Generic Medicine Info
Extended-release tab: Should be taken on an empty stomach. Swallow whole, do not crush/split/chew. Avoid grapefruit juice.
Immediate-release: May be taken with or without food. Avoid grapefruit juice.
Cardiogenic shock, clinically significant aortic stenosis, unstable angina, during or within 1 month of MI, acute attacks of angina; secondary prevention of MI. Concomitant use with rifampicin.
Special Precautions
Patient with hypotension, poor cardiac reserve, heart failure, hypertrophic cardiomyopathy with outflow tract obstruction, diabetes mellitus; undergoing major surgery. Extended-release form: Patient with oesophageal obstruction, Kock pouch (ileostomy after proctocolectomy), inflammatory bowel disease, gastrointestinal strictures (e.g. severe gastrointestinal narrowing, obstruction, bowel resection, gastric bypass, colon cancer, vertical banded gastroplasty). Immediate-release preparations are not recommended to manage angina or hypertension. Avoid abrupt withdrawal. Hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, lethargy, and transient blindness due to severe hypotension; if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, heart rate, LFTs; signs and symptoms of heart failure and peripheral oedema.
Adverse Reactions
Significant: Peripheral oedema, reflex tachycardia, increased angina or MI, cardiac ischaemic pain, symptomatic hypotension with or without syncope; impaired glucose tolerance. Rarely, bezoar formation (use of extended-release formulation in patients with gastrointestinal strictures). Gastrointestinal disorders: Constipation, abdominal pain, dyspepsia, flatulence, dry mouth, nausea. General disorders and administration site conditions: Feeling unwell, oedema, fatigue. Musculoskeletal and connective tissue disorders: Muscle cramps. Nervous system disorders: Headache, dizziness, tremor. Psychiatric disorders: Nervousness, mood changes. Respiratory, thoracic and mediastinal disorders: Nasal congestion, cough, wheezing, sore throat, dyspnoea. Vascular disorders: Vasodilatation, flushing.
Drug Interactions
May cause additive hypotensive effects with IV Mg sulfate and other antihypertensive agents (e.g. β-blockers, ACE inhibitors, diuretics). Increased exposure and plasma concentration with erythromycin, ritonavir, ketoconazole, fluoxetine, nefazodone, quinupristin/dalfopristin, cisapride, valproic acid, cimetidine, diltiazem. May increase plasma levels of digoxin and tacrolimus. Decreased exposure with phenytoin, carbamazepine, phenobarbital. May reduce plasma concentrations of quinidine.
CIMS Class
Anti-Anginal Drugs / Calcium Antagonists
ATC Classification
C08CA05 - nifedipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
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