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Nifedipine

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Generic and proprietary names

- Nifedipine/Adalat, Adipine, Cardilate, Coracten, Fortipine, Hypolar, Nifedipress, Nifopress, Slofedipine, Tensipine.

Action

- Calcium-channel blocker that interferes with signals to the heart and blood vessels. Dilates blood vessels by relaxing the muscle layer in the vessel walls thereby allowing more blood to be pumped and reducing the strain on the heart.

Classification

- Calcium-channel blocker; antianginal; antihypertensive.

Indications

- Prophylaxis of angina; hypertension; Raynaud’s phenomenon. 

Contraindications

- Cardiogenic shock; advanced aortic stenosis; acute angina; porphyria; within a month of myocardial infarction.

Cautions

- Should be discontinued if ischaemic pain occurs or worsens immediately after treatment.

- Poor cardiac reserve.

- Heart failure or impaired left ventricular function.

- Severe hypotension.

- Hepatic impairment.

- Diabetes.

- Pregnancy.

- Breastfeeding.

Common side-effects

- Headache.

- Flushing.

- Palpitations.

- Dizziness.

- Lethargy.

- Gravitational oedema.

- Tachycardia.

- Pruritis.

- Short-acting preparations can result in a fall in blood pressure and tachycardia leading to myocardial or cerebrovascular ischaemia.

- Rash.

- Urticaria.

- Nausea.

- Increased urine output.

- Constipation/diarrhoea.

- Eye pain.

- Visual disturbances.

- Gum hyperplasia.

- Asthenia.

- Paraesthesia.

- Myalgia.

- Tremor.

- Impotence.

- Gynaecomastia. 

- Depression.

- Telangiectasia.

- Cholestasis. 

Rare side-effects

- Jaundice has been reported.

Interactions

- Can increase the effects of antihypertensive medication.

- Can increase the effects of phenytoin.

- Can increase the effects and toxicity of digoxin. 

- The effects of nifedipine can be reduced by rifampicin.

- Grapefruit juice can inhibit the breakdown of nifedipine, increasing its effects. 

Administration

- Tablet and capsules. 

Nursing considerations

- Assess for anginal pain, including location, intensity, duration, and alleviating and aggravating factors.

- Assess cardiac status with BP, pulse, respiration and ECG.

- Monitor potassium and liver function tests throughout treatment with nifedipine.

Patient teaching

- Avoid dangerous activities until stabilised on the medicine or dizziness is not present.

- Limit caffeine.

- Avoid alcohol.

- Patients should change position carefully as orthostatic hypotension can occur.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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