What are the side effects of Procardia (Nifedipine) in pregnancy?

From the Guidelines

Procardia (nifedipine) is considered a safe and effective treatment option for hypertension in pregnancy, with common side effects including headaches, tachycardia, and edema, as reported in a 2025 study published in Circulation 1. When used during pregnancy, Procardia may cause side effects in the mother, such as:

• Headaches
• Tachycardia
• Edema
• Dizziness
• Flushing
• Hypotension It can also cause reflex tachycardia and, rarely, liver dysfunction. For the developing fetus, there is a theoretical risk of decreased uterine blood flow if maternal blood pressure drops significantly. The typical dose for hypertension management is extended-release formulations of 30-90 mg daily, as recommended in the 2025 Circulation study 1. Women taking Procardia during pregnancy should have regular blood pressure monitoring to avoid hypotension. The medication works by blocking calcium channels, causing smooth muscle relaxation in blood vessels and the uterus, which explains both its therapeutic effects and side effect profile. Despite these potential side effects, the benefits of treating conditions like preeclampsia or preterm labor often outweigh the risks, and Procardia is often selected as the initial treatment due to ease of once-daily administration, which improves patient adherence, as noted in the 2025 study 1.

From the FDA Drug Label

Pregnancy Category C In rodents, rabbits and monkeys, nifedipine has been shown to have a variety of embryotoxic, placentotoxic, teratogenic and fetotoxic effects, including stunted fetuses (rats, mice and rabbits), digital anomalies (rats and rabbits), rib deformities (mice), cleft palate (mice), small placentas and underdeveloped chorionic villi (monkeys), embryonic and fetal deaths (rats, mice and rabbits), prolonged pregnancy (rats; not evaluated in other species), and decreased neonatal survival (rats; not evaluated in other species). On a mg/kg or mg/m2 basis, some of the doses associated with these various effects are higher than the maximum recommended human dose and some are lower, but all are within an order of magnitude of it The digital anomalies seen in nifedipine-exposed rabbit pups are strikingly similar to those seen in pups exposed to phenytoin, and these are in turn similar to the phalangeal deformities that are the most common malformation seen in human children with in utero exposure to phenytoin. From the clinical evidence available, a specific prenatal risk has not been identified However, an increase in perinatal asphyxia, caesarean delivery, prematurity and intrauterine growth retardation have been reported. Careful monitoring of blood pressure must be exercised in pregnant women, when administering nifedipine in combination with IV magnesium sulfate due to the possibility of an excessive fall in blood pressure which could harm the mother and fetus There are no adequate and well-controlled studies in pregnant women.

The side effects of Procardia (nifedipine) in pregnancy include:

• Embryotoxic effects: stunted fetuses, digital anomalies, rib deformities, cleft palate
• Placentotoxic effects: small placentas and underdeveloped chorionic villi
• Teratogenic effects: embryonic and fetal deaths, prolonged pregnancy, decreased neonatal survival
• Increased risk of: perinatal asphyxia, caesarean delivery, prematurity, and intrauterine growth retardation It is recommended to exercise careful monitoring of blood pressure in pregnant women when administering nifedipine, especially in combination with IV magnesium sulfate 2.

From the Research

Side Effects of Procardia in Pregnancy

• Procardia, also known as nifedipine, is a calcium channel blocker used to treat high blood pressure and chest pain [ 3, 4, 5, 6 ].
• The use of nifedipine in pregnancy has been studied, and it is considered a viable option for treating severe hypertension in pregnant women [ 3, 5, 6 ].
• However, the studies do not provide detailed information on the side effects of procardia in pregnancy, but they do mention that nifedipine is generally well-tolerated and has a low risk of adverse effects [ 3, 5, 6 ].
• One study found that nifedipine was associated with a lower risk of persistent hypertension compared to hydralazine and labetalol [ 3 ].
• Another study found that nifedipine was effective in reducing blood pressure in pregnant women with severe hypertension, with a low risk of adverse effects [ 5 ].
• A systematic review of oral antihypertensive therapy for severe hypertension in pregnancy and postpartum found that nifedipine was a suitable option for treatment, with a low risk of hypotension and no differences in adverse maternal or fetal outcomes [ 6 ].

Comparison with Other Medications

• Nifedipine has been compared to other antihypertensive medications, such as labetalol and methyldopa, in pregnant women [ 3, 4, 5, 6 ].
• The studies suggest that nifedipine is as effective as these medications in reducing blood pressure, with a similar risk of adverse effects [ 3, 5, 6 ].
• However, one study found that nifedipine was more effective than methyldopa in achieving blood pressure control [ 5 ].

Safety Considerations

• The use of any medication during pregnancy requires careful consideration of the potential risks and benefits [ 7 ].
• Nifedipine, like other antihypertensive medications, should be used with caution in pregnant women, and the benefits of treatment should be carefully weighed against the potential risks [ 7 ].