Nifedipina Eg (Nifedipine)

• Nifedipine acts on the cardiovascular system to lower vascular resistance and improve myocardial oxygen balance.
• Hypertension: reduces systolic and diastolic blood pressure by vasodilation.
• Chronic stable angina: decreases myocardial oxygen demand, relieving chest pain during exertion.
• Raynaud's phenomenon: improves peripheral blood flow, reducing episodes of vasospasm.

• Nifedipine selectively blocks L‑type calcium channels in vascular smooth muscle and cardiac myocytes. Inhibition of calcium influx prevents contraction of arterial smooth muscle, causing vasodilation and lowering peripheral resistance, while also reducing calcium‑dependent myocardial contractility, which together lower blood pressure and myocardial oxygen consumption.

Nifedipine may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Flushing: warm sensation and reddening of skin.
• Headache: often due to rapid vasodilation.
• Dizziness or light‑headedness, especially on standing.
• Peripheral edema: swelling of ankles or feet.
• Tachycardia: increased heart rate.
• Hypotension: low blood pressure causing faintness.

Serious or Rare Side Effects

• Severe hypotension leading to syncope.
• Myocardial infarction or worsening angina.
• Life‑threatening arrhythmias.
• Hepatic dysfunction or jaundice.
• Allergic reactions such as rash, Stevens‑Johnson syndrome, or anaphylaxis.
• Severe bradycardia or heart block.

Before prescribing Nifedipine, clinicians should consider several safety measures.

• Blood pressure monitoring: ensure adequate control and avoid excessive drops.
• Cardiac assessment: evaluate for heart failure or recent myocardial infarction.
• Hepatic function: dose adjustment may be needed in severe liver disease.
• Concomitant antihypertensives: watch for additive hypotensive effects.
• Abrupt discontinuation: taper to prevent rebound hypertension.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Nifedipine can interact with several drug classes, altering its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): increase nifedipine levels and risk of toxicity.
• Grapefruit juice: markedly raises plasma concentrations.
• Concurrent use with other potent vasodilators (e.g., nitroglycerin): may cause severe hypotension.

Moderate Interactions (Monitor Closely):\n- Beta‑blockers: additive effect on heart rate and blood pressure.

• Digoxin: may increase serum digoxin concentrations.
• Diuretics: enhance hypotensive response.
• Other calcium channel blockers: risk of cumulative cardiovascular depression.
• NSAIDs: may blunt antihypertensive effect.