Top 300 Pharmacy Drug Cards

NIFEDIPINE EXTENDED RELEASE: Adalat CC, Procardia XL, Various

Class: Calcium Channel Blocker

Dosage Forms. Extended-Release Tablet: 30 mg, 60 mg, 90 mg; Capsule: 10 mg, 20 mg

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Common FDA Label Indication, Dosing, and Titration.

1. Hypertension: Adults, 30 mg po daily; may titrate to 90 mg/d po (Adalat CC) or 120 mg/d po (Procardia XL); Children, 0.25 mg/kg po daily or in 2 divided doses, may titrate to 3 mg/kg/d po (max of 180 mg/d)

2. Stable chronic angina: 30-60 mg po daily, may titrate to 120 mg/d po

3. Variant angina: 30-60 mg po daily, may titrate to 120 mg/d po

Off-Label Uses.

1. Raynaud phenomenon: 30-60 mg po daily

MOA. Nifedipine is a calcium ion influx inhibitor that inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle. Nifedipine selectively inhibits calcium ion influx across the cell membrane of cardiac muscle and vascular smooth muscle without altering serum calcium concentrations.

Drug Characteristics: Nifedipine Extended Release

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Medication Safety Issues: Nifedipine Extended Release

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Drug Interactions: Nifedipine Extended Release

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Adverse Reactions: Nifedipine Extended Release

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Efficacy Monitoring Parameters. BP, reduction of chest pain, decreased number of angina attacks, reduction in use of nitroglycerin to relieve chest pain.

Toxicity Monitoring Parameters. Signs/symptoms of peripheral edema, angina, tachycardia, CHF.

Key Patient Counseling Points. Take Adalat CC on an empty stomach. Report signs/symptoms of hypotension, exacerbation of angina peripheral edema, fatigue, or hypotension. Do not drink alcohol. Avoid sudden discontinuation of drug as this may cause rebound hypertension.

Clinical Pearls. With Adalat CC, although two 30-mg tablets may be interchanged for one 60-mg tablet, but using three 30-mg tablets results in 29% higher peak plasma concentrations than a single 90-mg tablet.