Procardia (nifedipine) is a leading calcium channel blocker prescription medication designed to manage hypertension and chronic stable angina. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes peripheral arterial vasodilation, reduces systemic vascular resistance, and decreases myocardial oxygen demand. This mechanism supports effective blood pressure control and angina prophylaxis, offering a targeted therapeutic option for appropriate patient populations under medical supervision.

Features

• Active ingredient: nifedipine
• Available in extended-release tablet formulations
• Dosing flexibility: 30mg, 60mg, and 90mg strengths
• Once-daily dosing regimen for adherence support
• FDA-approved for hypertension and chronic stable angina

Benefits

• Effectively lowers elevated blood pressure through arterial vasodilation
• Reduces frequency and severity of angina episodes
• Minimizes myocardial oxygen demand, supporting cardiovascular efficiency
• Once-daily dosing supports long-term treatment adherence
• Well-established safety profile with decades of clinical use
• Can be used as monotherapy or in combination with other antihypertensives

Common use

Procardia is primarily prescribed for the management of essential hypertension and prophylaxis of chronic stable angina pectoris. It may be used as initial monotherapy or as part of a comprehensive antihypertensive regimen. In angina management, it is particularly beneficial for patients who remain symptomatic despite adequate beta-blocker and nitrate therapy. The medication is not indicated for the treatment of acute anginal attacks or hypertensive emergencies.

Dosage and direction

The recommended starting dosage for hypertension or angina is 30 mg or 60 mg once daily, taken orally with a glass of water. Dosage may be titrated upward over 7 to 14 day intervals based on therapeutic response and tolerability. The maximum recommended dose is 90 mg daily. Tablets should be swallowed whole and not crushed, chewed, or divided. Administration with food does not significantly affect absorption but may help minimize potential gastrointestinal discomfort. Consistent timing of administration is recommended to maintain stable plasma concentrations.

Precautions

Regular blood pressure monitoring is essential, especially during initial titration. Patients should avoid grapefruit and grapefruit juice during treatment due to inhibition of CYP3A4 metabolism. Use with caution in patients with heart failure or significant aortic stenosis. Peripheral edema may occur and is typically dose-dependent. Abrupt discontinuation should be avoided as it may precipitate rebound hypertension or angina exacerbation. Hepatic impairment requires dosage adjustment and careful monitoring.

Contraindications

Procardia is contraindicated in patients with known hypersensitivity to nifedipine or other dihydropyridine calcium channel blockers. It should not be used in patients with cardiogenic shock, clinically significant aortic stenosis, or those experiencing acute myocardial infarction (especially within 4 weeks post-infarction). Concomitant use with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or clarithromycin is contraindicated due to risk of severe hypotension.

Possible side effects

Common side effects (≥5% incidence) include peripheral edema (10-30%), headache (10-20%), dizziness (5-10%), and flushing (5-10%). Less frequent adverse reactions include palpitations (2-5%), nausea (2-5%), and fatigue (2-5%). Serious but rare side effects include hypotension (<2%), syncope (<1%), and exacerbation of angina (<1%). Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment.

Drug interactions

Significant interactions occur with strong CYP3A4 inhibitors (ketoconazole, ritonavir) which increase nifedipine exposure. CYP3A4 inducers (rifampin, phenytoin) may decrease efficacy. Concurrent use with beta-blockers may potentiate hypotension and heart failure risk. Additive hypotensive effects may occur with other antihypertensives, nitrates, or phosphodiesterase-5 inhibitors. Nifedipine may increase digoxin levels by 15-45%, requiring monitoring. Grapefruit juice increases bioavailability and should be avoided.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling doses to make up for a missed dose is not recommended. Patients should maintain a consistent dosing routine and consider using reminder systems to support adherence.

Overdose

Nifedipine overdose may manifest as severe hypotension, bradycardia, and reflex tachycardia. In massive overdose, cardiac conduction abnormalities and cardiogenic shock may occur. Management includes cardiovascular monitoring, Trendelenburg positioning, IV fluids, and vasopressors if needed. Calcium gluconate administration (10% solution, 10-20 mL IV) may help counteract calcium channel blockade. Gastric lavage may be considered if presentation is early after ingestion. Activated charcoal may be effective for recent ingestions.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not transfer to alternative containers as this may affect stability. Do not use if tablets show evidence of discoloration, cracking, or other physical deterioration. Properly discard any unused medication after the expiration date.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Procardia is available by prescription only and should be used under appropriate medical supervision. Individual response to therapy may vary. Patients should consult their healthcare provider for personalized medical advice, including potential risks and benefits specific to their clinical situation. Never adjust dosage or discontinue medication without medical guidance.

Reviews

Clinical studies demonstrate Procardia’s efficacy in reducing systolic blood pressure by 10-15 mmHg and diastolic pressure by 8-10 mmHg in hypertensive patients. Angina frequency reduction of 40-60% has been observed in stable angina patients. Most patients report satisfactory control of symptoms with once-daily dosing. Peripheral edema remains the most frequently reported side effect but is often manageable with dosage adjustment or combination therapy. Long-term studies show maintained efficacy over 12-24 months of treatment with appropriate monitoring.