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Calcium Channel Blocker·Cardiovascular - Antihypertensives
Hypertension, angina
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Max Dose
120 mg/day
Half-life
15 h (XR)
Caution: Edema
COMMON
High risk: IR Form
AVOID
Avoid / Cautions
Acute STEMI (within 8 days), cardiogenic shock, severe aortic stenosis. Pregnancy Category C, but XR widely used as standard of care in maternal medicine.
Overview
Potent dihydropyridine CCB. The extended-release (XR/OROS) formulation is safe and effective for BP control, but immediate-release forms are dangerous in hypertension.
Clinical Focus
Never use short-acting sublingual or chewed nifedipine for hypertensive urgencies due to risk of fatal cerebral/myocardial ischemia.
Bottom Line
Nifedipine XR is a potent antihypertensive safe in pregnancy (gestational hypertension), but short-acting/sublingual nifedipine must never be used due to risk of stroke and MI.
Brand Names
Adalat OROS, Adefin XL, Nifehexal
Oral Routes
Extended-release tablets (30 mg, 60 mg). OROS tablets leave a 'ghost' shell in stool.
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Hypertension, angina.
Off-Label
Tocolysis in premature labour, Raynaud's phenomenon, High-altitude pulmonary oedema.
Clinical Place
Widely used in pregnancy-induced hypertension where ACEi/ARBs are strictly contraindicated.
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