How and where to order Adalat, Procardia (Nifedipine) 10, 20, 30 mg tablets or capsules online:
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Indications and usage:
Adalat CC (Nifedipine) is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.
Procardia (Nifedipine) is indicated for the management of vasospastic angina confirmed by any of the following criteria: 1) classical pattern of angina at rest accompanied by ST segment elevation, 2) angina or coronary artery spasm provoked by ergonovine, or 3) angiographically demonstrated coronary artery spasm. In those patients who have had angiography, the presence of significant fixed obstructive disease is not incompatible with the diagnosis of vasospastic angina, provided that the above criteria are satisfied. PROCARDIA may also be used where the clinical presentation suggests a possible vasospastic component but where vasospasm has not been confirmed, e.g., where pain has a variable threshold on exertion or when angina is refractory to nitrates and/or adequate doses of beta blockers.
Nifedipine is indicated for the management of chronic stable angina (effort-associated angina) without evidence of vasospasm in patients who remain symptomatic despite adequate doses of beta blockers and/or organic nitrates or who cannot tolerate those agents.
In chronic stable angina (effort-associated angina), nifedipine has been effective in controlled trials of up to eight weeks duration in reducing angina frequency and increasing exercise tolerance, but confirmation of sustained effectiveness and evaluation of long-term safety in these patients are incomplete.
Controlled studies in small numbers of patients suggest concomitant use of Nifedipine and beta-blocking agents may be beneficial in patients with chronic stable angina, but available information is not sufficient to predict with confidence the effects of concurrent treatment, especially in patients with compromised left ventricular function or cardiac conduction abnormalities. When introducing such concomitant therapy, care must be taken to monitor blood pressure closely since severe hypotension can occur from the combined effects of the drugs.
Concomitant administration with strong P450 inducers, such as rifampin, are contraindicated since the efficacy of nifedipine tablets could be significantly reduced. Nifedipine must not be used in cases of cardiogenic shock. Adalat and Procardia are contraindicated in patients with a known hypersensitivity to any component of the tablet.
Dosage and administration:
Dosage should be adjusted according to each patient’s needs. It is recommended that Adalat CC be administered orally once daily on an empty stomach. Adalat CC is an extended release dosage form and tablets should be swallowed whole, not bitten or divided. In general, titration should proceed over a 7-14 day period starting with 30 mg once daily. Upward titration should be based on therapeutic efficacy and safety. The usual maintenance dose is 30 mg to 60 mg once daily. Titration to doses above 90 mg daily is not recommended.
If discontinuation of Adalat CC is necessary, sound clinical practice suggests that the dosage should be decreased gradually with close physician supervision.
Co-administration of nifedipine with grapefruit juice is to be avoided.
Care should be taken when dispensing Adalat CC to assure that the extended release dosage form has been prescribed.
The dosage of Procardia needed to suppress angina and that can be tolerated by the patient must be established by titration. Excessive doses can result in hypotension.
Therapy should be initiated with the 10 mg capsule. The starting dose is one 10 mg capsule, swallowed whole, 3 times/day. The usual effective dose range is 10–20 mg three times daily. Some patients, especially those with evidence of coronary artery spasm, respond only to higher doses, more frequent administration, or both. In such patients, doses of 20–30 mg three or four times daily may be effective. Doses above 120 mg daily are rarely necessary. More than 180 mg per day is not recommended.
In most cases, Procardia titration should proceed over a 7–14 day period so that the physician can assess the response to each dose level and monitor the blood pressure before proceeding to higher doses.
If symptoms so warrant, titration may proceed more rapidly provided that the patient is assessed frequently. Based on the patient's physical activity level, attack frequency, and sublingual nitroglycerin consumption, the dose of Procardia may be increased from 10 mg t.i.d. to 20 mg t.i.d. and then to 30 mg t.i.d. over a three-day period.
In hospitalized patients under close observation, the dose may be increased in 10 mg increments over four- to six-hour periods as required to control pain and arrhythmias due to ischemia. A single dose should rarely exceed 30 mg.
Avoid co-administration of nifedipine with grapefruit juice.
No "rebound effect" has been observed upon discontinuation of Procardia. However, if discontinuation of nifedipine is necessary, sound clinical practice suggests that the dosage should be decreased gradually with close physician supervision.
Sublingual nitroglycerin may be taken as required for the control of acute manifestations of angina, particularly during Procardia titration.
Experience with nifedipine overdosage is limited. Generally, overdosage with nifedipine leading to pronounced hypotension calls for active cardiovascular support including monitoring of cardiovascular and respiratory function, elevation of extremities, and judicious use of calcium infusion, pressor agents, and fluids. Clearance of nifedipine would be expected to be prolonged in patients with impaired liver function. Since nifedipine is highly protein bound, dialysis is not likely to be of any benefit; however, plasmapheresis may be beneficial.
Warnings and precautions:
Hypotension, excessive hypotension
Increased angina and/or myocardial infarction
Congestive heart failure
Use in cirrhotic patients
Side effects, adverse reactions:
The most common adverse events reported with Adalat were peripheral edema, headache, flushing/heat sensation, dizziness, fatigue/asthenia, nausea, constipation.
Information for patients:
Adalat CC (Nifedipine) is an extended release tablet and should be swallowed whole and taken on an empty stomach. It should not be administered with food. Do not chew, divide or crush tablets.
Strong CYP3A inducers
Calcium channel blockers
Platelet Aggregation Inhibitors
Glucose lowering drugs
Medications interfering with food absorption
Use in specific populations:
In rodents, rabbits and monkeys, nifedipine has been shown to have a variety of embryotoxic, placentotoxic, teratogenic and fetotoxic effects, including stunted fetuses (rats, mice and rabbits), digital anomalies (rats and rabbits), rib deformities (mice), cleft palate (mice), small placentas and underdeveloped chorionic villi (monkeys), embryonic and fetal deaths (rats, mice and rabbits), prolonged pregnancy (rats; not evaluated in other species), and decreased neonatal survival (rats; not evaluated in other species). On a mg/kg or mg/m2 basis, some of the doses associated with these various effects are higher than the maximum recommended human dose and some are lower, but all are within an order of magnitude of it.
The digital anomalies seen in nifedipine-exposed rabbit pups are strikingly similar to those seen in pups exposed to phenytoin, and these are in turn similar to the phalangeal deformities that are the most common malformation seen in human children with in utero exposure to phenytoin.
From the clinical evidence available, a specific prenatal risk has not been identified. However, an increase in perinatal asphyxia, caesarean delivery, prematurity and intrauterine growth retardation have been reported.
Careful monitoring of blood pressure must be exercised in pregnant women, when administering nifedipine in combination with IV magnesium sulfate due to the possibility of an excessive fall in blood pressure which could harm the mother and fetus.
There are no adequate and well-controlled studies in pregnant women.
Nifedipine is excreted in human milk. Nursing mothers are advised not to breastfeed their babies when taking the drug.
The safety and effectiveness of nifedipine in pediatric patients have not been established.
Although small pharmacokinetic studies have identified an increased half-life and increased Cmax and AUC, clinical studies of nifedipine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Patients with galactose intolerance
Since this medicinal product contains lactose, patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Where to buy nifedipine online:
To purchase Procardia, Adalat (Nifedipine) 10 mg, 20 mg, 30 mg tablets from reliable online pharmacies and drugstores at low prices please use resources described above on this webpage.
1. Nifedipine tablet and capsule FAQ drug information from Netmeds.com:
2. Adalat (Nifedipine) tablets general review from Telehealth:
3. Understanding high blood pressure treatment by Nifedipine and other calcium channel blockers from ExpertsInHealth YouTube channel:
Here is a list of popular medications containing nifedipine as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:
|Trade name of the drug
||Pharmaceutical forms and doses
||Capsules; Oral; Nifedipine 5 mgCapsules; Oral; Nifedipine 10 mgCapsules; Oral; Nifedipine 20 mgInjectable; Infusion; Nifedipine 0.1 mg / mlTablets; Oral; Nifedipine 10 mgTablets; Oral; Nifedipine 20 mgTablets, Prolonged Release; Oral; Nifedipine 10 mgTablets, Prolonged Release; Oral; Nifedipine 20 mgTablets, Prolonged Release; Oral; Nifedipine 30 mgTablets, Prolonged Release; Oral; Nifedipine 60 mgTablets, Prolonged Release; Oral; Nifedipine 90 mg
||BayerBeragena ArzneimittelDoncaster Pharmaceuticals GroupEmra-Med ArzneimittelKohlpharmaLandmark PharmaLexon UKMedaO.P.D. LaboratoriesPrimecrownZuellig Pharma
||Tablets, Extended Release; Oral; Nifedipine 30 mgTablets, Extended Release; Oral; Nifedipine 60 mgTablets, Extended Release; Oral; Nifedipine 90 mg
||Capsules; Oral; Nifedipine 5 mgCapsules; Oral; Nifedipine 10 mgTablets, Prolonged Release; Oral; Nifedipine 10 mgTablets, Prolonged Release; Oral; Nifedipine 20 mg
||Unique Pharmaceutical LaboratoriesGIS PharmaJ.B. Chemicals & Pharmaceuticals
||Capsules; Oral; Nifedipine 10 mgCapsules; Oral; Nifedipine 20 mg