April 24, 2024

Understanding Nifedipine: Mechanism, Types, Uses, Side Effects, And Dosage

Nifedipine is a calcium channel blocker medication that is used to treat high blood pressure (hypertension) and chest pain (angina). It works by relaxing blood vessels so blood can flow more easily. Nifedipine comes as an extended-release capsule or tablet you take by mouth. It may also come as a tablet, capsule or liquid you can swallow.

Mechanism of Action

Nifedipine Medication belongs to a class of drugs known as calcium channel blockers. It works by blocking calcium channels found in heart and blood vessel muscle cells. When these channels are blocked, calcium is unable to enter the cells. Less calcium in the cells means the muscles relax more. For the heart, this lowers blood pressure and the force of contractions. For blood vessels, it causes them to relax and widen. This allows for better blood flow and oxygen delivery throughout the body.

Types of Nifedipine

There are different types or formulations of nifedipine available:

– Immediate-release: These are regular tablets or capsules meant to be taken as needed for chest pain. They work quickly but only last a short time.

– Extended-release: These are capsule or tablets formulated to release the drug slowly over many hours. These are preferred for high blood pressure since they maintain steady levels. Brand names include Adalat CC and Procardia XL.

– Long-acting: Similar to extended-release but provides coverage for up to 24 hours. Examples include generic nifedipine GITS and others.

-Sublingual: Special fast-dissolving tablets meant to dissolve under the tongue rapidly for fast chest pain relief. Brand name includes Nifediac CC.

Approved Medical Uses

The main approved uses of nifedipine include:

– High blood pressure (hypertension): Both immediate and extended-release forms are used to lower blood pressure often along with other medications.

– Chest pain (angina): Immediate-release is used as needed for episodic chest pain from reduced blood flow to the heart.

– Raynaud’s disease: Sometimes used long-term for this condition causing fingers/toes to feel numb and cold due to reduced blood flow.

Side Effects

Like all medications, Nifedipine Medication can cause some side effects. The most common ones include:

– Headache: One of the most frequently reported side effects. May occur in up to 15-20% of patients.

– Flushing: A warm, red feeling in the face may happen after taking immediate-release nifedipine.

-Dizziness: Lightheadedness, weakness or fainting can occur due to lowered blood pressure. Risk is higher when changing positions like standing up.

-Edema: Fluid retention leading to swollen hands/feet/ankles is possible, especially in elderly.

-Palpitations: Chest discomfort or awareness of heartbeat may occur rarely.

-Nausea: Feeling sick to stomach reported in around 5-10% cases initially. Usually improves with continued use.

-Constipation: Less frequent bowel movements as a side effect of calcium channel blockers.

-Gingival hyperplasia: Excessive gum growth reported rarely with long-term high dose nifedipine use.

Drug Interactions

Caution should be exercised when taking nifedipine with certain other medications due to potential interactions. Some examples include:

-Rifampin antibiotic: May decrease nifedipine levels significantly.

-HIV protease inhibitors: Can either increase or decrease nifedipine levels unpredictably.

-Diltiazem or verapamil: Increased risk of low blood pressure when combined.

-Grapefruit juice: May elevate nifedipine levels dangerously due to grapefruit compounds.

-CYP3A4 inhibitors: Drugs like macrolide antibiotics could raise nifedipine to toxic levels.

-P-glycoprotein inhibitors: Drugs serving this function like amiodarone require dose adjustment.

-Digoxin: Higher chance of digoxin toxicity when combined due to effects on kidneys.

Hence it is important to inform doctors about all medications and supplements being taken.


The dosage of nifedipine needs to be individualized based on the medical condition, severity, other drugs used and response. The typical adult dosing is:

– For hypertension: Extended-release 30-90 mg daily as a single dose, split into BID doses if needed.

– For angina: Immediate-release 10-20 mg every 4-6 hours as needed for chest pain attacks.

– Maximum dose: 90-180 mg per day depending on formulation and blood pressure/heart rate control achieved.

– Sublingual tablets: 5-10 mg tablets placed under the tongue for fast relief of angina.

– Raynaud’s disease: 30-90 mg per day as a starting dose.

Elderly or those with kidney/liver disease may need lower doses adjusted carefully by the prescribing doctor based on tolerability.

Nifedipine occupies an important place in the treatment of cardiovascular conditions like hypertension, angina and Raynaud’s phenomenon. As a calcium channel blocker, it effectively lowers blood pressure and relieves chest pain. Though generally well-tolerated, certain precautions must be exercised regarding drug interactions and adverse effects, especially with long-term use. Under medical supervision and with correct dosing, nifedipine provides benefit to millions suffering from these common circulatory system disorders.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it.