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Nifedical XL (nifedipine) Disease Interactions

There are 9 disease interactions with Nifedical XL (nifedipine):

Major

CCBs (Includes Nifedical XL) ↔ aortic stenosis

Severe Potential Hazard, High plausibility

Applies to: Aortic Stenosis

The use of some calcium channel blockers (CCBs) is contraindicated in patients with advanced aortic stenosis. CCBs whose pharmacologic effect is partially dependent on their ability to reduce afterload (e.g., diltiazem, nicardipine, nifedipine, verapamil) may be of less benefit in these patients due to a fixed impedance to flow across the aortic valve and may, in fact, worsen rather than improve myocardial oxygen balance. Rarely, heart failure has developed following the initiation of these CCBs, particularly in patients receiving concomitant beta-blocker therapy.

References

  1. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  2. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  3. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
Major

CCBs (Includes Nifedical XL) ↔ cardiogenic shock/hypotension

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock, Hypotension

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Stehle G, Buss J, Eibach J, et al "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet 336 (1990): 1079
  3. "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
  5. Kubota K, Pearce GL, Inman WHW "Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring." Eur J Clin Pharmacol 48 (1995): 1-7
  6. Pahor M, Manto A, Pedone C, Carosella L, Guralnik JM, Carbonin P "Age and severe adverse drug reactions caused by nifedipine and verapamil." J Clin Epidemiol 49 (1996): 921-8
View all 6 references
Major

CCBs (Includes Nifedical XL) ↔ coronary artery disease

Severe Potential Hazard, Low plausibility

Applies to: Ischemic Heart Disease

Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.

References

  1. Thomassen AR, Bagger JP, Nielsen TT "Hemodynamic and cardiac metabolic changes during nicardipine-induced myocardial ischemia." Cathet Cardiovasc Diagn 14 (1988): 41-3
  2. Kloner RA "Nifedipine in ischemic heart disease." Circulation 92 (1995): 1074-8
  3. Manga P, Vythilingum "Unstable angina precipitated by nifedipine." S Afr Med J 66 (1984): 144
  4. Myrhed M, Wiholm B-E "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh) 58 (1986): 133-6
  5. Lambert CR, Hill JA, Feldman RL, Pepine CJ "Myocardial ischemia during intravenous nicardipine administration." Am J Cardiol 55 (1985): 844-5
  6. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  7. Oei SG, Oei SK, Brolmann HAM "Myocardial infarction during nifedipine therapy for preterm labor." N Engl J Med 340 (1999): 154
  8. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  9. Furberg CD, Psaty BM, Meyer JV "Nifedipine: dose-related increase in mortality in patients with coronary heart disease." Circulation 92 (1995): 1326-31
  10. Schanzenbacher P, Deeg P, Liebau G, Kochsiek K "Paradoxical angina after nifedipine: angiographic documentation." Am J Cardiol 53 (1984): 345-6
  11. "Product Information. Norvasc (amlodipine)." Pfizer US Pharmaceuticals, New York, NY.
  12. Sia STB, MacDonald PS, Triester B, et al "Aggravation of myocardial ischaemia by nifedipine." Med J Aust 142 (1985): 48-50
  13. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  14. "Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
  15. Yusuf S "Calcium antagonists in coronary artery disease and hypertension: time for reevaluation?" Circulation 92 (1995): 1079-82
View all 15 references
Major

CCBs (Includes Nifedical XL) ↔ liver disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, several patients have developed cholestasis or hepatocellular injury that was proven by rechallenge. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function and for excessive pharmacologic effects (e.g., abnormal prolongation of PR interval) is advised, and the dosage adjusted if necessary.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  3. Regardh CG, Edgar B, Olsson R, Kendall M, Collste P, Shansky C "Pharmacokinetics of felodipine in patients with liver disease." Eur J Clin Pharmacol 36 (1989): 473-9
  4. Stern EH, Pitchon R, King BD, Wiener I "Possible hepatitis from verapamil." N Engl J Med 306 (1982): 612-3
  5. Cotting J, Reichen J, Kutz K, Laplanche R, Nuesch E "Pharmacokinetics of isradipine in patients with chronic liver disease." Eur J Clin Pharmacol 38 (1990): 599-603
  6. Elliott HL, Meredith PA "The clinical consequences of the absorption, distribution, metabolism and excretion of amlodipine." Postgrad Med J 67 (1991): s20-3
  7. "Product Information. Plendil (felodipine)." Merck & Co, Inc, West Point, PA.
  8. Graham D, Dow R, Hall D, Alexander O, Mroszczak E, Freedman A "The metabolism and pharmacokinetics of nicardipine hydrochloride in man." Br J Clin Pharmacol 20 (1985): s23-8
  9. Giacomini KM, Massoud N, Wong FM, Giacomini JC "Decreased binding of verapamil to plasma proteins in patients with liver disease." J Cardiovasc Pharmacol 6 (1984): 924-8
  10. Scherling D, Karl W, Ahr G, Ahr HJ, Wehinger E "Pharmacokinetics of nisoldipine. III. Biotransformation of nisoldipine in rat, dog, monkey, and man." Arzneimittelforschung 38 (1988): 1105-10
  11. Babany G, Uzzan F, Larrey D, et al "Alcoholic-like liver lesions induced by nifedipine." J Hepatol 9 (1989): 252-5
  12. Ramsch KD, Graefe KH, Scherling D, et al "Pharmacokinetics and metabolism of calcium-blocking agents nifedipine, nitrendipine, and nimodipine." Am J Nephrol 6 (1986): 73-80
  13. "Product Information. DynaCirc (isradipine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  14. Dunselman PH, Edgar B "Felodipine clinical pharmacokinetics." Clin Pharmacokinet 21 (1991): 418-30
  15. Stopher DA, Beresford AP, Macrae PV, Humphrey MJ "The metabolism and pharmacokinetics of amlodipine in humans and animals." J Cardiovasc Pharmacol 12 (1988): s55-9
  16. Rush WR, Alexander O, Hall DJ, Cairncross L, Dow RJ, Graham DJ "The metabolism of nicardipine hydrochloride in healthy male volunteers." Xenobiotica 16 (1986): 341-9
  17. Brodsky SJ, Cutler SS, Weiner DA, Klein MD "Hepatotoxicity due to treatment with verapamil." Ann Intern Med 94 (1981): 490-1
  18. Kurosawa S, Kurosawa N, Owada E, et al "Pharmacokinetics of diltiazem in patients with liver cirrhosis." Int J Clin Pharmacol Res 10 (1990): 311-8
  19. McAllister RG Jr, Hamann SR, Blouin RA "Pharmacokinetics of calcium-entry blockers." Am J Cardiol 55 (1985): b30-40
  20. Guarascio P, D'Amato C, Sette P, et al "Liver damage from verapamil." Br Med J 288 (1984): 362-3
  21. Woodcock BG, Rietbrock N "Verapamil bioavailability and dosage in liver disease." Br J Clin Pharmacol 13 (1982): 240-1
  22. Benet LZ "Pharmacokinetics and metabolism of bepridil." Am J Cardiol 55 (1985): c8-13
  23. "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  24. Kumar KL, Colley CA "Verapamil-induced hepatotoxicity." West J Med 160 (1994): 485-6
  25. Toner M, White A, Moriarty J, Clancy L "Allergic urticarial eruption, leukocytosis and abnormal liver function tests following nifedipine administration." Chest 93 (1988): 1320-1
  26. Traverse JH, Swenson LJ, Mcbride JW "Acute hepatic injury after treatment with diltiazem." Am Heart J 127 (1994): 1636-9
  27. Kleinbloesem CH, van Harten J, Wilson JP, et al "Nifedipine: kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration." Clin Pharmacol Ther 40 (1986): 21-8
  28. Kates RE "Calcium antagonists: pharmacokinetic properties." Drugs 25 (1983): 113-24
  29. Raemsch KD, Sommer J "Pharmacokinetics and metabolism of nifedipine." Hypertension 5 (1983): 18-24
  30. "Product Information. Norvasc (amlodipine)." Pfizer US Pharmaceuticals, New York, NY.
  31. Shallcross H, Padley SP, Glynn MJ, Gibbs DD "Fatal renal and hepatic toxicity after treatment with diltiazem." Br Med J 295 (1987): 1256-7
  32. Gengo FM, Fagan SC, Krol G, Bernhard H "Nimodipine disposition and haemodynamic effects in patients with cirrhosis and age-matched controls." Br J Clin Pharmacol 23 (1987): 47-53
  33. Meredith P, Elliott H "Clinical pharmacokinetics of amlodipine." Clin Pharmacokinet 22 (1992): 22-31
  34. "Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
  35. Razak TA, McNeil JJ, Sewell RB, Drummer OH, Smallwood RA, Conway EL, Louis WJ "The effect of hepatic cirrhosis on the pharmacokinetics and blood pressure response to nicardipine." Clin Pharmacol Ther 47 (1990): 463-9
  36. Stehle G, Buss J, Eibach J, et al "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet 336 (1990): 1079
  37. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  38. Colombo G, Zucchella G, Planca E, Grieco A "Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance." Clin Ther 9 (1987): 536-47
  39. Challenor VF, Waller DG, Renwick AG, et al "The trans-hepatic extraction of nifedipine." Br J Clin Pharmacol 24 (1987): 473-7
  40. Hare DL, Horowitz JD "Verapamil hepatotoxicity: a hypersensitivity reaction." Am Heart J 111 (1986): 610-11
  41. Finucci GF, Padrini R, Piovan D, et al "Verapamil pharmacokinetics and liver function in patients with cirrhosis." Int J Clin Pharmacol Res 8 (1988): 123-6
  42. "Product Information. Nimotop (nimodipine)." Bayer, West Haven, CT.
  43. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  44. Dow RJ, Graham DJM "A reveiw of the human metabolism and pharmacokinetics of nicardipine hydrochloride." Br J Clin Pharmacol 22 (1986): s195-202
  45. Saracheck NS, London RL, Matulewicz TJ, et al "Diltiazem and granulomatous hepatitis." Gastroenterology 88 (1985): 1260-2
  46. Somogyi A, Albrecht M, Kliems G, et al "Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis." Br J Clin Pharmacol 12 (1981): 51-60
  47. Woodcock BG, Rietbrock I, Vohringer HF, Rietbrock N "Verapamil disposition in liver disease and intensive-care patients: kinetics, clearance, and apparent blood flow relationships." Clin Pharmacol Ther 29 (1981): 27-34
  48. Johnson KE, Balderston SM, Pieper JA, Mann DE, Reiter MJ "Electrophysiologic effects of verapamil metabolites in the isolated heart." J Cardiovasc Pharmacol 17 (1991): 830-7
  49. Echizen H, Eichelbaum M "Clinical pharmacokinetics of verapamil, nifedipine and diltiazem." Clin Pharmacokinet 11 (1986): 425-49
  50. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
  51. Abramson M, Littlejohn GO "Hepatic reactions to nifedipine." Med J Aust 142 (1985): 47-8
  52. Toft E, Vyberg M, Therkelsen K "Diltiazem-induced granulomatous hepatitis." Histopathology 18 (1991): 474-5
  53. Tse FL, Jaffe JM "Pharmacokinetics of PN 200-110 (isradipine), a new calcium antagonist, after oral administration in man." Eur J Clin Pharmacol 32 (1987): 361-5
View all 53 references
Major

nifedipine (Includes Nifedical XL) ↔ hypertension

Severe Potential Hazard, High plausibility

Applies to: Hypertension

For the long-term treatment of hypertension, only the extended-release formulations of nifedipine should be used. The US National Heart, Lung, and Blood Institute and the FDA Cardiovascular and Renal Drug Advisory Committee have issued warnings against the use of immediate-release nifedipine for this purpose based on review of three epidemiologic studies of patients with hypertension and unstable angina who were treated with calcium channel blockers (CCBs) and at least two meta-analyses of randomized, controlled trials that included patients receiving CCBs. Two of the case-control studies found an increased risk of myocardial infarction (MI) in patients taking immediate-release nifedipine, although the third did not.

The use of immediate-release nifedipine (orally or sublingually) is also contraindicated for acute reduction of blood pressure. Profound hypotension, acute myocardial infarction, and deaths have been reported when nifedipine was used in this manner.

References

  1. Grossman E, Messerli FH, Grodzicki T, Kowey P "Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies?" JAMA 276 (1996): 1328-31
  2. Schwartz M, Naschitz JE, Yeshurun D, et al "Oral nifedipine in the treatment of hypertensive urgency: cerebrovascular accident following a single dose." Arch Intern Med 150 (1990): 686-7
  3. American Health Consultants "Do calcium-channel blockers increase the risk of myocardial infarctions?" Internal Medicine Alert 17 (1995): 49-50
  4. Zangerle KF, Wolford R "Syncope and conduction disturbances following sublingual nifedipine for hypertension." Ann Emerg Med 14 (1985): 1005-6
  5. Miller JL "FDA committee recommends stronger warning against inappropriate use of immediate-release nifedipine: no changes for other calcium-channel blockers." Am J Health Syst Pharm 53 (1996): 599-600
  6. Bloomfield RL, Carter J "Hypertensive urgencies: how to give a low dose of short-acting nifedipine." Geriatrics 51 (1996): 10
  7. Jick H, Derby LE, Gurewich V, Vasilakis C "The risk of myocardial infarction associated with antihypertensive drug treatment in persons with uncomplicated essential hypertension." Pharmacotherapy 16 (1996): 321-6
  8. Wachter RM "Symptomatic hypotension induced by nifedipine in the acute treatment of severe hypertension." Arch Intern Med 147 (1987): 556-8
  9. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  10. Carpi J "Calcium channel blocker debate refuses to die." Internal Medicine News June 15 (1995): 1(col4),2(col3)
  11. Marwick C "FDA gives calcium channel blockers clean bill of health but warns of short-acting nifedipine hazards." JAMA 275 (1996): 423-4
  12. Miller JL "FDA committee recommends stronger warnings against inappropriate use of immediate-release nifedipine." Am J Health Syst Pharm 53 (1996): 599-600
  13. Buring JE, Glynn RJ, Hennekens CH "Calcium channel blockers and myocardial infarction: a hypothesis formulated but not yet tested." JAMA 274 (1995): 654-5
  14. Kloner RA "The issue of the cardiovascular safety of dihydropyridines." Am J Hypertens 9 (1996): s182-6
  15. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  16. Woodmansey P, Channer KS "Nifedipine and hypotension." Lancet 338 (1991): 763-4
  17. Psaty BM, Heckbert SR, Koepsell TD, et al. "The risk of myocardial infarction associated with antihypertensive drug therapies." JAMA 274 (1995): 620-5
  18. Aromatorio GJ, Uretsky BF, Reddy PS "Hypotension and sinus arrest with nifedipine in pulmonary hypertension." Chest 87 (1985): 265-7
  19. Peters FP, de Zwaan C, Kho L "Prolonged QT interval and ventricular fibrillation after treatment with sublingual nifedipine for malignant hypertension" Arch Intern Med 157 (1997): 2665-6
  20. Bradbury J "Sublingual short-acting nifedipine causes serious side-effects." Lancet 348 (1996): 1159
View all 20 references
Major

nifedipine (Includes Nifedical XL) ↔ myocardial infarction

Severe Potential Hazard, High plausibility

Applies to: Myocardial Infarction

Clinical trials studying the use of immediate-release nifedipine in patients who had just sustained myocardial infarctions have not demonstrated any benefit. In fact, in some trials, patients who received immediate-release nifedipine had significantly worse outcomes than patients who received placebo. The manufacturers state that immediate-release formulations of nifedipine should not be administered for 1 week after myocardial infarction. They should also be avoided in the setting of acute coronary syndrome, when infarction may be imminent.

References

  1. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  2. Kloner RA "Nifedipine in ischemic heart disease." Circulation 92 (1995): 1074-8
  3. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  4. Furberg CD, Psaty BM, Meyer JV "Nifedipine: dose-related increase in mortality in patients with coronary heart disease." Circulation 92 (1995): 1326-31
  5. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  6. Sleight P "Calcium antagonists during and after myocardial infarction." Drugs 51 (1996): 216-25
View all 6 references
Moderate

CCBs (Includes Nifedical XL) ↔ CHF/AMI

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Myocardial Infarction

Calcium channel blockers (CCBs) may have varying degrees of negative inotropic effect. Congestive heart failure (CHF), worsening of CHF, and pulmonary edema have occurred in some patients treated with a CCB, primarily verapamil. Some CCBs have also caused mild to moderate peripheral edema due to localized vasodilation of dependent arterioles and small blood vessels, which can be confused with the effects of increasing left ventricular dysfunction. Although some CCBs have been used in the treatment of CHF, therapy with CCBs should be administered cautiously in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, caution is advised in patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened by administration of a CCB.

References

  1. Batlouni M, Armaganijan D, Ghorayeb N, Magliano MF "Clinical efficacy and tolerability of isradipine in the treatment of mild-to-moderate hypertension in young and elderly patients." J Cardiovasc Pharmacol 19 (1992): s53-7
  2. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  3. Sleight P "Calcium antagonists during and after myocardial infarction." Drugs 51 (1996): 216-25
  4. Fagan TC, Haggert BE, Liss C "Efficacy and tolerability of extended-release felodipine and extended-release nifedipine in patients with mild-to-moderate essential hypertension." Clin Ther 16 (1994): 634-46
  5. Brogden RN, Sorkin EM "Isradipine: an update of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the treatment of mild to moderate hypertension." Drugs 49 (1995): 618-49
  6. Batra AK, Segall PH, Ahmed T "Pulmonary edema with nifedipine in primary pulmonary hypertension." Respiration 47 (1985): 161-3
  7. Elkayam U "Calcium channel blockers in heart failure." Cardiology 89 (1998): 38-46
  8. Prigogine T, Waterlot Y, Gottignies P, et al "Acute nonhemodynamic pulmonary edema with nifedipine in primary pulmonary hypertension." Chest 100 (1991): 563-4
  9. Kubota K, Pearce GL, Inman WHW "Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring." Eur J Clin Pharmacol 48 (1995): 1-7
  10. Walton T, Symes LR "Felodipine and isradipine: new calcium-channel-blocking agents for the treatment of hypertension." Clin Pharm 12 (1993): 261-75
  11. "Product Information. DynaCirc (isradipine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  12. Scheidt S, LeWinter MM, Hermanovich J, Venkataraman K, Freedman D "Efficacy and safety of nicardipine for chronic, stable angina pectoris: a multicenter randomized trial." Am J Cardiol 58 (1986): 715-21
  13. Lorimer AR, Pringle SD "The safety of felodipine." J Cardiovasc Pharmacol 15 (1990): s85-9
  14. Yedinak KC, Lopez LM "Felodipine: a new dihydropyridine calcium-channel antagonist." DICP 25 (1991): 1193-206
  15. Schaefer RM, Aldons PM, Burgess ED, Tilvis R, Singh GP, Rehn L, Morgan TO "Improved tolerability of felodipine compared with amlodipine in elderly hypertensives: A randomised, double-blind study in 535 patients, focusing on vasodilatory adverse events." Int J Clin Pract 52 (1998): 381
  16. Myrhed M, Wiholm B-E "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh) 58 (1986): 133-6
  17. Taylor SH, Frais MA, Lee P, Verma SP, Jackson N, Reynolds G, Silke B "A study of the long-term efficacy and tolerability of oral nicardipine in hypertensive patients." Br J Clin Pharmacol 20 (1985): s139-42
  18. Sundstedt CD, Ruegg PC, Keller A, Waite R "A multicenter evaluation of the safety, tolerability, and efficacy of isradipine in the treatment of essential hypertension." Am J Med 86 (1989): 98-102
  19. "Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
  20. "Product Information. Norvasc (amlodipine)." Pfizer US Pharmaceuticals, New York, NY.
  21. "Product Information. Plendil (felodipine)." Merck & Co, Inc, West Point, PA.
  22. Blecker D "Antihypertensive therapy with isradipine in patients with special safety concerns." Angiology 45 (1994): 997-1008
  23. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  24. "Product Information. Nimotop (nimodipine)." Bayer, West Haven, CT.
  25. Ruegg PC, Nelson DJ "Safety and efficacy of isradipine, alone and in combination, in the treatment of angina pectoris." Am J Med 86 (1989): 70-4
  26. Johnson BF, Eisner GM, Mcmahon FG, Jain AK, Rudd P, Sowers JR "A multicenter comparison of adverse reaction profiles of isradipine and enalapril at equipotent doses in patients with essential hypertension." J Clin Pharmacol 35 (1995): 484-92
  27. Gillmer DJ, Kark P "Pulmonary oedema precipitated by nifedipine." Br Med J 280 (1980): 1420-1
  28. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  29. Dubois C, Blanchard D "Efficacy and safety of nicardipine in 29,104 patients with hypertension." Clin Ther 11 (1989): 452-60
View all 29 references
Moderate

nifedipine (Includes Nifedical XL) ↔ renal dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Although the clearance of nifedipine is not dependent on renal function, use of the drug in patients with uremia has been associated with enhanced pharmacologic effects, possibly due to increased sensitivity to the drug or reduced protein binding. Rarely, reversible elevations in BUN and serum creatinine have been reported in patients with preexisting chronic renal insufficiency given nifedipine, although a causal relationship has not been established. Nephritis and renal failure have also been observed. Therapy with nifedipine should be administered cautiously in patients with significantly impaired renal function.

References

  1. Echizen H, Eichelbaum M "Clinical pharmacokinetics of verapamil, nifedipine and diltiazem." Clin Pharmacokinet 11 (1986): 425-49
  2. Eicher JC, Morelon P, Chalopin JM, et al "Acute renal failure during nifedipine therapy in a patient with congestive heart failure." Crit Care Med 16 (1988): 1163-4
  3. Zucchelli P, Zuccala A, Borghi M, et al "Long-term comparison between captopril and nifedipine in the progression of renal insufficiency." Kidney Int 42 (1992): 452-8
  4. van Bortel L, Bohm R, Mooij J, et al "Total and free steady-state plasma levels and pharmacokinetics of nifedipine in patients with terminal renal failure." Eur J Clin Pharmacol 37 (1989): 185-9
  5. Cacoub P, Deray JY, Deray G, et al "Nifedipine-induced acute renal failure." Clin Nephrol 29 (1988): 272-3
  6. McAllister RG Jr, Hamann SR, Blouin RA "Pharmacokinetics of calcium-entry blockers." Am J Cardiol 55 (1985): b30-40
  7. Diamond JR, Cheung JY, Fang LS "Nifedipine-induced renal dysfunction." Am J Med 77 (1984): 905-9
  8. Diamond JR, Cheung JY, Fang LST "Nifedipine-induced renal dysfunction." Am J Med 77 (1984): 905-9
  9. Pahor M, Manto A, Pedone C, Carosella L, Guralnik JM, Carbonin P "Age and severe adverse drug reactions caused by nifedipine and verapamil." J Clin Epidemiol 49 (1996): 921-8
  10. Kleinbloesem CH, van Brummelen P, van Harten J, et al "Nifedipine: influence of renal function on pharmacokinetic/hemodynamic relationship." Clin Pharmacol Ther 37 (1985): 563-74
  11. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  12. Hall-Craggs M, Light PD, Peters RW "Development of immune complex nephritis during treatment with the calcium channel-blocking agent nifedipine." Hum Pathol 15 (1984): 691-4
  13. Ene MD, Roberts CJ "Pharmacokinetics of nifedipine after oral administration in chronic liver disease." J Clin Pharmacol 27 (1987): 1001-4
  14. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  15. Robertson DR, Waller DG, Renwick AG, George CF "Age-related changes in the pharmacokinetics and pharmacodynamics of nifedipine." Br J Clin Pharmacol 25 (1988): 297-305
  16. Kates RE "Calcium antagonists: pharmacokinetic properties." Drugs 25 (1983): 113-24
  17. Scoble JE, Uff JS, Eastwood B "Nifedipine nephritis." Clin Nephrol 21 (1984): 302
View all 17 references
Moderate

nifedipine XL (Includes Nifedical XL) ↔ GI narrowing

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction

The extended-release formulation of nifedipine (Procardia XL) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of nifedipine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

References

  1. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  2. Smitz S, Bonnet V, Delporte JP "Severe gastrointestinal dysfunction and retention of extended release nifedipine tablets." J Am Geriatr Soc 46 (1998): 656-7

Nifedical XL (nifedipine) drug Interactions

There are 793 drug interactions with Nifedical XL (nifedipine)

Nifedical XL (nifedipine) alcohol/food Interactions

There are 3 alcohol/food interactions with Nifedical XL (nifedipine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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