What is the starting dose for nifedipine?

From the Guidelines

The starting dose for nifedipine is 30 mg.

Nifedipine Dosing

• The usual dose range for nifedipine is 30 to 90 mg daily orally for the slow release formulation 1.
• According to the guidelines, nifedipine can be started at an initial dose of 30 mg of slow release formulation, twice a day, and increased cautiously and progressively to the maximum tolerated dose 2.
• It is essential to note that immediate-release nifedipine is not recommended for certain conditions, such as unstable angina or non-ST-elevation myocardial infarction, except with concomitant beta blockade 3, 4.
• The properties of nifedipine, including its usual dose, duration of action, and side effects, are outlined in Table 16 of the guidelines 3, 4.

Key Considerations

• Nifedipine is a dihydropyridine calcium channel blocker that reduces cell transmembrane inward calcium flux, inhibiting both myocardial and vascular smooth muscle contraction 4.
• The choice of nifedipine dose and formulation should be based on the patient's specific condition, medical history, and response to treatment 1, 2.
• Patients should be monitored closely for potential side effects, such as hypotension, dizziness, flushing, nausea, constipation, and edema 3, 4.

From the Research

Starting Dose for Nifedipine

The starting dose for nifedipine can vary depending on the specific formulation and the patient's condition.

• According to the study 5, the initial dose of nifedipine was 20 mg twice a day.
• The study 6 mentions that the decision to prescribe nifedipine 30 or 60 mg once daily was made by the treating physician.
• The study 7 evaluated the dose response and length of action of nifedipine capsules and tablets in patients with essential hypertension, with doses ranging from 5 to 20 mg.
• The study 8 administered nifedipine to pregnant women with gestational hypertension at a dose of 40-80 mg/24 hr in 2-3 administrations.
• The study 9 evaluated the efficacy of a low dose nifedipine GITS (20 mg) in patients with mild to moderate hypertension.

Common Starting Doses

Some common starting doses for nifedipine include:

• 20 mg twice a day 5
• 30 mg once daily 6
• 20 mg once daily 9
• 40-80 mg/24 hr in 2-3 administrations 8

Formulations and Dosing

Different formulations of nifedipine, such as slow-release tablets or gastrointestinal therapeutic system (GITS), may have different starting doses and dosing regimens.

• The study 5 used slow-release nifedipine tablets.
• The study 6 used long-acting nifedipine GITS/OROS.
• The study 9 used nifedipine GITS.