Nifedipine L.P. Arrow (Nifedipine)

• Nifedipine is employed in cardiovascular and peripheral vascular conditions, acting through vasodilation of arterial smooth muscle.
• Hypertension: lowers systemic blood pressure by reducing peripheral vascular resistance.
• Angina pectoris: relieves chest pain by decreasing myocardial oxygen demand.
• Raynaud's phenomenon: improves blood flow to extremities, reducing episodic vasospasm.

• Nifedipine selectively blocks L‑type calcium channels in vascular smooth muscle and cardiac myocytes. Inhibition of calcium influx prevents contraction, leading to arterial vasodilation, reduced after‑load, and decreased myocardial oxygen consumption, which underlies its antihypertensive and anti‑anginal effects.

Adverse reactions may range from mild to severe and should be monitored during therapy.

Common Side Effects

• Headache: mild to moderate intensity.
• Flushing: transient warmth and redness.
• Peripheral edema: swelling of ankles or feet.
• Dizziness or light‑headedness: especially on standing.
• Nausea: occasional gastrointestinal upset.
• Gingival hyperplasia: overgrowth of gum tissue.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure.
• Myocardial infarction: rare but possible in high‑risk patients.
• Atrioventricular block: conduction disturbances.
• Liver enzyme elevation: hepatotoxicity signs.
• Allergic reactions: rash, pruritus, or anaphylaxis.
• Thrombocytopenia: low platelet count.

• Before initiating therapy, consider patient‑specific factors and monitor for adverse events.
• Renal impairment: adjust monitoring as excretion may be altered.
• Hepatic disease: use caution; liver metabolism may be affected.
• Concomitant antihypertensives: risk of additive blood pressure lowering.
• Elderly patients: start at lower doses due to increased sensitivity.
• Pregnancy and lactation: safety not established; weigh benefits against risks.
• Store at ambient temperature: keep in original container, protect from moisture and direct sunlight.

Nifedipine may interact with several drug classes, influencing its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase plasma levels.
• Grapefruit juice: can markedly raise nifedipine concentrations.
• Simultaneous use with other calcium channel blockers: risk of excessive hypotension.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: additive heart rate reduction.
• Diuretics: may enhance orthostatic hypotension.
• Antacids containing aluminum or magnesium: may reduce absorption if taken simultaneously.
• Rifampin: may lower nifedipine levels, reducing efficacy.
• Digoxin: monitor for potential increased serum digoxin concentrations.