Nifedipine - Revision history

Fire: Marked this version for translation

2023-11-15T12:32:56Z

Marked this version for translation

Fire at 12:32, 15 November 2023

2023-11-15T12:32:42Z

← Older revision		Revision as of 21:32, 15 November 2023
Line 1:		Line 1:
			<languages />
			<translate>
	{{Pathnav\|Medication\|Antihypertensive drug\|Calcium channel blocker\|frame=1}}		{{Pathnav\|Medication\|Antihypertensive drug\|Calcium channel blocker\|frame=1}}
	{{Short description\|Calcium channel blocker medication}}		{{Short description\|Calcium channel blocker medication}}
Line 148:		Line 150:
	[[Category:Tocolytics]]		[[Category:Tocolytics]]
	[[Category:World Health Organization essential medicines]]		[[Category:World Health Organization essential medicines]]
			</translate>

Fire: /* References */

2023-11-15T12:31:52Z

References

← Older revision		Revision as of 21:31, 15 November 2023
Line 120:		Line 120:
	* [[Nilvadipine]]		* [[Nilvadipine]]
	* [[Nimodipine]]		* [[Nimodipine]]

	~~== References ==~~
	~~{{Reflist}}~~

	== External links ==		== External links ==

Fire at 12:18, 15 November 2023

2023-11-15T12:18:59Z

← Older revision		Revision as of 21:18, 15 November 2023
Line 1:		Line 1:
			{{Pathnav\|Medication\|Antihypertensive drug\|Calcium channel blocker\|frame=1}}
	{{Short description\|Calcium channel blocker medication}}		{{Short description\|Calcium channel blocker medication}}
	{{Drugbox		{{Drugbox

Fire at 12:17, 15 November 2023

2023-11-15T12:17:16Z

← Older revision		Revision as of 21:17, 15 November 2023
Line 1:		Line 1:
	{{Short description\|Calcium channel blocker medication}}		{{Short description\|Calcium channel blocker medication}}
	~~{{Redirect\|Camont\|the unincorporated community in West Virginia\|Gaymont, West Virginia}}~~
	{{Drugbox		{{Drugbox
	\| verifiedrevid = 462260435		\| verifiedrevid = 462260435

Fire: /* Other */

2023-11-14T23:32:27Z

Other

← Older revision		Revision as of 08:32, 15 November 2023
Line 81:		Line 81:
	Nifedipine is one of the main choices for the treatment of [[Prinzmetal angina]] due to its vasodilating effects on the coronary arteries.		Nifedipine is one of the main choices for the treatment of [[Prinzmetal angina]] due to its vasodilating effects on the coronary arteries.

	Other uses include painful spasms of the [[esophagus]] such as from [[cancer]] or [[tetanus]].~~{{medcn\|date=January 2020}}~~ It is also used for the small subset of people with [[pulmonary hypertension]].		Other uses include painful spasms of the [[esophagus]] such as from [[cancer]] or [[tetanus]]. It is also used for the small subset of people with [[pulmonary hypertension]].

	Finally, nifedipine can be used in the treatment of renal calculi, which are commonly referred to as [[kidney stones]]. Studies have indicated that it helps to relieve renal colic. However, alpha blockers (such as [[tamsulosin]]) have been described as being significantly better.		Finally, nifedipine can be used in the treatment of renal calculi, which are commonly referred to as [[kidney stones]]. Studies have indicated that it helps to relieve renal colic. However, alpha blockers (such as [[tamsulosin]]) have been described as being significantly better.

Fire at 23:19, 14 November 2023

2023-11-14T23:19:18Z

Show changes

Fire: /* Side effects */

2023-11-14T23:13:09Z

Side effects

← Older revision		Revision as of 08:13, 15 November 2023
Line 87:		Line 87:

	==Side effects==		==Side effects==
	Nifedipine rapidly lowers blood pressure, and patients are commonly warned they may feel dizzy or faint after taking the first few doses. [[Tachycardia]] (fast heart rate) may occur as a reaction. These problems are much less frequent in the sustained-release preparations of nifedipine.~~{{medcn\|date=January 2020}}~~		Nifedipine rapidly lowers blood pressure, and patients are commonly warned they may feel dizzy or faint after taking the first few doses. [[Tachycardia]] (fast heart rate) may occur as a reaction. These problems are much less frequent in the sustained-release preparations of nifedipine.

	Extended release formulations of nifedipine should be taken on an empty stomach, and patients are warned not to consume anything containing [[grapefruit]] or grapefruit juice, as they raise blood nifedipine levels. There are several possible mechanisms, including the inhibition of [[CYP3A4]]-mediated metabolism.<ref>{{cite journal \| vauthors = Odou P, Ferrari N, Barthélémy C, Brique S, Lhermitte M, Vincent A, Libersa C, Robert H \| display-authors = 6 \| title = Grapefruit juice-nifedipine interaction: possible involvement of several mechanisms \| journal = Journal of Clinical Pharmacy and Therapeutics \| volume = 30 \| issue = 2 \| pages = 153–8 \| date = April 2005 \| pmid = 15811168 \| doi = 10.1111/j.1365-2710.2004.00618.x \| s2cid = 30463290 \| doi-access = free }}</ref>		Extended release formulations of nifedipine should be taken on an empty stomach, and patients are warned not to consume anything containing [[grapefruit]] or grapefruit juice, as they raise blood nifedipine levels. There are several possible mechanisms, including the inhibition of [[CYP3A4]]-mediated metabolism.

	As calcium channel blocker, nifedipine has a risk of causing [[gingival hyperplasia]]~~<ref>{{Cite web\|title=Nifedipine\|url=https://bnf.nice.org.uk/drug/nifedipine.html\|access-date=1 April 2021\|website=NICE}}</ref>~~		As calcium channel blocker, nifedipine has a risk of causing [[gingival hyperplasia]]

	==Overdose==		==Overdose==

Fire: /* Other */

2023-11-14T23:12:42Z

Other

← Older revision		Revision as of 08:12, 15 November 2023
Line 74:		Line 74:

	===Other===		===Other===
	[[Raynaud's phenomenon]] is often treated with nifedipine. A 2005 meta-analysis showed modest benefits (33% decrease in attack severity, 2.8-5 reduction in absolute number of attacks per week); it does conclude that most included studies used low doses of nifedipine.<ref>{{cite journal \| vauthors = Thompson AE, Pope JE \| title = Calcium channel blockers for primary Raynaud's phenomenon: a meta-analysis \| journal = Rheumatology \| volume = 44 \| issue = 2 \| pages = 145–50 \| date = February 2005 \| pmid = 15546967 \| doi = 10.1093/rheumatology/keh390 \| doi-access = free }}</ref>		[[Raynaud's phenomenon]] is often treated with nifedipine. A 2005 meta-analysis showed modest benefits (33% decrease in attack severity, 2.8-5 reduction in absolute number of attacks per week); it does conclude that most included studies used low doses of nifedipine.

	[[Topical]] nifedipine has been shown to be as effective as topical nitrates for [[anal fissure]]s.<ref name="pmid12794583">{{cite journal \| vauthors = Ezri T, Susmallian S \| title = Topical nifedipine vs. topical glyceryl trinitrate for treatment of chronic anal fissure \| journal = Diseases of the Colon and Rectum \| volume = 46 \| issue = 6 \| pages = 805–8 \| date = June 2003 \| pmid = 12794583 \| doi = 10.1007/s10350-004-6660-8 \| s2cid = 24717470 }}</ref>		[[Topical]] nifedipine has been shown to be as effective as topical nitrates for [[anal fissure]]s.

	Nifedipine is also used in high-altitude medicine to treat [[high altitude pulmonary edema]].<ref name="eMedicine">{{cite web\| url= http://www.emedicine.com/med/topic1956.htm\| title= Pulmonary Edema, High-Altitude\| author1= Ali, Mir Omar\| author2= Qazi, Samia\| name-list-style= amp\| date= 19 September 2007\| publisher= eMedicine\| access-date= 25 November 2007\| url-status= live\| archive-url= https://web.archive.org/web/20071116141543/http://www.emedicine.com/med/topic1956.htm\| archive-date= 16 November 2007}}</ref>		Nifedipine is also used in high-altitude medicine to treat [[high altitude pulmonary edema]].

	Nifedipine is one of the main choices for the treatment of [[Prinzmetal angina]] due to its vasodilating effects on the coronary arteries.~~<ref name=AHFS2015/>~~		Nifedipine is one of the main choices for the treatment of [[Prinzmetal angina]] due to its vasodilating effects on the coronary arteries.

	Other uses include painful spasms of the [[esophagus]] such as from [[cancer]] or [[tetanus]].{{medcn\|date=January 2020}} It is also used for the small subset of people with [[pulmonary hypertension]].~~{{medcn\|date=January 2020}}~~		Other uses include painful spasms of the [[esophagus]] such as from [[cancer]] or [[tetanus]].{{medcn\|date=January 2020}} It is also used for the small subset of people with [[pulmonary hypertension]].

	Finally, nifedipine can be used in the treatment of renal calculi, which are commonly referred to as [[kidney stones]]. Studies have indicated that it helps to relieve renal colic. However, alpha blockers (such as [[tamsulosin]]) have been described as being significantly better.<ref>{{cite journal \| vauthors = Bos D, Kapoor A \| title = Update on medical expulsive therapy for distal ureteral stones: Beyond alpha-blockers \| journal = Canadian Urological Association Journal \| volume = 8 \| issue = 11–12 \| pages = 442–5 \| date = November–December 2014 \| pmid = 25553160 \| doi = 10.5489/cuaj.2472 \| pmc = 4277526 \| doi-access = free }}</ref>		Finally, nifedipine can be used in the treatment of renal calculi, which are commonly referred to as [[kidney stones]]. Studies have indicated that it helps to relieve renal colic. However, alpha blockers (such as [[tamsulosin]]) have been described as being significantly better.

	==Side effects==		==Side effects==

Fire: Created page with "{{Short description|Calcium channel blocker medication}} {{Redirect|Camont|the unincorporated community in West Virginia|Gaymont, West Virginia}} {{Use dmy dates|date=October 2022}} {{Drugbox | verifiedrevid = 462260435 | IUPAC_name = 3,5-dimethyl 2,6-dimethyl-4-(2-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylate | imageL = Nifedipine.svg | imageR = Nifedipine-from-xtal-3D-balls.png | image2 = Nifedipine_substance_photo.jpg | tradename = Adalat, Pr..."

2023-11-14T23:07:40Z

Created page with "{{Short description|Calcium channel blocker medication}} {{Redirect|Camont|the unincorporated community in West Virginia|Gaymont, West Virginia}} {{Use dmy dates|date=October 2022}} {{Drugbox | verifiedrevid = 462260435 | IUPAC_name = 3,5-dimethyl 2,6-dimethyl-4-(2-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylate | imageL = Nifedipine.svg | imageR = Nifedipine-from-xtal-3D-balls.png | image2 = Nifedipine_substance_photo.jpg  | tradename = Adalat, Pr..."

New page

{{Short description|Calcium channel blocker medication}}
{{Redirect|Camont|the unincorporated community in West Virginia|Gaymont, West Virginia}}
{{Use dmy dates|date=October 2022}}
{{Drugbox
| verifiedrevid = 462260435
| IUPAC_name = 3,5-dimethyl 2,6-dimethyl-4-(2-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylate
| imageL = Nifedipine.svg
| imageR = Nifedipine-from-xtal-3D-balls.png
| image2 = Nifedipine_substance_photo.jpg

| tradename = Adalat, Procardia, others
| Drugs.com = {{drugs.com|monograph|nifedipine}}
| MedlinePlus = a684028
| DailyMedID = Nifedipine
| pregnancy_AU = C
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web|title=Nifedipine Pregnancy and Breastfeeding Warnings|url=https://www.drugs.com/pregnancy/nifedipine.html|access-date=25 December 2015|url-status=live|archive-url=https://web.archive.org/web/20151221122156/http://www.drugs.com/pregnancy/nifedipine.html|archive-date=21 December 2015}}</ref>
| pregnancy_category=
| legal_status =
| routes_of_administration = [[Oral administration|By mouth]], topical
| class = [[Calcium channel blocker]] ([[dihydropyridine]])<ref name=AHFS2015/>

| bioavailability = 45-56%
| protein_bound = 92-98%
| metabolism = Gastrointestinal, Liver
| elimination_half-life = 2 hours
| excretion = Kidneys: >50%, Biliary: 5-15%

| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 21829-25-4
| ATC_prefix = C08
| ATC_suffix = CA05
| ATC_supplemental =
| PubChem = 4485
| IUPHAR_ligand = 2514
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB01115
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 4330
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = I9ZF7L6G2L
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D00437
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 7565
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 193

| C=17 | H=18 | N=2 | O=6
| smiles = O=C(OC)\C1=C(\N/C(=C(/C(=O)OC)C1c2ccccc2[N+]([O-])=O)C)C
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C17H18N2O6/c1-9-13(16(20)24-3)15(14(10(2)18-9)17(21)25-4)11-7-5-6-8-12(11)19(22)23/h5-8,15,18H,1-4H3
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = HYIMSNHJOBLJNT-UHFFFAOYSA-N
| melting_point = 173
}}

'''Nifedipine''', sold under the brand names '''Adalat''' and '''Procardia''' among others, is a [[calcium channel blocker]] medication used to manage [[angina]], [[hypertension|high blood pressure]], [[Raynaud's phenomenon]], and [[premature labor]].<ref name=AHFS2015>{{cite web|title=Nifedipine|url=https://www.drugs.com/monograph/nifedipine.html|publisher=The American Society of Health-System Pharmacists|access-date=17 September 2019|url-status=live|archive-url=https://web.archive.org/web/20180808043257/https://www.drugs.com/monograph/nifedipine.html|archive-date=8 August 2018}}</ref> It is one of the treatments of choice for [[Prinzmetal angina]].<ref name=AHFS2015/> It may be used to treat severe [[high blood pressure in pregnancy]].<ref name=AHFS2015/> Its use in preterm labor may allow more time for [[corticosteroid|steroids]] to improve the baby's lung function and provide time for transfer of the mother to a well qualified medical facility before delivery.<ref name=AHFS2015/> It is a calcium channel blocker of the [[Dihydropyridine calcium channel blockers|dihydropyridine]] type.<ref name=AHFS2015/> Nifedipine is taken by mouth and comes in fast- and slow-release formulations.<ref name=AHFS2015/>


Common side effects include [[lightheadedness]], [[headache]], feeling tired, leg swelling, cough, and shortness of breath.<ref name=AHFS2015/> Serious side effects may include [[hypotension|low blood pressure]] and [[heart failure]].<ref name=AHFS2015/> Nifedipine is considered safe in pregnancy and breastfeeding.<ref name="NICHHD 2023">{{cite web |title=Nifedipine |publisher=National Institute of Child Health and Human Development |date=15 August 2023 |pmid=30000106 |url=https://www.ncbi.nlm.nih.gov/books/NBK501047/ |access-date=14 October 2023}}</ref>


Nifedipine was patented in 1967, and approved for use in the United States in 1981.<ref name=AHFS2015/><ref>{{cite book | vauthors = Sliskovic DR | veditors = Li JJ, Corey EJ |editor-link1=Jie Jack Li |editor-link2=E.J. Corey |year=2013 |orig-date= |chapter= Cardiovascular Drugs | title= Drug Discovery: Practices, Processes, and Perspectives |isbn=9781118354469 | chapter-url= https://books.google.com/books?id=mIyxO5cLEAcC&pg=PA172 |url-status= live |location= Hoboken, NJ |publisher= John Wiley & Sons |pages= 141–204 |archive-url= https://web.archive.org/web/20170901032155/https://books.google.ca/books?id=mIyxO5cLEAcC&pg=PA172 |archive-date= 1 September 2017 |access-date= 20 January 2022 |quote= nifedipine...1,4-dihydropyrine originally approved in 1981. |quote-page=172 |mode= }}</ref><ref>{{cite book | vauthors = Fischer J, Ganellin CR |title=Analogue-based Drug Discovery |date=2006 |publisher=John Wiley & Sons |isbn=9783527607495 |page=464 |url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA464 |language=en}}</ref> It is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref> It is available as a [[Generic drug|generic medication]].<ref name=AHFS2015/> In 2020, it was the 135th most commonly prescribed medication in the United States, with more than 4{{nbsp}}million prescriptions.<ref>{{cite web | title = The Top 300 of 2020 | url = https://clincalc.com/DrugStats/Top300Drugs.aspx | website = ClinCalc | access-date = 7 October 2022}}</ref><ref>{{cite web | title = Nifedipine - Drug Usage Statistics | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Nifedipine | access-date = 7 October 2022}}</ref>

==Medical uses==

===High blood pressure===
The approved uses are for the long-term treatment of [[hypertension]] and [[angina pectoris]]. In hypertension, recent clinical guidelines generally favour [[diuretic]]s and [[ACE inhibitor]]s, although calcium channel antagonists, along with [[Thiazide|thiazide diuretics]], are still favoured as primary treatment for patients over 55 and black patients.<ref>{{cite book | title = Hypertension: management of hypertension in adults in primary care. Clinical guideline CG34 | publisher = [[National Institute for Health and Clinical Excellence]] (NICE) | date = June 2006 | url = http://www.nice.org.uk/CG034 | archive-url = https://web.archive.org/web/20070617040043/http://www.nice.org.uk/CG034 | archive-date=17 June 2007 | isbn = 1-86016-285-1}}</ref>

Nifedipine given as [[sublingual administration]] has previously been used in [[Hypertensive emergency|hypertensive emergencies]]. It was once frequently prescribed on an as-needed basis to patients taking [[Monoamine oxidase inhibitor|MAOIs]] for real or perceived hypertensive crises.<ref>{{Cite web|url = http://www.dr-bob.org/tips/split/Nifed-MAOI-hypertension.html|title = Nifedipine for MAOI Hypertension? Reversing a Previous Recommendation|date = March 1997|access-date = 22 January 2015|publisher = Biological Therapies in Psychiatry|url-status = dead|archive-url = https://web.archive.org/web/20150910023142/http://www.dr-bob.org/tips/split/Nifed-MAOI-hypertension.html|archive-date = 10 September 2015}}</ref> This was found to be dangerous, and has been abandoned. Sublingual administration of nifedipine promotes a hypotensive effect via peripheral vasodilation. It can cause an uncontrollable decrease in blood pressure, [[Tachycardia|reflex tachycardia]], and a ''steal phenomenon'' in certain vascular beds. There have been multiple reports in the medical literature of serious adverse effects with sublingual nifedipine, including [[Brain ischemia|cerebral ischemia/infarction]], [[myocardial infarction]], complete [[heart block]], and death. As a result of this, in 1985 the [[Food and Drug Administration|FDA]] reviewed all data regarding the safety and effectiveness of sublingual nifedipine for the management of hypertensive emergencies, and concluded that the practice should be abandoned because it was neither safe nor effective.<ref name="pmid8861992">{{cite journal | vauthors = Grossman E, Messerli FH, Grodzicki T, Kowey P | title = Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies? | journal = JAMA | volume = 276 | issue = 16 | pages = 1328–31 | year = 1996 | pmid = 8861992 | doi = 10.1001/jama.276.16.1328 }}</ref><ref name="pmid12974970">{{cite journal | vauthors = Varon J, Marik PE | title = Clinical review: the management of hypertensive crises | journal = Critical Care | volume = 7 | issue = 5 | pages = 374–84 | date = October 2003 | pmid = 12974970 | pmc = 270718 | doi = 10.1186/cc2351 | doi-access = free }}</ref> An exception to the avoidance of this practice is in the use of nifedipine for the treatment of hypertension associated with [[autonomic dysreflexia]] in [[spinal cord injury]].<ref>{{cite web| vauthors = Campagnolo DI |title=Autonomic Dysreflexia in Spinal Cord Injury|url=http://emedicine.medscape.com/article/322809-medication|publisher=eMedicine|access-date=14 July 2011}}</ref>

===Early labor===
Nifedipine has been used frequently as a [[tocolytic]] (agent that delays premature labor). A [[Cochrane review]] has concluded that it has benefits over placebo or no treatment for prolongation of pregnancy. It also has benefits over [[beta-agonists]] and may also have some benefits over [[atosiban]] and [[magnesium sulfate]], although [[atosiban]] results in fewer maternal adverse effects. No difference was found in the rate of deaths among babies around the time of birth, while data on longer-term outcomes is lacking.<ref>{{cite journal | vauthors = Flenady V, Wojcieszek AM, Papatsonis DN, Stock OM, Murray L, Jardine LA, Carbonne B | title = Calcium channel blockers for inhibiting preterm labour and birth | journal = The Cochrane Database of Systematic Reviews | issue = 6 | pages = CD002255 | date = June 2014 | volume = 2014 | pmid = 24901312 | doi = 10.1002/14651858.CD002255.pub2 | pmc = 7144737 }}</ref>

===Other===
[[Raynaud's phenomenon]] is often treated with nifedipine. A 2005 meta-analysis showed modest benefits (33% decrease in attack severity, 2.8-5 reduction in absolute number of attacks per week); it does conclude that most included studies used low doses of nifedipine.<ref>{{cite journal | vauthors = Thompson AE, Pope JE | title = Calcium channel blockers for primary Raynaud's phenomenon: a meta-analysis | journal = Rheumatology | volume = 44 | issue = 2 | pages = 145–50 | date = February 2005 | pmid = 15546967 | doi = 10.1093/rheumatology/keh390 | doi-access = free }}</ref>

[[Topical]] nifedipine has been shown to be as effective as topical nitrates for [[anal fissure]]s.<ref name="pmid12794583">{{cite journal | vauthors = Ezri T, Susmallian S | title = Topical nifedipine vs. topical glyceryl trinitrate for treatment of chronic anal fissure | journal = Diseases of the Colon and Rectum | volume = 46 | issue = 6 | pages = 805–8 | date = June 2003 | pmid = 12794583 | doi = 10.1007/s10350-004-6660-8 | s2cid = 24717470 }}</ref>

Nifedipine is also used in high-altitude medicine to treat [[high altitude pulmonary edema]].<ref name="eMedicine">{{cite web| url= http://www.emedicine.com/med/topic1956.htm| title= Pulmonary Edema, High-Altitude| author1= Ali, Mir Omar| author2= Qazi, Samia| name-list-style= amp| date= 19 September 2007| publisher= eMedicine| access-date= 25 November 2007| url-status= live| archive-url= https://web.archive.org/web/20071116141543/http://www.emedicine.com/med/topic1956.htm| archive-date= 16 November 2007}}</ref>

Nifedipine is one of the main choices for the treatment of [[Prinzmetal angina]] due to its vasodilating effects on the coronary arteries.<ref name=AHFS2015/>

Other uses include painful spasms of the [[esophagus]] such as from [[cancer]] or [[tetanus]].{{medcn|date=January 2020}} It is also used for the small subset of people with [[pulmonary hypertension]].{{medcn|date=January 2020}}

Finally, nifedipine can be used in the treatment of renal calculi, which are commonly referred to as [[kidney stones]]. Studies have indicated that it helps to relieve renal colic. However, alpha blockers (such as [[tamsulosin]]) have been described as being significantly better.<ref>{{cite journal | vauthors = Bos D, Kapoor A | title = Update on medical expulsive therapy for distal ureteral stones: Beyond alpha-blockers | journal = Canadian Urological Association Journal | volume = 8 | issue = 11–12 | pages = 442–5 | date = November–December 2014 | pmid = 25553160 | doi = 10.5489/cuaj.2472 | pmc = 4277526 | doi-access = free }}</ref>

==Side effects==
Nifedipine rapidly lowers blood pressure, and patients are commonly warned they may feel dizzy or faint after taking the first few doses. [[Tachycardia]] (fast heart rate) may occur as a reaction. These problems are much less frequent in the sustained-release preparations of nifedipine.{{medcn|date=January 2020}}

Extended release formulations of nifedipine should be taken on an empty stomach, and patients are warned not to consume anything containing [[grapefruit]] or grapefruit juice, as they raise blood nifedipine levels. There are several possible mechanisms, including the inhibition of [[CYP3A4]]-mediated metabolism.<ref>{{cite journal | vauthors = Odou P, Ferrari N, Barthélémy C, Brique S, Lhermitte M, Vincent A, Libersa C, Robert H | display-authors = 6 | title = Grapefruit juice-nifedipine interaction: possible involvement of several mechanisms | journal = Journal of Clinical Pharmacy and Therapeutics | volume = 30 | issue = 2 | pages = 153–8 | date = April 2005 | pmid = 15811168 | doi = 10.1111/j.1365-2710.2004.00618.x | s2cid = 30463290 | doi-access = free }}</ref>

As calcium channel blocker, nifedipine has a risk of causing [[gingival hyperplasia]]<ref>{{Cite web|title=Nifedipine|url=https://bnf.nice.org.uk/drug/nifedipine.html|access-date=1 April 2021|website=NICE}}</ref>

==Overdose==
A number of persons have developed toxicity due to acute overdosage with nifedipine, either accidentally or intentionally, and via either oral or [[parenteral administration]]. The adverse effects include lethargy, bradycardia, marked hypotension and [[unconsciousness|loss of consciousness]]. The drug may be quantified in blood or plasma to confirm a diagnosis of poisoning, or to assist in a medicolegal investigation following death. Analytical methods usually involve gas or liquid [[chromatography]] and specimen concentrations are usually in the 100-1000 μg/L range.<ref>Nifediac package insert, TEVA Pharmaceuticals, Sellersville, Pennsylvania, August 2009.</ref><ref>{{cite book |author=Baselt, Randall C. |title=Disposition of Toxic Drugs and Chemicals in Man |publisher=Biomedical Publications |location=Foster City, CA |year=2008 |pages=1108–1110|isbn=978-0-9626523-7-0}}</ref>

==Mechanism of action==
Nifedipine is a [[calcium channel blocker]]. Although nifedipine and other [[dihydropyridines]] are commonly regarded as specific to the [[L-type calcium channel]], they also possess nonspecific activity towards other [[voltage-dependent calcium channels]].<ref>{{cite journal | vauthors = Curtis TM, Scholfield CN | title = Nifedipine blocks Ca2+ store refilling through a pathway not involving L-type Ca2+ channels in rabbit arteriolar smooth muscle | journal = The Journal of Physiology | volume = 532 | issue = Pt 3 | pages = 609–23 | date = May 2001 | pmid = 11313433 | pmc = 2278590 | doi = 10.1111/j.1469-7793.2001.0609e.x }}</ref><ref>{{cite journal | vauthors = McDonald TF, Pelzer S, Trautwein W, Pelzer DJ | title = Regulation and modulation of calcium channels in cardiac, skeletal, and smooth muscle cells | journal = Physiological Reviews | volume = 74 | issue = 2 | pages = 365–507 | date = April 1994 | pmid = 8171118 | doi = 10.1152/physrev.1994.74.2.365 }}</ref>

Nifedipine has additionally been found to act as an [[receptor antagonist|antagonist]] of the [[mineralocorticoid receptor]], or as an [[antimineralocorticoid]].<ref name="Luther2014">{{cite journal | vauthors = Luther JM | title = Is there a new dawn for selective mineralocorticoid receptor antagonism? | journal = Current Opinion in Nephrology and Hypertension | volume = 23 | issue = 5 | pages = 456–61 | date = September 2014 | pmid = 24992570 | pmc = 4248353 | doi = 10.1097/MNH.0000000000000051 }}</ref>

==History==
Nifedipine (initially BAY a1040, then Adalat) was developed by the German pharmaceutical company [[Bayer]], with most initial studies being performed in the early 1970s.<ref>{{cite journal | vauthors = Vater W, Kroneberg G, Hoffmeister F, Saller H, Meng K, Oberdorf A, Puls W, Schlossmann K, Stoepel K | display-authors = 6 | title = [Pharmacology of 4-(2'-nitrophenyl)-2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxylic acid dimethyl ester (Nifedipine, BAY a 1040)] | language = de | journal = Arzneimittel-Forschung | volume = 22 | issue = 1 | pages = 1–14 | date = January 1972 | pmid = 4622472 }}</ref>

The use of nifedipine and related calcium channel antagonists was much reduced in response to 1995 trials that mortality was increased in patients with [[coronary artery disease]] who took nifedipine.<ref>{{cite journal | vauthors = Furberg CD, Psaty BM, Meyer JV | title = Nifedipine. Dose-related increase in mortality in patients with coronary heart disease | journal = Circulation | volume = 92 | issue = 5 | pages = 1326–31 | date = September 1995 | pmid = 7648682 | doi = 10.1161/01.cir.92.5.1326 | s2cid = 32044931 }}</ref> This study was a meta-analysis, and demonstrated harm mainly in short-acting forms of nifedipine (that could cause large fluctuations in blood pressure) and at high doses of 80 mg a day and more.<ref>{{cite journal | vauthors = Opie LH, Messerli FH | title = Nifedipine and mortality. Grave defects in the dossier | journal = Circulation | volume = 92 | issue = 5 | pages = 1068–73 | date = September 1995 | pmid = 7648646 | doi = 10.1161/01.cir.92.5.1068 }}</ref>
[[File:Urkunde Otto-Bayer-Medaille für galenische Erfindung Copräzipitat.jpg|thumb|Official document Otto-Bayer prize, 1991]]
[[File:Letter Dr Knut Schauerte, patent rights Adalat, 1987.pdf|thumb|Letter Dr Knut Schauerte, patent rights Adalat tablets, 1987. Source: Family archive.]]
Adalat was the first German pharmaceutical to be awarded the prestigious [[Prix Galien]] in 1980.<ref>{{Cite book| vauthors = Lichtlen PR |title=Adalat: A Comprehensive Review|publisher=Springer-Verlag|year=1991|isbn=3642855008|location=Berlin et al|pages=2|language=English}}</ref> In the same year, [[Ahmed Hegazy (pharmacist)|Ahmed Hegazy]] submitted his invention (in collaboration with Klaus-Dieter Rämsch) of an extended release, solid medicinal preparation of nifedipine to the German Patent Office in Munich, patenting the “use of nifedipine crystals with a specific surface area of 1-4 m2/g for the production of solid medicinal formulations for achieving long-lasting blood levels for the oral treatment of hypertension by administration 1 to 2 times”,<ref>{{Cite web|last=Europäisches Patentamt|date=28 February 1996|title=Solid pharmaceutical compositions containing nifedipine, and process for their preparation|url=https://patentimages.storage.googleapis.com/8c/e7/6b/65e124ccf4f4bd/EP0047899B2.pdf|access-date=29 January 2022|website=Patentimages|page=4}}</ref> an invention that became known as ''Adalat retard'' from Bayer (see letter Dr Schauerte).<ref>{{Cite web| vauthors = Hegasy A, Rämsch KD |date=4 January 1984|title=Feste Arzneizubereitungen enthaltend Nifedipin und Verfahren zu ihrer Herstellung.|url=https://patentimages.storage.googleapis.com/e8/22/cb/ddc8b8fc5afac4/EP0047899B1.pdf|access-date=29 January 2022|website=Europäisches Patentamt}}</ref> In that formulation, the active ingredient is released over a period of up to 36 hours.<ref>{{Cite web|title=Adalat Retard Tablet|url=https://www.tabletwise.net/uk/adalat-retard-tablet|access-date=29 January 2022|website=tabletwise.net|language=en}}</ref> With the increasing incidence of heart disease in that period—heart failure became the first cause of death in West Germany<ref>{{Cite web|title=Herzversagen Todesursache - Sterbefälle Sterbeziffern 1980-1997|url=https://www.gbe-bund.de/gbe/!pkg_olap_tables.prc_set_orientation?p_uid=gast&p_aid=15879310&p_sprache=D&p_help=2&p_indnr=7&p_ansnr=60803800&p_version=2&D.000=3&D.001=3&D.002=3&D.003=3&D.004=3&D.006=2&D.011=3&D.100=1|access-date=29 January 2022|website=www.gbe-bund.de}}</ref>—and the new formulation, the medication replaced [[Aspirin]] in the 1990s as the biggest single product of Bayer.<ref>{{Cite book| vauthors = Bletzer S |url=https://books.google.com/books?id=NjPvBgAAQBAJ|title=Pharma-Unternehmen und Gesundheitsmanagement: Strategische Diversifizierung durch Dienstleistungen|date=2 July 2013|publisher=Springer-Verlag|isbn=978-3-322-99515-5|pages=8, footnote 49|language=de}}</ref> As Alexander Mey noted, "[d]iese Maßnahmen führten dazu, dass der Umsatz im Jahr 2000 auf 1,7 Mrd. US-$ stieg, obwohl das Präparat bereits ein Vierteljahrhundert am Markt war."<ref>{{Cite journal| vauthors = Mey A | veditors = Drees N | date=2013|title=Pharmamarketing: Rx-to-OTC-Switch als strategischer Ansatz im Life-Cycle-Management für pharmazeutische Produkte | url=https://www.db-thueringen.de/servlets/MCRFileNodeServlet/dbt_derivate_00043994/Heft40Pharmamarketingkomplett%20A.pdf|access-date=8 March 2021|journal=Erfurter Hefte zum Angewandten Marketing | via = DB-Thueringen.de | language = de | publisher = Fachhochschule Erfurt University of Applied Sciences Wirtschafts-wissenschaften | location = Erfurt, Deutschland | issue = 40 | pages = 1–56, esp. 17 }}</ref> On 14 October 1991, Hegazy was awarded the Otto Bayer Medal—no relation to the company founder—for his work solubilizing poorly soluble active ingredients such as nifedipine, a prize, that the Bayer Group has been using to honor excellent research since 1984. By 2020, 528 researchers had received the award.<ref>{{Cite web|last=Bayer|date=3 January 2022|title=The Otto Bayer Medal|url=https://www.bayer.com/en/innovation/otto-bayer-medal|access-date=29 January 2022|website=Science Prize for Bayer Employees}}</ref> A 1995 US lawsuit, in which Hegazy defended his patent, found that Pfizer's Procardia XL product was also based on his European patent No. [https://patentimages.storage.googleapis.com/8c/e7/6b/65e124ccf4f4bd/EP0047899B2.pdf 0047899], United States Patent [https://patentimages.storage.googleapis.com/80/e0/2f/1e0ab56b05b557/US5264446.pdf 5264446].<ref>{{Cite web|title=Pfizer Found Guilty In Adalat CC Case - Pharmaceutical industry news|url=https://www.thepharmaletter.com/article/pfizer-found-guilty-in-adalat-cc-case|access-date=29 January 2022|website=www.thepharmaletter.com}}</ref>

== Society and culture ==
=== Brand names ===
In India, nifedipine is manufactured by JB Chemicals, and comes in brands Nicardia Retard (Nifedipine 10 mg, 20 mg tablets) and Nicardia XL 30/60, which are Nifedipine Extended Release tablets.<ref>{{cite web | url=https://medicaldialogues.in/partner/jbcpl/nicardia-xl-nifedipine | title=Nicardia XL | publisher=Medical Dialogues | access-date=24 February 2021}}</ref>

In Switzerland, nifedipine is sold only as a generic version of extended release formulation, under the names Nifedipin Mepha and Nifedipin Spirig.<ref>{{cite web | url=https://compendium.ch/search?q=Nifedipin&type=ProductActiveSubstanceGroup | title=Compendium | access-date=10 February 2023}}</ref>

== See also ==
* [[Cilnidipine]]
* [[Felodipine]]
* [[Lacidipine]]
* [[Nilvadipine]]
* [[Nimodipine]]

== References ==
{{Reflist}}

== External links ==
* {{cite web| url = https://druginfo.nlm.nih.gov/drugportal/name/nifedipine | publisher = U.S. National Library of Medicine| work = Drug Information Portal| title = Nifedipine }}

{{Other gynecologicals}}
{{Navboxes
| title = [[Pharmacodynamics]]
| titlestyle = background:#ccccff
| list1 =
{{Glycine receptor modulators}}
{{Ion channel modulators}}
{{Mineralocorticoid receptor modulators}}
{{Xenobiotic-sensing receptor modulators}}
}}
{{Portal bar|Medicine}}

{{二次利用|date=25 October 2023}}
[[Category:Antimineralocorticoids]]
[[Category:Bayer brands]]
[[Category:Calcium channel blockers]]
[[Category:Carboxylate esters]]
[[Category:Pfizer brands]]
[[Category:Dihydropyridines]]
[[Category:Glycine receptor antagonists]]
[[Category:Nitrobenzenes]]
[[Category:Wikipedia medicine articles ready to translate]]
[[Category:Tocolytics]]
[[Category:World Health Organization essential medicines]]