Does Procardia (Nifedipine) Cause Cough?
No, Procardia (nifedipine) does not cause cough as a side effect; in fact, it has been studied as a potential treatment to reduce ACE inhibitor-induced cough. 1
Evidence from Clinical Guidelines
The ACCP (American College of Chest Physicians) evidence-based clinical practice guidelines specifically address medication-induced cough and make important distinctions:
- ACE inhibitors are the primary pharmaceutical cause of chronic dry cough, occurring in 5-35% of patients, and this is a well-documented class effect 2, 3
- Nifedipine is not listed among medications that cause cough 1
- In fact, nifedipine has been studied as a therapeutic agent to suppress ACE inhibitor-induced cough, with one study showing it eliminated cough in 3% and significantly reduced it in 51% of patients with ACE inhibitor-induced cough 1
Nifedipine as Treatment for Cough
The evidence actually positions nifedipine in the opposite role:
- The ACCP guidelines recommend nifedipine as one of several pharmacologic options for patients who cannot discontinue ACE inhibitor therapy but are experiencing cough 1
- Research demonstrates that nifedipine (30 mg daily for 14 days) can reduce ACE inhibitor-induced cough, though it is less effective than indomethacin 4
- The mechanism appears related to nifedipine's ability to inhibit prostaglandin synthesis, which may play a role in ACE inhibitor-induced cough 4, 5
Clinical Context
When evaluating a patient on Procardia who develops cough, you should investigate alternative causes:
- Concomitant ACE inhibitor use (the most likely medication culprit) 1, 2
- Pulmonary edema from congestive heart failure (which can occasionally present with cough as the sole symptom) 1, 3
- Gastroesophageal reflux disease 1
- Asthma or other primary respiratory conditions 1
Important Caveat
The Thorax guidelines note that "there are only occasional reports of cough as a troublesome side effect of other drug treatments" beyond ACE inhibitors, but nifedipine is not specifically mentioned among these rare cases 1