Nifedipine is a dihydropyridine calcium channel blocker and is used mainly as an antianginal and antihypertensive. Most recent studies showed that Nifedipine can be used in Raynaud’s phenomenon, premature labor, and painful spasms of the esophagus and tetanus patients. Common brand names for Nifedipine are Adalat, Calcibloc, Darat, Hartigard, Heblopin, Hyperten, Nelapine, Nifestad, and Odipin. Nifedipine is classified as a Calcium channel blocker, Antianginal, and Antihypertensive.
Indication for Nifedipine
Nifedipine is used in the treatment of angina due to coronary artery spasm (Prinzmetal’s variant angina), chronic stable angina (Effort-associated angina). It is also used in the treatment of essential hypertension. Nifedipine can also be used in the treatment of Raynaud’s phenomena.
Routes and Dosage of Nifedipine
Alert: May give 10-20mg sublingual as needed for acute attacks of angina.
Prinzmetal’s Variant Angina, Chronic Stable Angina
PO: ADULTS, ELDERLY: Initially, 10mg three times a day. Increase at 7 to 14 day intervals. MAINTENANCE: 10mg three times a day up to 30mg four times a day.
Extended-release: ADULTS, ELDERLY: Initially, 30-60mg per day. MAINTENANCE: up to 120mg per day.
Hypertension
Extended-release:ADULTS, ELDERLY: Initially, 30-60mg per day. MAINTENANCE: up to 120mg per day.
Action of Nifedipine
Nifedipine inhibits calcium ion movement across cell membrane, depressing contraction of cardiac or vascular smooth muscle. It also increases heart rate and cardiac output. Nifedipine decreases systemic vascular resistance and blood pressure.
Side Effects and Adverse Reactions of Nifedipine
Side Effects of Nifedipine
- Peripheral edema
- Headache
- Flushed skin
- Dizziness
- Nausea
- Shakiness
- Muscle cramps or pain
- Drowsiness
- Palpitations
- Nasal congestion
- Cough
- Dyspnea
- Wheezing
- Hypotension
- Rash
- Pruritus
- Urticaria
- Constipation
- Abdominal discomfort
- Flatulence
- Sexual dysfunction
Adverse Reactions of Nifedipine
- May precipitate Congestive Heart Failure and Myocardial Infarction in patients with cardiac disease and peripheral ischemia.
- Nausea
- Drowsiness
- Confusion
- Slurred speech
Nursing Considerations for Clients Taking Nifedipine
- Do not crush or break film-coated tablets and sustained-release capsules.
- Give without regards to meals
- Grapefruit juice may alter absorption.
- Concurrent therapy of sublingual nitroglycerin may be used for relief of anginal pain.
- Record onset, type, radiation, location, intensity, and duration of anginal pain or precipitating factors.
- Check blood pressure for hypotension immediately prior to giving medication.
- Assist with ambulation if client is lightheaded or dizziness occurs.
- Assess for peripheral edema behind medial malleolus.
- Assess skin for flushing.
- Monitor liver enzyme tests.
Patient Teachings for Clients Taking Nifedipine
- Rise slowly from lying to sitting position, dangle legs from bed before standing to reduce hypotensive effect.
- Contact physician or nurse if irregular heartbeat, shortness of breath, pronounced dizziness, or nausea occurs.
- Avoid alcohol and grapefruit juice use.
