Adalat CR

Nifedipine

Mild to moderate HTN, CHD: Stable angina pectoris (angina of effort).

Initially 30 mg once daily in the morning. Increase if necessary up to max 120 mg once daily.

May be taken with or without food: Avoid grapefruit juice. Swallow whole, do not chew/crush.

Hypersensitivity. CV shock; Kock pouch. Concomitant use w/ rifampicin. Pregnancy & lactation.

Impaired liver function. Severe hypotension (systolic pressure <90 mm Hg). Carefully monitor BP. Preexisting severe GI narrowing. False +ve effect when doing barium contrast X-ray. Concomitant use w/ erythromycin, ritonavir, ketoconazole, antidepressants, nefazodone & fluoxetine, quinupristin/dalfopristin, valproic acid, cimetidine. May impair ability to drive or operate machinery.  

Headache; oedema, vasodilation; constipation; feeling unwell.

Clearance may be altered by drugs known to either inhibit or induce CYP450 3A4 enzyme system. Reduced bioavailability & weakened efficacy w/ rifampicin & phenytoin. Potential increase in plasma conc w/ erythromycin, fluoxetine, nefazodone, quinupristin/dalfopristin, valproic acid, cisapride. Substantial increase in plasma conc & decreased elimination w/ ritonavir. Substantial increase in systemic bioavailability & decreased 1st pass metabolism w/ ketoconazole. Elevated plasma conc & antihypertensive effect may be potentiated w/ cimetidine. Decrease in plasma conc & efficacy may occur w/ carbamazepine or phenobarb. Increase BP lowering effect of diuretics, β-blockers, ACE inhibitors, angiotensin 1 (AT1) receptor-antagonist, other Ca antagonists, α-adrenergic blocking agents, phosphodiesterase-5 inhibitors, α-methyldopa. May reduce clearance & increase plasma conc of digoxin. Increase plasma conc of quinidine. Tacrolimus. Elevated plasma conc & prolonged action w/ grapefruit juice. 

Calcium Antagonists / Anti-Anginal Drugs / Cardiac Drugs

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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