From the Guidelines
Nifedipine XL should be initiated at a dose of 30 mg once daily and titrated up to a maximum of 90 mg once daily, as needed, to control hypertension, based on the most recent guidelines 1.
Key Considerations
- The dosage of Nifedipine XL can be adjusted gradually, usually at 7-14 day intervals, to assess the patient's response to the medication.
- For elderly patients or those with hepatic impairment, it is recommended to start with a lower dose of 30 mg daily.
- Nifedipine XL should be taken consistently with or without food, but not with grapefruit juice, which can increase drug levels.
- The tablet must be swallowed whole and not crushed or chewed to maintain its extended-release properties.
Mechanism of Action
- Nifedipine XL is a calcium channel blocker that works by relaxing blood vessels, reducing the workload on the heart, and lowering blood pressure.
Important Interactions and Precautions
- Patients should be aware of potential side effects, including hypotension, dizziness, flushing, nausea, constipation, and edema.
- Nifedipine XL should not be used in combination with certain medications, such as beta blockers, without careful consideration of the potential risks and benefits.
Clinical Evidence
- The recommended dosage and usage of Nifedipine XL are based on the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
- The guideline provides evidence-based recommendations for the use of calcium channel blockers, including Nifedipine XL, in the management of hypertension.
From the FDA Drug Label
Nifedipine extended-release tablets contain either: 30,60, or 90 mg of nifedipine for once-a-day oral administration The recommended dosage of Nifedipine XL is once daily, with available doses of 30 mg, 60 mg, or 90 mg 2.
- The dosage is administered orally, once a day.
- Key points to consider when dosing Nifedipine XL include the patient's individual response to the medication and any potential interactions with other medications 2.
From the Research
Nifedipine XL Dosage
- The dosage of Nifedipine XL is not explicitly stated in the provided studies, but its effectiveness in treating mild-to-moderate hypertension is compared with other antihypertensive medications 3.
- In the study comparing once-daily nifedipine GITS with once-daily amlodipine, the initial treatment consisted of 30 mg nifedipine GITS, which could be increased to 60 mg once daily if the blood pressure was not below 140/90 mmHg after 6 weeks of treatment 3.
- Nifedipine GITS is a long-acting dihydropyridine, and its value in treating hypertension is re-established in the study, showing comparable safety and effectiveness with amlodipine 3.
- The interaction between antihypertensive drugs, including nifedipine, and anti-inflammatory drugs is discussed in another study, which suggests that calcium antagonists like nifedipine may be preferable for treating hypertension in patients who require NSAIDs therapy 4.
- Other studies discuss the use of different antihypertensive drugs, including beta-blockers, ACE inhibitors, and diuretics, but do not provide specific information on Nifedipine XL dosage 5, 6, 7.