Nidipine SR-20mg Tablet 10pcs

Uses of Nidipine SR

• Hypertension (high blood pressure)
• Angina (heart-related chest pain)

Side Effects of Nidipine SR

Common side effects include peripheral edema, dizziness, flushing, headache, heartburn, nausea, muscle cramps, mood changes, nervousness, cough, dyspnea, palpitations, wheezing, transient hypotension, urticaria, pruritus, constipation, and chest pain. Gingival hyperplasia, agranulocytosis, and erectile dysfunction have also been reported.

Quick Suggestions:

• Take Nidipine SR at the same time every day to help you remember.
• A sudden drop in blood pressure may occur, especially when you first start taking it. Rise slowly if you have been sitting or lying down to avoid dizziness.
• It can cause ankle or foot swelling. Raise your legs while sitting to reduce swelling. Consult your doctor if it persists.
• Nidipine SR may cause dizziness. Avoid driving or activities that require mental focus until you know how it affects you.
• Inform your doctor if you are pregnant, planning a pregnancy, or breastfeeding.

Pharmacology

Nifedipine blocks calcium ions from entering cardiac and smooth muscle cells during depolarization, causing peripheral and coronary vasodilation. This reduces afterload, peripheral resistance, and blood pressure, increases coronary blood flow, and may cause reflex tachycardia. It has minimal effect on cardiac conduction and rarely has negative inotropic effects.

Dosage & Administration

Adult Dose

• Hypertension:
  • Immediate-release: Start with 5 mg three times daily. Maintenance: 10-20 mg three times daily.
  • Extended-release: Start with 10-40 mg twice daily or 20-90 mg once daily.
• Angina pectoris:
  • Immediate-release: Start with 10 mg three times daily. Maintenance: 10-20 mg three times daily.
  • Extended-release: 10-40 mg twice daily or 30-60 mg once daily.
• Raynaud's syndrome:
  • Immediate-release: 5-20 mg three times daily.
  • Elderly: Dose reduction may be necessary.
  • Hepatic impairment: Dose reduction may be necessary.

Administration

• Immediate-release: Can be taken with or without food. Avoid grapefruit juice.
• Retard, GITS & OROS: Can be taken with or without food. Avoid grapefruit juice. Swallow whole without chewing or crushing.

Interaction

• Enhanced antihypertensive effects with other antihypertensives, aldesleukin, and antipsychotics.
• Severe hypotension may occur with concomitant use of fentanyl during surgery.
• May modify insulin and glucose responses.
• Prothrombin time may be increased with coumarin anticoagulants.
• Increased serum levels with CYP3A4 inhibitors (e.g., azole antifungals, cimetidine, erythromycin, HIV-protease inhibitors, nefazodone, fluoxetine, quinupristin/dalfopristin).
• Potentially fatal decreased bioavailability and efficacy with strong CYP3A4 inducers (e.g., rifampicin, phenytoin, carbamazepine).

Contraindications

• Acute myocardial infarction (MI)
• Cardiogenic shock
• Acute unstable angina
• Treatment of anginal attack in chronic stable angina

Precautions & Warnings

Use caution in patients with hypotension, poor cardiac reserve, heart failure, severe aortic stenosis, diabetes mellitus, and severe gastrointestinal narrowing (for extended-release tablets). Avoid abrupt withdrawal as it may cause rebound angina. Monitor liver function in patients with hepatic impairment. Discontinue if ischemic pain follows administration. Monitor blood pressure and heart rate. During lactation, consult your doctor as the drug is distributed into breast milk. The American Academy of Pediatrics states the drug is safe for nursing.

Storage:

Store in a cool and dry place, and protect from light. Do not use the drug after the expiry date. Keep out of reach of children.