Nifedipine Cf (Nifedipine)

• Nifedipine belongs to the calcium channel blocker class and is employed in cardiovascular and peripheral vascular disorders.
• Hypertension: lowers systolic and diastolic pressure by relaxing arterial smooth muscle.
• Angina pectoris: reduces myocardial oxygen demand through vasodilation and improved coronary blood flow.
• Raynaud's phenomenon: alleviates vasospasm in peripheral arteries, improving blood flow to extremities.

• Nifedipine selectively inhibits L‑type calcium channels in vascular smooth muscle and cardiac myocytes. By blocking calcium influx, it prevents contraction of arterial smooth muscle, leading to vasodilation, reduced peripheral resistance, and decreased cardiac workload. The resulting drop in blood pressure and improved coronary perfusion underlies its therapeutic effects in hypertension and angina.

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

Common Side Effects

• Headache: often transient and related to vasodilation.
• Flushing: warm sensation, usually mild.
• Peripheral edema: swelling of ankles or feet.
• Dizziness or light‑headedness, especially on standing.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure requiring medical attention.
• Myocardial infarction: rare but reported in susceptible patients.
• Hepatic dysfunction: abnormal liver enzymes or hepatitis.
• Allergic reactions: rash, itching, or anaphylaxis.
• Cardiac arrhythmias: irregular heart rhythms that may be life‑threatening.

• Before initiating therapy, clinicians should evaluate patient‑specific factors and monitor for potential complications.
• Monitor blood pressure: adjust dose based on response.
• Avoid sudden position changes: reduce risk of orthostatic hypotension.
• Use caution in heart failure: may exacerbate symptoms.
• Review concomitant CYP3A4 inhibitors: may increase nifedipine levels.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Nifedipine can interact with several drug classes, influencing its efficacy and safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may cause toxic plasma concentrations.
• Concurrent use with other potent antihypertensives (e.g., clonidine): risk of excessive hypotension.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: additive effects on heart rate and blood pressure.
• Digoxin: increased risk of digitalis toxicity.
• Grapefruit juice: may raise nifedipine levels.
• Diuretics: monitor electrolytes and volume status.