Nifedipine DYNAMED 2014

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Nifedipine Updated 2013 Jan 18 12:30:46 PM:Nifedipinebrands data updatedShow more updatesRelated Summaries: Management of angina Antihypertensive medication management Raynaud phenomenonWarningsPotentially Inappropriate Medication Use in Older Adults: American Geriatrics Society (AGS) Beers Criteria recommends avoiding immediate releasenifedipinein elderly patients due to risk of hypotension and of precipitating myocardial ischemia (AGS Strong recommendation, High quality evidence) (2012 AGS Beers Criteria for potentially inappropriate medication use in older adults [J Am Geriatr Soc 2012 Apr;60(4):616])General InformationDescription:Calcium-channel blocking agent; dihydropyridine derivative.284307342343Class:Class: DihydropyridinesBrands:United States Brands: genericnifedipineavailable Adalat CC Afeditab CR Nifedical XL Procardia see alsonifedipineinDailyMedCanadian Brands: genericnifedipineavailable Adalat XL see alsoHealth Canada Drug Product Database (DPD)United Kingdom Brands: Adalat Adalat Retard Adipene Coracten Fortipine Nifedipress Nimodrel Tensipine Valni see alsonifedipineinBritish National Formulary (BNF)orelectronic Medicines Compendium (eMC)Combination Products Containing This Drug (UK): Beta-Adalat (atenolol,nifedipine) Tenif (atenolol,nifedipine)Australian Brands: APO-NifedipineXR Controlled release tablets (seeMIMS Online) Adalat Oros Controlled release tablets (seeMIMS Online) Adalat Tablets (seeMIMS Online) Addos XR Controlled release tablets (seeMIMS Online) Adefin 10 Tablets (seeMIMS Online) Adefin 20 Tablets (seeMIMS Online) Adefin XL Controlled release tablets (seeMIMS Online) Nifehexal Tablets (seeMIMS Online) Nyefax Tablets (seeMIMS Online)Uses and EfficacyUses:Angina:Used in the management of Prinzmetal variant angina and chronic stable angina pectoris.aCalcium-channel blockers considered the drugs of choice in management of Prinzmetal variant angina.aAppears to be as effective as -adrenergic blocking agents (e.g., propranolol) and/or oral nitrates in the management of chronic stable angina pectoris; however, generally should be used only when the patient cannot tolerate adequate doses of or is refractory to these drugs.aHypertension:Management of hypertension (alone or in combination with other classes of antihypertensive agents).126309342343344345348351500Only extended-release formulations currently are recommended for management of hypertension.121126178181183184191192193197201202204205206207208209210211212213225226264309342344348500(See Cautions.)Calcium-channel blockers are recommended as one of several preferred agents for the initial management of hypertension; other options include ACE inhibitors, angiotensin II receptor antagonists, and thiazide diuretics.501502503504While there may be individual differences with respect to specific outcomes, these antihypertensive drug classes all produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.501502503504Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).500501502503504515Calcium-channel blockers may be preferred in hypertensive patients with certain coexisting conditions (e.g., ischemic heart disease)171185187192198523and in geriatric patients, including those with isolated systolic hypertension.181183220221222227502510Black hypertensive patients generally respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to other antihypertensive drug classes (e.g., ACE inhibitors, angiotensin II receptor antagonists).500501504However, diminished response to these other drug classes is largely eliminated when administered concomitantly with a calcium-channel blocker or thiazide diuretic.500504The optimum BP threshold for initiating antihypertensive drug therapy is controversial.501504505506507508515523530Further study needed to determine optimum BP thresholds/goals; individualize treatment decisions.501503507515526530JNC 7 recommends initiation of drug therapy in all patients with uncomplicated hypertension and BP 140/90 mm Hg;500JNC 8 panel recommends SBP threshold of 150 mm Hg for patients 60 years of age.501Although many experts agree that SBP goal of


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