Nifedipine

Dosage forms available

• Nifedipine is available in oral dosage forms, including immediate-release capsules and extended-release tablets. 

Age and dose restrictions

• Nifedipine is not typically recommended for children below 18 years.

Contraindications

• Nifedipine is contraindicated in individuals with known allergy to the medicine or its components. It should not be used in patients with cardiogenic shock, severe aortic stenosis, or unstable angina. It is also not recommended immediately after a heart attack unless prescribed by a healthcare professional under close monitoring.

Other medications to avoid

• Avoid using nifedipine with antibiotics (rifampin), anticonvulsants (phenytoin, carbamazepine) and St. John’s Wort, as these can decrease its effectiveness. Concurrent use with beta-blockers (e.g., propranolol), antifungals (e.g., ketoconazole), and macrolide antibiotics (e.g., erythromycin) can increase the risk of hypotension and heart-related side effects. 

Overdose and missed dose

• An overdose of nifedipine can cause severe hypotension, bradycardia, or even cardiac arrest. Emergency medical attention is required in suspected overdose cases. 
• If a dose is missed, take it as soon as remembered. If it’s almost time for the next dose, skip the missed one and resume the regular schedule. Do not double the dose.

Management of side effects

• To manage dizziness, avoid sudden movements such as standing up quickly. For swelling in the legs or ankles, elevating the feet and reducing salt intake may help. Persistent or severe side effects require medical evaluation for possible dose adjustment.

Use in driving and operating machinery

• Nifedipine can cause dizziness, especially when starting treatment or adjusting the dose. It is advisable to avoid driving, operating heavy machinery, or performing activities requiring alertness until you understand how the medicine affects you.

Use in pregnancy and lactation

• Nifedipine may be used during pregnancy to manage certain hypertensive disorders but only under strict medical supervision. Its use during lactation should be evaluated carefully, as it can pass into breast milk in small amounts. Discuss risks and benefits with your healthcare provider before use.

Caution in other conditions

• Use caution in patients with liver dysfunction, heart failure, low blood pressure, or recent myocardial infarction. Individuals with gastrointestinal disorders affecting medicine absorption (e.g., severe diarrhea) may need alternative treatments or dosage adjustments. Elderly patients may be more sensitive to the blood pressure-lowering effects and should be monitored closely.

Special dietary and lifestyle recommendations

• Reduce sodium intake to manage blood pressure effectively. 
• Avoid processed foods and limit salt to less than 5 grams per day. Include potassium-rich foods like bananas and spinach, unless contraindicated by kidney conditions.