From the Guidelines
The recommended dosage of nifedipine for treating hypertension or angina is immediate release: 30 to 90 mg daily orally and slow release: 30 to 180 mg orally, as indicated in the most recent guidelines 1.
Key Considerations
- The dosage of nifedipine varies by formulation, with immediate-release and slow-release options available.
- The usual dose for immediate-release nifedipine is 30 to 90 mg daily orally, while slow-release nifedipine is typically 30 to 180 mg orally.
- Potential side effects of nifedipine include hypotension, dizziness, flushing, nausea, constipation, and edema, as outlined in the guidelines 1.
Important Guidelines
- Nifedipine should be used with caution in patients with certain medical conditions, such as liver impairment or elderly patients, who may require lower starting doses.
- The medication should be taken consistently, with extended-release tablets swallowed whole, not crushed or chewed.
- Patients should be aware of potential side effects and monitor their blood pressure regularly when starting or adjusting nifedipine dosage.
Clinical Context
- Nifedipine is a calcium channel blocker that works by blocking calcium channels in blood vessels and the heart, causing vasodilation and reducing blood pressure and cardiac workload.
- The choice of nifedipine dosage and formulation should be individualized based on patient-specific factors, such as medical history and current medications.
- Regular monitoring and follow-up with a healthcare provider are essential to ensure safe and effective use of nifedipine, as recommended in the guidelines 1.
From the Research
Dosage Information
- The recommended dosage of nifedipine for treating hypertension or angina can vary depending on the specific formulation and the patient's response to treatment 2, 3.
- For the gastrointestinal therapeutic system (GITS) formulation, the initial dose is typically 30 mg/day, which can be titrated up to a maximum dose of 180 mg/day 3.
- In some studies, doses of 30-60 mg/day were effective in controlling blood pressure in more than 50% of patients 3.
- For acute treatment of severe hypertension, a dose of 10 mg sublingually or orally has been used, with the option to repeat the dose 30-60 minutes later if necessary 4, 5, 6.
Administration Time
- The time of day for administering nifedipine GITS can affect its efficacy and safety profile, with bedtime administration reducing the incidence of edema and other adverse events compared to morning dosing 2.
- Bedtime administration of nifedipine GITS has been shown to provide improved therapeutic coverage and reduced adverse events compared to morning dosing 2.
Special Considerations
- Nifedipine can be used safely in patients with severe hypertension, including those with left ventricular failure, and can provide rapid reduction in blood pressure and symptoms 4, 5, 6.
- The drug's pharmacokinetic profile and routes of administration make it particularly valuable in the practice of emergency medicine 5.