From the Guidelines
Yes, nifedipine is associated with flushing.
Side Effects of Nifedipine
- The side effects of nifedipine include hypotension, dizziness, flushing, nausea, constipation, and edema 1.
- Nifedipine is a dihydropyridine calcium channel blocker that produces significant peripheral arterial vasodilation, which can lead to flushing 1.
- The use of nifedipine without concomitant beta-blocker therapy is not recommended due to increased adverse potential, including flushing 1.
- The usual dose of nifedipine is 30 to 90 mg daily orally for immediate release, and 30 to 180 mg orally for slow release, with a short duration of action 1.
- Other calcium channel blockers, such as amlodipine and felodipine, have longer durations of action and may be preferred in certain situations 1.
From the FDA Drug Label
The main effects of ingestion of approximately 4800 mg of nifedipine in a young man attempting suicide as a result of cocaine-induced depression was initial dizziness, palpitations, flushing, and nervousness
- Flushing is listed as one of the initial effects of nifedipine overdosage in a reported case.
- This suggests that nifedipine is associated with flushing, at least in the context of overdosage. 2
From the Research
Nifedipine and Flushing
- Nifedipine is associated with flushing, a vasodilatory symptom, as reported in several studies 3, 4, 5, 6, 7
- The mechanism of nifedipine-induced flushing is related to its potent peripheral and coronary arterial dilator properties 5
- Flushing is a common adverse effect of nifedipine, particularly in women, and can be exacerbated by estrogen withdrawal 4
- The severity of flushing can vary, but it is often mild to moderate and transient, diminishing with continued treatment 5
- Other vasodilatory symptoms associated with nifedipine include dizziness, headaches, and palpitation 3
Studies on Nifedipine-Induced Flushing
- A study in mice found that ovariectomy increased the tail skin temperature, a parameter of skin flushing, induced by nifedipine, and that this effect was blocked by estradiol replacement 4
- A clinical trial in patients with achalasia found that nifedipine improved symptoms, but also caused flushing of extremities in one patient 6
- A case report of a massive overdose of nifedipine found that the patient developed hypotension, tachycardia, and flushing, but remained in sinus rhythm 7