedipine response. Risk D: Consider therapy modification

CYP3A4 Inhibitors (Moderate): May increase the serum concentration of NIFEdipine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of NIFEdipine. Management: Consider alternatives to this combination when possible. If combined, initiate nifedipine at the lowest dose available and monitor patients closely for increased nifedipine effects and toxicities (eg, hypotension, edema). Risk D: Consider therapy modification

Dantrolene: May enhance the hyperkalemic effect of Calcium Channel Blockers. Dantrolene may enhance the negative inotropic effect of Calcium Channel Blockers. Risk X: Avoid combination

Dapoxetine: May enhance the orthostatic hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Digoxin: NIFEdipine may increase the serum concentration of Digoxin. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Fexinidazole: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

FLUoxetine: May increase the serum concentration of NIFEdipine. Risk C: Monitor therapy

Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Consider avoiding this combination if possible. If required, monitor patients closely for increased adverse effects of the CYP3A4 substrate. Risk D: Consider therapy modification

Grapefruit Juice: May increase the serum concentration of NIFEdipine. Risk X: Avoid combination

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Iloperidone: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Inhalational Anesthetics: May enhance the hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy

Isocarboxazid: May enhance the antihypertensive effect of Antihypertensive Agents. Risk X: Avoid combination

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Magnesium Sulfate: May enhance the adverse/toxic effect of Calcium Channel Blockers (Dihydropyridine). Specifically, the risk of hypotension or muscle weakness may be increased. Risk C: Monitor therapy

Melatonin: May diminish the antihypertensive effect of Calcium Channel Blockers (Dihydropyridine). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Neuromuscular-Blocking Agents (Nondepolarizing): Calcium Channel Blockers may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

QuiNIDine: NIFEdipine may decrease the serum concentration of QuiNIDine. NIFEdipine may increase the serum concentration of QuiNIDine. QuiNIDine may increase the serum concentration of NIFEdipine. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sincalide: Drugs that Affect Gallbladder Function may diminish the therapeutic effect of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Risk D: Consider therapy modification

Tacrolimus (Systemic): Calcium Channel Blockers (Dihydropyridine) may increase the serum concentration of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

VinCRIStine: NIFEdipine may increase the serum concentration of VinCRIStine. Risk C: Monitor therapy

VinCRIStine (Liposomal): NIFEdipine may increase the serum concentration of VinCRIStine (Liposomal). Risk C: Monitor therapy

Food Interactions

Nifedipine serum levels may be decreased if taken with food. Food may decrease the rate but not the extent of absorption of Procardia XL. Increased nifedipine concentrations resulting in therapeutic and vasodilator side effects, including severe hypotension and myocardial ischemia, may occur if nifedipine is taken by patients ingesting grapefruit. Management: Avoid grapefruit/grapefruit juice.

Reproductive Considerations

Medications considered acceptable for the treatment of chronic hypertension during pregnancy may generally be continued in patients trying to conceive. Nifedipine is one of the medications patients can transition to if currently taking an agent that is ineffective or should be avoided during pregnancy (ACC/AHA [Whelton 2018]. ACOG 2019, NICE 2019).

Pregnancy Considerations

Nifedipine crosses the placenta (Mulrenin 2021; van de Vusse 2022).

An increase in perinatal asphyxia, cesarean delivery, prematurity, and intrauterine growth restriction have been reported following maternal use (ESC [Regitz-Zagrosek 2018]).

Chronic maternal hypertension is also associated with adverse events in the fetus/infant. Chronic maternal hypertension may increase the risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to the duration and severity of maternal hypertension. Untreated chronic hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, preeclampsia, delivery complications, stroke, and myocardial infarction (ACOG 2019a).

Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of nifedipine may be altered. Close monitoring is recommended (Mulrenin 2021; van de Vusse 2022).

Patients with preexisting hypertension may continue their medication during pregnancy unless contraindications exist (ESC [Regitz-Zagrosek 2018]). When treatment for chronic hypertension is initiated during pregnancy, long-acting oral nifedipine is one of the preferred agents; avoid in patients with tachycardia (ACOG 2019a; ESC [Regitz-Zagrosek 2018]; SOGC [Magee 2022]). IR oral nifedipine is recommended for the management of acute-onset, severe hypertension in pregnant and postpartum patients, including those with preeclampsia or eclampsia (ACOG 2020; ESC [Cífková 2020]; ESC [Regitz-Zagrosek 2018]; SOGC [Magee 2022]).

IR oral nifedipine has also been evaluated for the treatment of preterm labor. Tocolytics may be used for the short-term (48-hour) prolongation of pregnancy to allow for the administration of antenatal steroids and should not be used prior to fetal viability or when the risks of use to the fetus or mother are greater than the risk of preterm birth (ACOG 2016). Nifedipine is ineffective for maintenance tocolytic therapy (ACOG 2016; Aggarwal 2018; Roos 2013; Verspyck 2017).

Breastfeeding Considerations

Nifedipine is present in breast milk.

Multiple reports summarize data related to the presence of nifedipine in breast milk:

• Breast milk was sampled in a patient following a full-term delivery who received nifedipine 10 mg/day prior to the study. Nifedipine 20 mg was administered on the day of the study at 10 days postpartum. Nifedipine and the pyridine metabolite were present in breast milk. Peak concentrations occurred ~1 hour following the maternal dose (Penny 1989).

• Following delivery at 26 weeks gestation, breast milk was sampled in a patient who received nifedipine 30 mg every 8 hours for 48 hours, followed by nifedipine 20 mg every 8 hours for 48 hours, then 10 mg every 8 hours for 36 hours. The highest breast milk concentration (53.35 ng/mL) occurred within 1 hour of the 30 mg dose. The highest breast milk concentrations following the 20 mg and 10 mg doses were 16.35 ng/mL and 12.89 ng/mL, respectively. Nifedipine was measurable in breast milk 8 hours following the 20 mg and 30 mg doses, but not the 10 mg dose. The reported half-life of nifedipine in breast milk was ~3 hours (Ehrenkranz 1989).

• Using a milk concentration of 53.35 ng/mL, the estimated daily infant dose of nifedipine via breast milk is 8 mcg/kg/day providing a relative infant dose (RID) of 0.27% to 3.2% compared to an infant therapeutic dose of 0.25 to 3 mg/kg/day.

• In general, breastfeeding is considered acceptable when the RID is <10% (Anderson 2016; Ito 2000).

• In addition to maternal dose, breast milk concentrations may be influenced by maternal ABCG2 genotype. Nifedipine is a substrate to ABCG2 transporter which is expressed on lactating breasts. Patients genotyped as wild-type homozygous 421CC (n=13) had lower breast milk concentrations of nifedipine than patients genotyped as 421CA heterozygous (n=6) following a maternal dose of slow-release nifedipine 20 mg administered 15 to 30 days postpartum (Malfará 2019).

The use of nifedipine in breastfeeding patients for the treatment of Raynaud phenomenon has been described in case reports and case series; no adverse events were noted in the infants exposed to nifedipine via breast milk (Anderson 2004; Barrett 2013; Garrison 2002; Jansen 2019; Page 2006; Wu 2012).

Nifedipine is considered compatible with breastfeeding (ESC [Cífková 2020]; SOGC [Magee 2022]; WHO 2002), although data following long-term use is limited (WHO 2002). According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

The Academy of Breastfeeding Medicine recommends the use of nifedipine for the treatment of Raynaud phenomenon of the nipple in breastfeeding mothers (ABM [Berens 2016]).

Dietary Considerations

Avoid grapefruit juice with all products.

Immediate release: Capsule is rapidly absorbed orally if it is administered without food, but may result in vasodilator side effects; if flushing is problematic, administration with low-fat meals may decrease. In general, can take with or without food.

Monitoring Parameters

Heart rate; blood pressure; peripheral edema.

Mechanism of Action

Inhibits calcium ion from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation; increases myocardial oxygen delivery in patients with vasospastic angina; also reduces peripheral vascular resistance, producing a reduction in arterial blood pressure.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Immediate release: ~20 minutes

Protein binding (concentration dependent): 92% to 98%; Note: Protein-binding may be significantly decreased in patients with renal or hepatic impairment

Metabolism: Hepatic via CYP3A4 to inactive metabolites

Bioavailability: Capsule: 40% to 77%; ER: 65% to 89% relative to immediate release capsules; bioavailability increased with significant hepatic disease

Half-life elimination: Adults: Healthy: 2 to 5 hours; Cirrhosis: 7 hours; Elderly: 7 hours (extended release tablet)

Excretion: Urine (60% to 80% as inactive metabolites); feces

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Older adult: Mean C_max is 36% higher and plasma concentration is 70% greater in elderly patients.

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Adalat | Coracten | Epilat | Fenamon | Nifecard | Zenusin;
(AR) Argentina: Adalat | Nifecor | Nifed sol | Nifedel | Nifedipina | Nifedipina r 20 | Nifelat | Nifenitron | Nitenk;
(AT) Austria: Adalat | Fedip | Majolat | Nifebene | Nifedipin stada artzneimittel | Nifedipin-genericon pharma | Nifehexal;
(AU) Australia: Adalat | Adapine | Addos xr | Adefin | Adefin xl | Apo-Nifedipine XR | Chemmart Nifedipine | Cm nifedipine | Nifecard | Nifedipine-bc | Nifehexal | Nyefax | Sbpa nifedipine | Terry White Chemists Nifedipine | Tw nifedipine;
(BD) Bangladesh: Ampine | Fenamon | Ficard | Nefelon | Nicodin | Nidipine | Nifecap | Nifecard | Nifedin | Nificap | Nifin;
(BE) Belgium: Adalat | Hypan | Nifedipine doc | Nifedipine eg | Nifedipine mylan | Nifedipine ratiopharm | Nifeslow;
(BF) Burkina Faso: Adalat | Adalate la | Arconifed sr | Nifcal | Nifedi denk 10 retard | Nifedi denk 20 retard | Nifedipine lp tm;
(BG) Bulgaria: Adalat | Adalat Eins | Adalat oros | Cordaflex | Cordipin xl | Corinfar | Korincare | Korincare neo | Nifedipin;
(BR) Brazil: Adalat | Adalat oros | Adalex | Adcor | Cardalin | Cronodipin | Dilaflux | Dilavax | Dipinal | Loncord | Neo fedipina | Nifadil | Nifedax | Nifedicard | Nifedipress | Nifehexal | Nioxil | Normopres | Oxcord;
(CH) Switzerland: Adalat | Cardipin | Corotrend | Ecodipin | Nife-basan | Nifedipin "genericon" | Nifedipin Helvepharm | Nifedipin mepha | Nifedipin Sandoz | Nifedipin spirig | Nifedipin spirig hc | Nifedipin upsa;
(CI) Côte d'Ivoire: Adalat la | Adalate | Apo nifedipine | Arconifed sr | Nifesha;
(CL) Chile: Adalat | Angiodisten | Carbloc | Cardicon | Nifedipino | Nifedipino L.Ch. | Nipress | Nipress Oad | Pabalat | Sulotil;
(CN) China: Adalat | De gao ning | Ecodipin | Er kang bi tong | Heng xin | Jiu bao ka di | Jiu bao ping | Jupocardia | Na xin tong | Ni fu da | Nifedipin ratiopharm | Nifedipine extended release tablets (iii) | Nifedipine sustained release tablets (i) | Nifedipine sustained release tablets (ii) | Nifedipine sustained release tablets (iv) | Sai yan teng | Sheng tong ping | Tian hai li | Xin ran | Yi xin | Yi xin ping;
(CO) Colombia: Acerdil 24 horas | Beclazone | Cardiosol | Nicaloc | Nifecor | Nifedipina | Nifedipino | Nifetabs | Nifevas-O | Tensomax | Tensopin;
(CZ) Czech Republic: Adalat | Apo nifed | Cordafen | Cordipin | Cordipin xl | Corinfar | Coronipin | Depin e | Nifecard | Nifehexal | Pidilat | Sponif | Supracordin;
(DE) Germany: Adalat | Adalate | Aprical | Cisday | Coracten | Cordicant | Corinfar | Corotrend | Dignokonstant | Duranifin | Jedipin | Jutadilat | Nife | Nife biochemie | Nife klast | Nife wolff | Nife-puren | Nifeclair | Nifecor | Nifedipat | Nifedipin | Nifedipin al | Nifedipin denk | Nifedipin Sandoz | Nifedipin stada | Nifedipin Verla | Nifehexal | Nifelat | Nifical | Nifsigma | Pidilat;
(DK) Denmark: Adalat oros | Nifedipin alternova;
(DO) Dominican Republic: Adalat | Adalat oros | Cardiomed | Corapres | Dilcor | Evopril sr | Fusepina | Lufradipina | Nicardia xl | Nifecol | Nifed | Nifedicor | Nifedilat | Nifedip | Nifedipina | Nifedipina alfa | Nifedipina Inmenol | Nifedipina Lam | Nifedipina retard lam | Nifedipino | Nifedipres | Nifek | Nifelac | Nificard | Nifpin AP | Nitensor | Presnife retard 30 | Presnife retard 60 | Tensopin | Unifedipina;
(EC) Ecuador: Nifedin | Nifedipina | Nifedipino | Nifelan | Zenusin;
(EE) Estonia: Adalat | Adalat crono | Adalat oros | Cordafen | Cordaflex | Cordipin | Cordipin xl | Corinfar | Nifangin | Nifebene | Nifecard | Nifedeks | Nifedipin | Nifedipin ratiopharm | Nifedipina mylan | Nifehexal | Nifesan | Nifetard | Niphedipin | Nycopin | Nycopin depo | Phenihydin | Sanfidipin | Sponif;
(EG) Egypt: Adalat | Cardiopine | Dilcor | Epilat | Epilat retard | Nifepin | Vasonipine;
(ES) Spain: Adalat | Adalat oros | Cordilan | Dilcor | Nifedipino bayvit | Nifedipino ratiopharm | Pertensal;
(ET) Ethiopia: Depin e retard | Epilat retard | Nifedi denk 10 retard | Nifedi denk 20 retard;
(FI) Finland: Adalat | Adalat oros | Coronipin | Enilevol | Nical | Nifangin | Nifdemin | Nifecor | Nifedipin alternova | Onidin;
(FR) France: Adalate | Chronadalate | Mapakna lp | Nifedipine Arrow | Nifedipine eg | Nifedipine g gam | Nifedipine gnr | Nifedipine merck | Nifedipine ratiopharm | Nifedipine rpg | Nifedipine sandoz | Nifedipine teva | Nifedirex;
(GB) United Kingdom: Adalat | Adanif | Adipine | Adipine mr | Angiopine | Calanif | Calchan mr | Calcilat | Cardilate mr | Cardiofin | Coracten | Coroday | Dexipress MR 20 | Fortipine | Fortipine la | Fortipine nye | Genalat | Hypolar | Kentipine | Nidef | Nifedipine Arrow | Nifedipine berk | Nifedipine cox | Nifedipine kent | Nifedipine sandoz | Nifedipress | Nifedipress berk | Nifedipress cox | Nifedipress sandoz | Nifedotard | Nifelease | Nifensar | Nifopress | Nimodrel | Nivaten | Slofedipine | Tensipine MR | Unipine xl | Valni | Vasad;
(GH) Ghana: Cardigen retard | Ndip | Ndip xr | Nifedose | NIFIN 20 R | Novodep | Pinek | Pinfed sr | Retardine XL | Vl nifedipine | Vynif;
(GR) Greece: Adalat | Antiblut | Coracten | Flecor n | Glopir | Macorel | Nefelid | Nifedicor | Nifedipat | Nifedipin al | Nifelat | Viscard;
(HK) Hong Kong: Adalat | Apo nifedipine | Cardilate mr | Carditas | Coracten | Cordipin | Nadipinia | Nifecard | Nifecard xl | Nifelat | Nifopress | Vasdalat | Waridipin;
(HR) Croatia: Cordipin | Nifedipin | Nifedipin Pliva;
(HU) Hungary: Adalat | Cordaflex | Cordipin xl | Corinfar | Huma-nifedin | Nidipin | Nifecard xl | Nifedipin al;
(ID) Indonesia: Adalat | Calcianta | Calcigard | Carvas | Cordalat | Coronipin | Farmalat | Fedipin | Ficor | Inficard | Nifecard | Nifedin | Pincard | Vasdalat | Vasoner | Xepalat | Zendalat;
(IE) Ireland: Adalat | Adanif | Adefin xl | Coracten | Nifed | Nifelease | Nifensar | Systepin | Tensipine MR | Vasofed;
(IL) Israel: Megalat | Nifedilong | Nifedipine teva | Pressolat;
(IN) India: Adalat | Alnipine | Calbloc | Calcigard | Calnif | Cardipin | Cardovasc xl | Cardules | Depicor | Depin | Dolocard | Myogard | Myogard la | Nacten | Needin | Nepin | Nexidin | Nf | Nfd retard | Nicardia | Nicardia retard | Nifed | Nifedine | Nifelat | Niferil;
(IT) Italy: Adalat | Adalat a.r. | Adalat crono | Citilat | Coral | Euxat | Fenidina | Nifedicor | Nifedicron | Nifedin | Nifedipina | Nifedipina doc | Nifedipina eg | Nifedipina mylan generica | Nifedipina provvisoria | Nifesal | Nipin;
(JO) Jordan: Adalat | Coracten | Epilat | Fenamon | Myogard | Nifecard;
(JP) Japan: Adalat | ADALAT CR | Allotop l sawai | Allotop l tsumura | Alonix s | Anpect | Atanaal mita | Atanaal sawai | Atanaal towa | Atenerate kaken | Atenerate l mita | Atenerate merck hoei | Atenerate tsuruhara | Cardiobren | Cardioluft l | Cardioluft l fuji | Casanmil | Casanmil s | Celebrate | Cobalat | Cobalate kobayashi kako | Corinael | Corodilate | Emaberin | Emaberin l | Herlat | Kepakuru l | Kisalart hexal | Kisalart nichiiko | Knoramin | Knoramin chemiphar | Lemar | Marivolon | Menoprizin l | Milfadin | Moderat | Nalicidin | Nerabole kotobuki | Nerabole zeria | Nifedipine fujimoto | Nifedipine Kyorin Rimedio | Nifedipine L | Nifedipine merck hoei | Nifedipine mylan | Nifedipine nichiiko | Nifedipine teva | Nifedipine tsuruhara | Nifedipine yoshindo | Nifelanterin cr | Nifelantern | Nifelat | Nifelat l | Nifeplan L | Nifeslow | Nifpine | Nirena | Palpeat kyowa hakko | Palpeat pfizer | Ramitalate | Ramitalate taiyo | Ramitalate towa | Ramitalate-L | Ramitlalate l kayaku | Ronian | Sepamit | Siopelmin l | Towarat | Towarat l;
(KE) Kenya: Adalat | Adalat la | Calcigard retard | Carditas retard | Depin e retard | Epilat retard | Nefdin | Nefin er | Nepif retard | Nepin sr | Nicardia | Nicardin sr | Nifecard xl | Nifed retard | Nifedi denk | Nifelat r | Nifelat retard | Nifpine retard | Nipine sr | Zenusin 20 sr;
(KR) Korea, Republic of: Adalat | Adalat oros | Adapine osmo | Caranta | Dongkoo nifedipine | Fedipine 24 | Hadipine | Hawon nifedipine | Medicoret | Nadipine | Neprin | Nifedin | Nifedipinaeuderma | Nifedix | Nifedsol | Nifel | Nifelan | Nifendal | Niferon | Niferon cr | Nipidin | Nipine | Niporin | Pidipin | Sanodipine | Union nifedipine;
(KW) Kuwait: Adalat | Coracten | Zenusin;
(LB) Lebanon: Adalat | Apo nifed | Dilcor | Nifedicor | Nifedip | Nifelat | Nifelat r | Niferetard | Nipin | Zenusin;
(LT) Lithuania: Adalat | Adalat oros | Apo nifed | Calcigarde | Cordafen | Cordaflex | Cordipin | Corinfar | Coronipin | Depin e | Nifadil | Nifebene | Nifecard | Nifedeks | Nifedipin | Nifedipin al | Nifedipin ratiopharm | Nifedipin stada | Nifedipin stada uno | Nifehexal | Nifesan | Phenihidin | Sanfidipin;
(LU) Luxembourg: Adalat | Aprical | Hypan | Nifedipine mylan | Nifehexal;
(LV) Latvia: Adalat | Adalat oros | Calcigarde | Cordafen | Cordipin | Corinfar | Coronipin | Depin e | Duranifin | Fenamon | Nifadil | Nifecard | Nifedex | Nifedipin | Nifesan | Night rest | Phenihidin | Sanfidipin;
(MA) Morocco: Adalate | Apo nifed | Chronadalate | Coracten | Nifedicor | Nifegen | Pharmadipine | Servidipine;
(MX) Mexico: Adalat | Anhiten a | Apo-fidipisal | Cordilat | Corogal | Corotrend | Difepar | Fusepina | Gelprim | Kabloc | Linam | Nifar | Nifar gb | Nifedigel | Nifedipino | Nifedipino bruluart | Nifedipino gi | Nifedipino gi serr | Nifedipino hispanoamericano | Nifedipino protein | Nifezzard | Nifser | Notinzalten | Noviken LP | Pidef;
(MY) Malaysia: Adalat | Adifen | Calcigard | Cordipin | Fenamon | Nicardia xl | Nifecard | Nifecip | Nifedipin | Nifehexal | Nifehexal retard | Nifelat | Niferin sr | Nudipin | Servidipine | Uphadipine;
(NG) Nigeria: Acefex | Adalat la | Adopine | Cardipin | D glopa nifedipine | Eglofedipine | Epnif retard | Eufedipine | Exus nifedipine | Fladipine retard | Glopir retard | Hartipin | Jamcelia nifedipine | Lifeback nifedipine retard | Macfedipine | Milton nifedipine | Myolax | Nicardia xl | Nifebond | Nifecard xl | Nifecure | Nifedin dexcel | Nifetab | Normodipin | Orfedipine | Patuo sr | Rebok nifedipine | Replek nifedipine retard | Scrip nifedipine | Topnife | Transglobe nifedipine | Zenusin 20 sr | Zibadipin;
(NL) Netherlands: Adalat | Adalat oros | Adalate | Nifedipin abz | Nifedipin acis | Nifedipin al | Nifedipine A | Nifedipine accord | Nifedipine merck | Nifedipine PCH | Nifedipine ratiopharm | Nifedipine sandoz;
(NO) Norway: Adalat | ADALAT CR | Adalat crono | Adalat la | Adalat oros | Adalat unimedic | Adalat xl | Nifedipin | Nifedipin al | Nifedipin ratiopharm | Nifedipine cf | Nifedipine sandoz | Nifenova | Nycopin;
(NZ) New Zealand: Adalat | Adefin xl | Arrow nifedipine | Nyefax | Tensipine MR;
(PE) Peru: Angidex | Fediral | Nifedipino | Nifedipino genfar | Nifensar | Nifepharm | Tensomax | Unipine xl;
(PH) Philippines: Adalat | Angipine | Calcibloc | Calcicor | Calgina | Cardicap | Darat | Denkifed | Fedcor | Fedipin | Hartigard | Heblopin | Heblopine | Hyperten | Nelapine | Nicardia | Nicardia xl | Nifecar | Nifedipine Medicap | Nifedipine Pacific | Nifelan | Nifestad | Normadil | Odipin | Servidipine | Tensibloc;
(PK) Pakistan: Adalat | Anifed | Caranta | Cardipine | Masdipine sr | Nidipine | Nifecard | Nifed | Nifedi denk | Nifedicor | Nifedil | Nifelat | Ronian;
(PL) Poland: Adalat | Cordafen | Cordipin | Corinfar | Nifecard | Nifedicor | Nifedipin acis | Nifedipin al | Nifedipin ratiopharm | Nifehexal;
(PR) Puerto Rico: Adalat | Afeditab CR | Nifediac CC | Nifedical | Nifedipine er | Nifedipine extended release | Procardia;
(PT) Portugal: Adalat | Adalat a.p. | Besdipina | Corinfar | Nifedate | Nifedipina | Nifedipina Generis | Nifedipina ratiopharm | Zenusin 20 sr;
(PY) Paraguay: Adalat | Cuorex retard | Nifedil a.r. | Nifeten | Nifeten retard | Tensimeg | Tensoprel retard;
(QA) Qatar: Adalat | Adalat LA | Adalat Retard | Adalat XL | Epilat | Epilat Retard | Myogard | Nifedipin AL | Nifedipine AL | Nifedipress MR | Valni Retard;
(RO) Romania: Adalat | Cordafen | Cordipin | Corinfar | Epilat retard;
(RU) Russian Federation: Adalat | Calcigard | Calcigard retard | Calcigarde | Carinfer | Cordafen | Cordaflex | Cordipin | Cordipin xl | Corinfar | Corinfar retard | Fenamon | Nicardia | Nicardia cd retard | Nifebene | Nifecard | Nifecard xl | Nifedex | Nifedicap | Nifedipin | Nifedipin ns | Nifedipin-fpo | Nifedipine akrihin | Nifedipine mik | Nifehexal | Nifelat | Nifesan | Nificard | Osmo adalat | Phenihidin | Vero nifedipin;
(SA) Saudi Arabia: Adalat | Apo nifedipine | Epilat | Nifecard;
(SE) Sweden: Adalat | Adalat oros;
(SG) Singapore: Adalat | Apo nifed | Cardiolat | Cordipin | Cordipin xl | Depin e retard | Fenamon | Nifecard | Nifedi denk | Nifedipine la | Nipin | Vasdalat;
(SI) Slovenia: Adalat | Adalat oros | Cordipin | Nifecard;
(SK) Slovakia: Cordafen | Cordipin | Cordipin xl | Corinfar | Nifecard | Nifehexal | Sponif;
(TH) Thailand: Adalat | Adipine | Apo nifed | Calcigard | Carnif | Coracten | Depin e retard | Fenamon | Jedipin | Nelapine | Nicaloc | Nicardia | Nicardia cd | Nifecard | Nifedi denk | Nifedipin stada | Nifedipine ratiopharm | Nifelat | Nifelat r | Nifelat-q | Nificard | Nifiran | Niufedepine | Nyefax | Servidipine | Stada Uno | Towarat | Zenusin;
(TN) Tunisia: Adalate | Anifed | Coracten | Corinfar | Nifedicor | Nifepine;
(TR) Turkey: Adalat | Adalat crono | Kardilat | Nidicard | Nidilat;
(TW) Taiwan: Adalat | Adalat cc | Adalat oros | Adapine | Ajulate | Alat | Alonix s | Apo nifed | Atanaal | Badipine | Cardiobren | Citilat | Coracten | Coral | Coronipin | Dekalat | Emaberin | Fedipine | Fenamon | Glopir | Harwell | Memoprizin | Nedipin | Neocardia | Nidepin | Nidomate | Nifate | Nifecardia | Nifed | Nifedin | Nifehexal | Nifelan | Nifelat | Nifepine | Niferos oros | Nirena | Nisimlone | Nisipin | Nit | Palpeat | Posipin | Ronian | Servidipine | Sidalat | Sindipine | Towarat;
(UA) Ukraine: Adalat | Cordafen | Cordaflex | Cordipin | Cordipin retard | Cordipin xl | Corinfar | Corinfar retard | Epilat | Fenamon | Nicardia | Nifecard | Nifedicap | Nifedipin | Nifelat | Osmo adalat | Phenihidin;
(UG) Uganda: Adalat la | Agopine | Calcigard retard | Carditas retard | Fenamon sr | Nepin sr | Nicardia | Nifedi denk 20 retard | Nifelat | Nifelat retard;
(UY) Uruguay: Adalat | Ciruton | Cordipin | Cuorex | Ficarel | Nifed sol | Nifedel | Nifedilat | Nifedin | Nifedipina | Novodipen | Tonacor;
(VE) Venezuela, Bolivarian Republic of: Adalat | Adalat oros | Cardiosol | Conducil | Fedilex | Nifal | Nifebiopina | Nifedicor retard | Nifedipina | Nifedipina lp | Nifedipino | Nioxil | Tensodiam | Tensomax | Tensopin;
(VN) Viet Nam: Nifedipin hasan | Nifedipin t20 retard | Nifehexal 30 la | Nifephabaco | Pymenife;
(ZA) South Africa: Adalat | Anginor-20 cr | Apo nifedipine | Bio nifedipine xl | Cardifen | Cardilat | Cipalat | Fedaloc | Gitsalat | Macorel | Nifedalat | Norton-nifedipine | Rolab-nifedipine | Spec nifedipine | Vascard;
(ZM) Zambia: Calcigard | Calnif | Cardifen | Carditas retard | Nifedi denk | Nifelat | Nipine sr;
(ZW) Zimbabwe: Adalat xl | Calcigard retard | Nifelat

2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
Adalat XL (nifedipine extended release tablet) [product monograph]. Mississauga, Ontario, Canada: Bayer Inc; June 2023.
Adcock KG, Wilson JT. Nifedipine Labeling Illustrates the Pediatric Dilemma for Off-Patent Drugs. Pediatrics. 2002;109(2):319-321. [PubMed 11826214]
Aggarwal A, Bagga R, Girish B, Kalra J, Kumar P. Effect of maintenance tocolysis with nifedipine in established preterm labour on pregnancy prolongation and neonatal outcome. J Obstet Gynaecol. 2018;38(2):177-184. doi:10.1080/01443615.2017.1331340 [PubMed 28784001]
Agrawal V, Kaushal G, Gupta R. Randomized controlled pilot trial of nifedipine as oral therapy vs. topical application in the treatment of fissure-in-ano. Am J Surg. 2013;206(5):748-751. doi:10.1016/j.amjsurg.2013.05.003 [PubMed 24035211]
American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 171: Management of preterm labor. Obstet Gynecol. 2016;128(4):e155-e164. doi:10.1097/AOG.0000000000001711 [PubMed 27661654]
American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 222: Gestational hypertension and preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260. doi:10.1097/AOG.0000000000003891 [PubMed 32443079]
American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 203: Chronic hypertension in pregnancy. Obstet Gynecol. 2019a;133(1):e26-e50. doi:10.1097/AOG.0000000000003020 [PubMed 30575676]
American College of Obstetricians and Gynecologists (ACOG). ACOG Committee Opinion No. 767: Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2019b;133(2):e174-e180. doi:10.1097/AOG.0000000000003075 [PubMed 30575639]
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. doi:10.1016/j.jacc.2014.09.017 [PubMed 25260718]
Anderson JE, Held N, Wright K. Raynaud's phenomenon of the nipple: a treatable cause of painful breastfeeding. Pediatrics. 2004;113(4):e360-364. doi:10.1542/peds.113.4.e360 [PubMed 15060268]
Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. [PubMed 27060684]
Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation, 2004, 110(9):e82-292. [PubMed 15339869]
Aronow WS, Fleg JL, Pepine CJ, et al; ACCF Task Force. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation. 2011;123(21):2434-2506. doi:10.1161/CIR.0b013e31821daaf6 [PubMed 21518977]
ASHP. Standardize 4 Safety Initiative Compounded Oral Liquid Version 1.01. July 2017. https://www.ashp.org/-/media/assets/pharmacy-practice/s4s/docs/s4s-ashp-oral-compound-liquids.ashx?la=en&hash=4C2E4F370B665C028981B61F6210335AD5D0D1D6.
August P. Treatment of hypertension in pregnant and postpartum patients. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 6, 2023.
Barrett ME, Heller MM, Stone HF, Murase JE. Raynaud phenomenon of the nipple in breastfeeding mothers: an underdiagnosed cause of nipple pain. JAMA Dermatol. 2013;149(3):300-306. [PubMed 23682366]
Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O. Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med. 1991;325(18):1284-1289. doi: 10.1056/NEJM199110313251805. [PubMed 1922223]
Berens P, Eglash A, Malloy M, Steube AM. ABM clinical protocol #26: persistent pain with breastfeeding. Breastfeed Med. 2016;11(2):46-53. [PubMed 26881962]
Bertel O. Symptomatic hypotension induced by nifedipine. Arch Intern Med. 1987;147(9):1683-1684. [PubMed 3632177]
Bewley AP, Feher MD, Staughton RC. Erythema multiforme following substitution of amlopidine for nifedipine. BMJ. 1993;307(6898):241. doi:10.1136/bmj.307.6898.241-a [PubMed 8369687]
Blaszak RT, Savage JA, Ellis EN. The use of short-acting nifedipine in pediatric patients with hypertension. J Pediatr, 2001;139(1):34-37. doi: 10.1067/mpd.2001.114699. [PubMed 11445791]
Bleday R. Anal fissure: Medical management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed May 5, 2020.
Boden WE, Korr KS, Bough EW. Nifedipine-induced hypotension and myocardial ischemia in refractory angina pectoris. JAMA. 1985;253(8):1131-1135. [PubMed 2857206]
Chobanian AV, Bakris GL, Black HR, et al, “The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report,” JAMA, 2003, 289(19):2560-72. [PubMed 12748199]
Cífková R, Johnson MR, Kahan T, et al. Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension. Eur Heart J Cardiovasc Pharmacother. 2020;6(6):384-393. doi:10.1093/ehjcvp/pvz082 [PubMed 31841131]
Deen-Duggins L, Fry HR, Clay JR, Turner JR. Nifedipine-associated gingival overgrowth: a survey of the literature and report of four cases. Quintessence Int. 1996;27(3):163-170. [PubMed 9063228]
Deshwal R, Iqbal M, Basnet S. Nifedipine for the treatment of high altitude pulmonary edema. Wilderness Environ Med. 2012;23(1):7-10. doi: 10.1016/j.wem.2011.10.003. [PubMed 22441082]
Dilmen U, Cagfülar MK, Senses A, et al, “Nifedipine in Hypertensive Emergencies of Children,” Am J Dis Child, 1983, 137(12):1162-5. [PubMed 6637932]
Egger DW, Deming DD, Hamada N, Perkin RM, Sahney S. Evaluation of the safety of short-acting nifedipine in children with hypertension. Pediatr Nephrol. 2002;17(1):35-40. doi: 10.1007/s004670200006. [PubMed 11793132]
Ehrenkranz RA, Ackerman BA, Hulse JD. Nifedipine transfer into human milk. J Pediatr. 1989;114(3):478-480. doi:10.1016/s0022-3476(89)80579-7 [PubMed 2921695]
Elkayam U, Amin J, Mehra A, Vasquez J, Weber L, Rahimtoola SH. A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure. Circulation. 1990;82(6):1954-1961. [PubMed 2242521]
Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
Ezri T, Susmallian S. Topical nifedipine vs. topical glyceryl trinitrate for treatment of chronic anal fissure. Dis Colon Rectum. 2003;46(6):805-808. [PubMed 12794583]
Flynn JT. Safety of short-acting nifedipine in children with severe hypertension. Expert Opin Drug Saf. 2003;2(2):133-139. [PubMed 12904113]
Flynn JT, Kaelber DC, Baker-Smith CM, et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3). doi: 10.1542/peds.2017-1904. [PubMed 28827377]
Flynn JT, Pasko DA. Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension. Pediatr Nephrol, 2000;15(3-4):302-316. [PubMed 11149130]
Friedman GD, Asgari MM, Warton EM, Chan J, Habel LA. Antihypertensive drugs and lip cancer in non-Hispanic whites. Arch Intern Med. 2012;172(16):1246-1251. doi: 10.1001/archinternmed.2012.2754. [PubMed 22869299]
Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi: 10.1210/jc.2015-4061. [PubMed 26934393]
Furberg CD, Psaty BM, Meyer JV. Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation. 1995;92(5):1326-1331. doi:10.1161/01.cir.92.5.1326 [PubMed 7648682]
Gallagher SA, Hackett P. High-altitude pulmonary edema. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed August 5, 2022.
Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologist and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2019 executive summary [published correction appears in Endocr Pract. 2019;25(2):204]. Endocr Pract. 2019;25(1):69-100. doi:10.4158/CS-2018-0535 [PubMed 30742570]
Garrison CP. Nipple vasospasms, Raynaud's syndrome, and nifedipine. J Hum Lact. 2002;18(4):382-385. [PubMed 12449056]
Go AS, Bauman M, King SM, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. Published online November 15, 2013. [PubMed 24243703]
Goundry B, Bell L, Langtree M, Moorthy A. Diagnosis and management of Raynaud's phenomenon. BMJ. 2012;344:e289. doi:10.1136/bmj.e289 [PubMed 22315243]
Harel-Raviv M, Eckler M, Lalani K, Raviv E, Gornitsky M. Nifedipine-induced gingival hyperplasia. A comprehensive review and analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(6):715-722. [PubMed 7621029]
Hopkins W, Rubin LJ. Treatment of pulmonary arterial hypertension (group 1) in adults: Pulmonary hypertension-specific therapy. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed January 27, 2023.
Humbert M, Kovacs G, Hoeper MM, et al; ESC/ERS Scientific Document Group. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43(38):3618-3731. doi:10.1093/eurheartj/ehac237 [PubMed 36017548]
Impey L. Severe hypotension and fetal distress following sublingual administration of nifedipine to a patient with severe pregnancy induced hypertension at 33 weeks. Br J Obstet Gynaecol. 1993;100(10):959-961. doi:10.1111/j.1471-0528.1993.tb15120.x [PubMed 8217985]
Ito S. Drug therapy for breast-feeding women. N Engl J Med. 2000;343(2):118-126. doi:10.1056/NEJM200007133430208 [PubMed 10891521]
James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. Published online December 18, 2013. [PubMed 24352797]
Jansen S, Sampene K. Raynaud phenomenon of the nipple: an under-recognized condition. Obstet Gynecol. 2019;133(5):975-977. [PubMed 30969221]
Jung SY, Choi NK, Kim JY, et al. Short-acting nifedipine and risk of stroke in elderly hypertensive patients. Neurology. 2011;77(13):1229-1234. doi:10.1212/WNL.0b013e318230201a [PubMed 21849654]
Juurlink DN, Hellings C, Gomes T, et al. Extended-release nifedipine and the risk of intestinal obstruction: a population-based study. BMJOpen. 2014;4:e005377. doi:10.1136/bmjopen-2014-005377
Khoo F, Mathur M. Severe resistant maternal hypotension following tocolysis with nifedipine. BMJ Case Rep. 2014;2014:bcr2014208059. doi:10.1136/bcr-2014-208059 [PubMed 25515131]
Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int. 2021;99(3S):S1-S87. doi:10.1016/j.kint.2020.11.003 [PubMed 33637192]
Kleinbloesem CH, van Brummelen P, Breimer DD. Nifedipine. Relationship between pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 1987;12(1):12-29. doi:10.2165/00003088-198712010-00002 [PubMed 3545614]
Kleinbloesem CH, van Brummelen P, van Harten J, Danhof M, Breimer DD. Nifedipine: influence of renal function on pharmacokinetic/hemodynamic relationship. Clin Pharmacol Ther. 1985;37(5):563-574. doi:10.1038/clpt.1985.89 [PubMed 3987180]
Kleinbloesem CH, van Brummelen P, Woittiez AJ, Faber H, Breimer DD. Influence of haemodialysis on the pharmacokinetics and haemodynamic effects of nifedipine during continuous intravenous infusion. Clin Pharmacokinet. 1986;11(4):316-322. doi:10.2165/00003088-198611040-00004 [PubMed 3757391]
Klinger JR, Elliott CG, Levine DJ, et al. Therapy for pulmonary arterial hypertension in adults: update of the CHEST guideline and expert panel report. Chest. 2019;155(3):565-586. doi:10.1016/j.chest.2018.11.030 [PubMed 30660783]
Kowal-Bielecka O, Fransen J, Avouac J, et al; EUSTAR Coauthors. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017;76(8):1327-1339. doi:10.1136/annrheumdis-2016-209909 [PubMed 27941129]
Lavy A. Corrosive effect of nifedipine in the upper gastrointestinal tract. Diagn Ther Endosc. 1999;6(1):39-41. doi:10.1155/DTE.6.39 [PubMed 18493524]
Liptzin DR, Abman SH, Giesenhagen A, Ivy DD. An approach to children with pulmonary edema at high altitude. High Alt Med Biol. 2018;19(1):91-98. doi:10.1089/ham.2017.0096 [PubMed 29470103]
Lopez-Herce J, Albajara L, Cagigas P, et al, “Treatment of Hypertensive Crisis in Children With Nifedipine,” Intensive Care Med, 1988, 14(5):519-21. [PubMed 3221006]
Luks AM, Auerbach PS, Freer L, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019;30(4S):S3-S18. doi:10.1016/j.wem.2019.04.006 [PubMed 31248818]
Luks AM, McIntosh SE, Grissom CK, et al; Wilderness Medical Society. Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update. Wilderness Environ Med. 2014;25(4 suppl):S4-S14. doi:10.1016/j.wem.2014.06.017. [PubMed 25498261]
Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002 [PubMed 35577426]
Makani H, Bangalore S, Romero J, et al. Peripheral edema associated with calcium channel blockers: incidence and withdrawal rate--a meta-analysis of randomized trials. J Hypertens. 2011;29(7):1270-1280. doi:10.1097/HJH.0b013e3283472643 [PubMed 21558959]
Malfará BN, Benzi JRL, de Oliveira Filgueira GC, et al. ABCG2 c.421C>A polymorphism alters nifedipine transport to breast milk in hypertensive breastfeeding women. Reprod Toxicol. 2019;85:1-5. doi: 10.1016/j.reprotox.2019.01.007. [PubMed 30659932]
Mann JFE, Flack JM. Choice of drug therapy in primary (essential) hypertension. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 7, 2023.
Martre H, Sari R, Taburet AM, Jacobs C, Singlas E. Haemodialysis does not affect the pharmacokinetics of nifedipine. Br J Clin Pharmacol. 1985;20(2):155-158. doi:10.1111/j.1365-2125.1985.tb05049.x [PubMed 4041333]
McLaughlin VV, Archer SL, Badesch DB, et al; American College of Cardiology Foundation Task Force on Expert Consensus Documents; American Heart Association; American College of Chest Physicians; American Thoracic Society, Inc; Pulmonary Hypertension Association. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53(17):1573-1619. doi:10.1016/j.jacc.2009.01.004 [PubMed 19389575]
Meyrick Thomas RH, Rademaker M, Grimes SM, et al. Nifedipine in the treatment of Raynaud's phenomenon in patients with systemic sclerosis. Br J Dermatol. 1987;117(2):237-241. doi:10.1111/j.1365-2133.1987.tb04122.x [PubMed 3307894]
Morimoto K, Yoshida T, Washida N, et al. Bullous pemphigoid in patients receiving peritoneal dialysis: a case series and a literature survey. Ren Fail. 2021;43(1):651-657. doi:10.1080/0886022X.2021.1910045 [PubMed 33820495]
Muller JE, Morrison J, Stone PH, et al. Nifedipine therapy for patients with threatened and acute myocardial infarction: a randomized, double-blind, placebo-controlled comparison. Circulation. 1984;69(4):740-747. doi:10.1161/01.cir.69.4.740 [PubMed 6365350]
Mulrenin IR, Garcia JE, Fashe MM, et al. The impact of pregnancy on antihypertensive drug metabolism and pharmacokinetics: current status and future directions. Expert Opin Drug Metab Toxicol. 2021;17(11):1261-1279. doi:10.1080/17425255.2021.2002845 [PubMed 34739303]
National Heart, Lung, and Blood Institute. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Clinical Practice Guidelines. National Institutes of Health; 2011. http://www.nhlbi.nih.gov/guidelines/cvd_ped/peds_guidelines_full.pdf [PubMed 1681227]
National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. NICE guideline, No. 133. http://www.nice.org.uk/guidance/ng133. Published June 25, 2019. Accessed December 1, 2022.
Nery EB, Edson RG, Lee KK, Pruthi VK, Watson J. Prevalence of nifedipine-induced gingival hyperplasia. J Periodontol. 1995;66(7):572-578. doi:10.1902/jop.1995.66.7.572 [PubMed 7562349]
Nifedipine capsules [product monograph]. Vaughan, Ontario, Canada: AA Pharma Inc; December 2023.
Nifedipine capsules, USP [prescribing information]. Indianapolis, IN: Major Pharmaceuticals; March 2022.
Nifedipine extended release tablet [prescribing information]. Orlando, FL: Ingenus Pharmaceuticals, LLC; March 2018.
Nishikawa SJ, Tada H, Hamasaki A, et al. Nifedipine-induced gingival hyperplasia: a clinical and in vitro study. J Periodontol. 1991;62(1):30-35. doi:10.1902/jop.1991.62.1.30 [PubMed 2002429]
Nishimura RA, Otto CM, Bonow RO, et al; ACC/AHA Task Force Members. 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440-2492. doi:10.1161/CIR.0000000000000029 [PubMed 24589852]
Oelz O, Maggiorini M, Ritter M, et al. Prevention and treatment of high altitude pulmonary edema by a calcium channel blocker. Int J Sports Med. 1992;13(suppl 1):S65-S68. doi:10.1055/s-2007-1024598 [PubMed 1483797]
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):e362-e425. doi:10.1161/CIR.0b013e3182742cf6 [PubMed 23247304]
O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1007/s41999-023-00777-y [PubMed 37256475]
Otto CA. Altitude-associated illness in children (acute mountain sickness). In: Kliegman RM, St. Geme J, eds. Nelson Textbook of Pediatrics. 21st ed. Saunders Elsevier; 2019:chap. 90.
Page SM, McKenna DS. Vasospasm of the nipple presenting as painful lactation. Obstet Gynecol. 2006;108(3, pt 2):806-808. [PubMed 17018510]
Pedrinelli R, Dell'Omo G, Mariani M. Calcium channel blockers, postural vasoconstriction and dependent oedema in essential hypertension. J Hum Hypertens. 2001;15(7):455-461. doi:10.1038/sj.jhh.1001201 [PubMed 11464254]
Penny WJ, Lewis MJ. Nifedipine is excreted in human milk. Eur J Clin Pharmacol. 1989;36(4):427-428. doi:10.1007/BF00558309 [PubMed 2737237]
Pollard AJ, Niermeyer S, Barry P, et al. Children at high altitude: an international consensus statement by an ad hoc committee of the International Society for Mountain Medicine, March 12, 2001. High Alt Med Biol. 2001;2(3):389-403. doi:10.1089/15270290152608561 [PubMed 11682018]
Poole-Wilson PA, Lubsen J, Kirwan BA, et al; Coronary disease Trial Investigating Outcome with Nifedipine gastrointestinal therapeutic system investigators. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Lancet. 2004;364(9437):849-857. doi:10.1016/S0140-6736(04)16980-8 [PubMed 15351192]
Procardia (nifedipine) [prescribing information]. New York, NY: Pfizer; July 2016.
Procardia XL (nifedipine) [prescribing information]. New York, NY: Pfizer; May 2021.
Rademaker M, Cooke ED, Almond NE, et al. Comparison of intravenous infusions of iloprost and oral nifedipine in treatment of Raynaud's phenomenon in patients with systemic sclerosis: a double blind randomised study. BMJ. 1989;298(6673):561-564. doi:10.1136/bmj.298.6673.561 [PubMed 2467711]
Raynaud's Treatment Study Investigators. Comparison of sustained-release nifedipine and temperature biofeedback for treatment of primary Raynaud phenomenon. Results from a randomized clinical trial with 1-year follow-up. Arch Intern Med. 2000;160(8):1101-1108. [PubMed 10789602]
Refer to manufacturer's labeling.
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al; ESC Scientific Document Group. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165-3241. doi:10.1093/eurheartj/ehy340 [PubMed 30165544]
Rich S, Kaufmann E, Levy PS. The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med. 1992;327(2):76-81. doi:10.1056/NEJM199207093270203 [PubMed 1603139]
Roos C, Spaanderman ME, Schuit E, et al; APOSTEL-II Study Group. Effect of maintenance tocolysis with nifedipine in threatened preterm labor on perinatal outcomes: a randomized controlled trial. JAMA. 2013;309(1):41-47. doi:10.1001/jama.2012.153817 [PubMed 23280223]
Rosen WJ, Johnson CE. Evaluation of Five Procedures for Measuring Nonstandard Doses of Nifedipine Liquid. Am J Hosp Pharm. 1989;46(11):2313-2317. [PubMed 2589350]
Roujeau JC, Bioulac-Sage P, Bourseau C, et al. Acute generalized exanthematous pustulosis. Analysis of 63 cases. Arch Dermatol. 1991;127(9):1333-1338. [PubMed 1832534]
Seggev JS, Lagstein Z. Photosensitivity skin reactions to calcium channel blockers. J Allergy Clin Immunol. 1996;97(3):852-855. doi:10.1016/s0091-6749(96)80164-3 [PubMed 8613643]
Silverstein LH, Koch JP, Lefkove MD, Garnick JJ, Singh B, Steflik DE. Nifedipine-induced gingival enlargement around dental implants: a clinical report. J Oral Implantol. 1995;21(2):116-120. [PubMed 8699502]
Simhan HN, Caritis S. Inhibition of acute preterm labor. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 9, 2023.
Singh D, Akingbola O, Yosypiv I, El-Dahr S. Emergency management of hypertension in children. Int J Nephrol. 2012;2012:420247. doi:10.1155/2012/420247 [PubMed 22577545]
Snider ME, Nuzum DS, Veverka A. Long-acting nifedipine in the management of the hypertensive patient. Vasc Health Risk Manag. 2008;4(6):1249-1257. doi:10.2147/vhrm.s3661 [PubMed 19337538]
Song G, Yoon HY, Yee J, Kim MG, Gwak HS. Antihypertensive drug use and psoriasis: a systematic review, meta- and network meta-analysis. Br J Clin Pharmacol. Published online October 5, 2021. doi:10.1111/bcp.15060 [PubMed 34611920]
Spital A, Scandling JD. Nifedipine in continuous ambulatory peritoneal dialysis. Arch Intern Med. 1983;143(10):2025. [PubMed 6625800]
Steele RM, Schuna AA, Schreiber RT. Calcium antagonist-induced gingival hyperplasia. Ann Intern Med. 1994;120(8):663-664. [PubMed 8135450]
Stern R, Khalsa JH. Cutaneous adverse reactions associated with calcium channel blockers. Arch Intern Med. 1989;149(4):829-832. [PubMed 2523214]
Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR. Clinical practice guideline for the management of anal fissures. Dis Colon Rectum. 2017;60(1):7-14. doi:10.1097/DCR.0000000000000735 [PubMed 27926552]
Thompson AE, Pope JE. Calcium channel blockers for primary Raynaud's phenomenon: a meta-analysis. Rheumatology (Oxford). 2005;44(2):145-150. doi:10.1093/rheumatology/keh390 [PubMed 15546967]
Thomas E, Witt P, Willis M, Morse J. Nifedipine therapy for diffuse esophageal spasm. South Med J. 1986;79(7):847-849. doi:10.1097/00007611-198607000-00017 [PubMed 3726585]
Tripathy S, Mishra M. Nifedipine-induced acute generalized exanthematous pustulosis in a case of acute glomerulonephritis. Indian J Dermatol Venereol Leprol. 2009;75(4):408-410. doi:10.4103/0378-6323.53150 [PubMed 19584474]
US Food and Drug Administration (FDA). FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. 2015. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-strengthens-warning-non-aspirin-nonsteroidal-anti-inflammatory.
van de Vusse D, Mian P, Schoenmakers S, et al. Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: a systematic review. Eur J Clin Pharmacol. 2022;78(11):1763-1776. doi:10.1007/s00228-022-03382-3 [PubMed 36104450]
van Veen AJ, Pelinck MJ, van Pampus MG, Erwich JJ. Severe hypotension and fetal death due to tocolysis with nifedipine. BJOG. 2005;112(4):509-510. doi:10.1111/j.1471-0528.2004.00480.x [PubMed 15777455]
Varon J, Elliott WJ. Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 1, 2022.
Verspyck E, de Vienne C, Muszynski C, et al. Maintenance nifedipine therapy for preterm symptomatic placenta previa: A randomized, multicenter, double-blind, placebo-controlled trial. PLoS One. 2017;12(3):e0173717. doi:10.1371/journal.pone.0173717 [PubMed 28333939]
Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119. doi:10.1161/CIR.0000000000001168 [PubMed 37471501]
Wachter RM. Symptomatic hypotension induced by nifedipine in the acute treatment of severe hypertension. Arch Intern Med. 1987;147(3):556-558. [PubMed 3827433]
Wald A, Bharucha AE, Limketkai B, et al. ACG clinical guidelines: management of benign anorectal disorders. Am J Gastroenterol. 2021;116(10):1987-2008. doi:10.14309/ajg.0000000000001507 [PubMed 34618700]
Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16(1):14-26. doi:10.1111/jch.12237 [PubMed 24341872]
Westbrook P, Bednarczyk EM, Carlson M, Sheehan H, Bissada NF. Regression of nifedipine-induced gingival hyperplasia following switch to a same class calcium channel blocker, isradipine. J Periodontol. 1997;68(7):645-650. doi:10.1902/jop.1997.68.7.645 [PubMed 9249636]
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Hypertension. 2018;71(6):e140-e144]. Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065 [PubMed 29133356]
Wigley FM. Clinical practice. Raynaud's phenomenon. N Engl J Med. 2002;347(13):1001-1008. doi:10.1056/NEJMcp013013 [PubMed 12324557]
Wigley FM. Treatment of Raynaud phenomenon: Initial management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed January 31, 2020a.
World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the eleventh WHO model list of essential drugs. 2002. https://apps.who.int/iris/handle/10665/62435.
Wu M, Chason R, Wong M. Raynaud's phenomenon of the nipple. Obstet Gynecol. 2012;119(2, pt 2):447-449. doi:10.1097/AOG.0b013e31822c9a73 [PubMed 22270434]
Wynn RL. Calcium channel blockers and gingival hyperplasia--an update. Gen Dent. 2009;57(2):105-107. [PubMed 19552357]
Ye Z, Yang H, Li H, et al. A multicentre, prospective, randomized trial: comparative efficacy of tamsulosin and nifedipine in medical expulsive therapy for distal ureteric stones with renal colic. BJU Int. 2011;108(2):276-279. [PubMed 21083640]
Yiu V, Orrbine E, Rosychuk RJ, et al. The safety and use of short-acting nifedipine in hospitalized hypertensive children. Pediatr Nephrol. 2004;19(6):644-650. doi:10.1007/s00467-004-1444-x [PubMed 15054645]
Zenarola P, Gatti S, Lomuto M. Photodermatitis due to nifedipine: report of 2 cases. Dermatologica. 1991;182(3):196-198. doi:10.1159/000247783 [PubMed 1831774]
Zhang MY, Ding ST, Lü JJ, et al. Comparison of tamsulosin with extracorporeal shock wave lithotripsy in treating distal ureteral stones. Chin Med J (Engl). 2009;122(7):798-801. [PubMed 19493392]

Topic 9700 Version 666.0

خرید پکیج

Nifedipine: Drug information