Maximum Recommended Dose of Nifedipine
The maximum recommended dose of nifedipine is 180 mg daily for extended-release formulations, while immediate-release formulations have a maximum daily dose of 90 mg. 1
Formulation-Specific Dosing Guidelines
Extended-release nifedipine:
Immediate-release nifedipine:
Special Population Considerations
- Pediatric patients:
- Initial dose: 0.25-0.5 mg/kg per day 1
- Maximum dose: 3 mg/kg per day up to 120 mg/day 1
- For children weighing less than 10 kg: 2.5 mg per dose has been established as effective and safe 3
- For children weighing 10-20 kg: 5 mg per dose 3
- The American Academy of Pediatrics suggests considering amlodipine as an alternative, starting at 2.5 mg daily 2
Safety Considerations and Warnings
- Immediate-release nifedipine should not be administered sublingually due to risk of precipitous blood pressure decline 4
- Common side effects include hypotension, dizziness, flushing, nausea, constipation, and edema 1
- Tachycardia may occur, particularly with immediate-release formulations 1
- Caution is advised when combining nifedipine with magnesium sulfate due to risk of severe hypotension 4
- Rapid blood pressure reduction with immediate-release nifedipine can lead to serious adverse effects including cerebrovascular ischemia, stroke, acute myocardial infarction, and conduction disturbances 2
- Immediate-release nifedipine causes dose-related increases in mortality in patients with coronary artery disease 2
Administration Considerations
- Extended-release formulations allow for less frequent dosing compared to immediate-release formulations 5
- For twice-daily dosing regimens with tablets, effective blood pressure control can be maintained over 24 hours 6
- For obstetric uses such as tocolysis, therapeutic doses range from 10-30 mg orally every 6-8 hours 7