Nifedipine: Side Effects, Dosage, Uses, and More

Highlights for nifedipine

Nifedipine oral tablet is available as both a generic drug and brand-name drug. Brand name: Procardia XL.
Nifedipine tablets are an extended-release form of the drug. Nifedipine is also available in immediate-release oral capsules. The capsules are available as the brand-name drug Procardia. They are also available in a generic drug.
Nifedipine is used to treat hypertension (high blood pressure). It's also used to treat two types of angina (chest pain): vasospastic angina and chronic stable angina.

Important warnings

Congestive heart failure warning: In rare cases, upon starting to take nifedipine, some patients without a history of heart failure have developed heart failure.
Chest pain (angina) warning: If you're taking this drug to treat angina, it can cause a temporary increase in chest pain.
Low blood pressure warning: This drug can cause very low blood pressure. This most often occurs when the drug is started, or when the dosage is increased.

Nifedipine oral tablet is a prescription drug that's available as the brand-name drugs Adalat CC, Afeditab CR, and Procardia XL. These are all extended-release tablets. An extended-release drug is slowly released into your bloodstream over time. Nifedipine immediate-release capsules are available as the brand-name drug Procardia. The capsules are used to treat angina (chest pain). The tablets are used to treat either high blood pressure or angina.

Both the nifedipine immediate-release capsules and extended-release tablets are also available as generic drugs. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it's used

Nifedipine is used to lower blood pressure in people with hypertension. It's also used to treat vasospastic angina (chest pain due to a spasm in arteries around the heart) or chronic stable angina (chest pain that occurs with activity or stress). The drug form used depends on the condition it is treating. Talk with your doctor about which form is right for you.

Nifedipine may be used as part of a combination therapy. This means you may need to take it with other medications. If you are using it to treat high blood pressure, you may take it with other drugs that lower blood pressure. If you are using it to treat angina, you may take it with nitrates (nitroglycerin products) or beta-blockers.

How it works

Nifedipine belongs to a class of drugs called calcium channel blockers. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Calcium channel blockers help lower blood pressure by relaxing the blood vessels throughout your body. As a result, less pressure is built up and your heart does not have to work as hard to pump blood.

Calcium channel blockers help to prevent angina in two ways. First, they lower pressure in the coronary arteries (the arteries that supply blood to your heart). As a result, your heart receives more blood and oxygen. Second, they help prevent spasm of the coronary arteries. (A spasm is a temporary, sudden narrowing of these arteries.)

Nifedipine oral tablet doesn't cause drowsiness. However, it may cause other side effects.

More common side effects

The more common side effects that can occur with nifedipine include:

headache
nausea
dizziness or lightheadedness
flushing (reddening of the skin)
heartburn
muscle cramps
constipation
cough
decreased sexual ability or desire
edema (swelling in the legs or feet)
weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency. Serious side effects and their symptoms can include the following:

Edema (fluid retention). Symptoms can include:
- swelling in the arms, hands, lower legs, feet, or ankles
Allergic reaction. Symptoms can include:
- trouble breathing
- trouble swallowing
- rash or hives
- swelling of the face, eyes, lips, or tongue
Low blood pressure or low heart rate. Symptoms can include:
- lightheadedness
- fainting
Liver damage. Symptoms can include:
- yellowing of the skin
- yellowing of the whites of the eyes
Chest pain (angina) that is worse or occurs more often

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Nifedipine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you're taking. To find out how this drug might interact with something else you're taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with nifedipine oral tablet are listed below.

Antibiotics

Taking certain antibiotics with nifedipine can cause higher levels of nifedipine in your body. This can increase your risk of side effects from nifedipine. These drugs include:

clarithromycin
erythromycin
quinupristin/dalfopristin

Taking the antibiotic rifampin can decrease the levels of nifedipine in your body. This could make nifedipine less effective. You shouldn't take rifampin and nifedipine together.

Antifungal drugs

Taking certain antifungal drugs with nifedipine can cause higher levels of nifedipine in your body. This can increase your risk of side effects from nifedipine. These drugs include:

fluconazole
itraconazole
ketoconazole

Antiviral drugs

Taking certain antiviral drugs with nifedipine can cause higher levels of nifedipine in your body. This can increase your risk of side effects from nifedipine. These drugs include:

atazanavir
fosamprenavir
indinavir
nelfinavir
ritonavir

Antiseizure drugs

Taking certain antiseizure drugs with nifedipine can cause lower levels of nifedipine in your body. This can make it less effective. These drugs include:

phenytoin
carbamazepine

Taking other antiseizure drugs with nifedipine can cause higher levels of nifedipine in your body. This raises your risk of side effects from nifedipine. These drugs include:

valproic acid

Heart drugs

Digoxin is used to treat heart rhythm problems. Using digoxin with nifedipine can increase or decrease the amount of digoxin in your body. If you take these drugs together, your doctor should monitor the level of digoxin in your body.

Other drugs

Beta-blockers are used to treat many conditions. These include high blood pressure, migraines, or heart failure. Using these drugs with nifedipine has a low risk of causing heart failure, extremely low blood pressure, or a worsening of chest pain (angina).

If you're taking a beta-blocker and your doctor has you stop taking it before starting nifedipine, the beta-blocker should be tapered slowly. Stopping it suddenly could cause increased chest pains. Beta-blockers include:

atenolol
metoprolol
nadolol
propranolol
timolol

Doxazosin is used to treat high blood pressure, as well as benign prostate hyperplasia in men. Using doxazosin with nifedipine can lower the amount of doxazosin in your body. This makes it less effective. Using these drugs together can also cause increased levels of nifedipine in your body. This raises your risk of dangerous side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This dosage information is for nifedipine oral tablet. All possible dosages and drug forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, drug form, and how often you take the drug will depend on:

your age
the condition being treated
how severe your condition is
other medical conditions you have
how you react to the first dose

Forms and strengths

Generic: nifedipine

Form: Oral capsule
Strengths: 10 mg, 20 mg

Form: Oral extended-release tablet
Strengths: 30 mg, 60 mg, 90 mg

Brand: Procardia XL

Form: Oral extended-release tablet
Strengths: 30 mg, 60 mg, 90 mg

Brand: Procardia

Form: Oral capsule
Strengths: 10 mg

Dosage for hypertension (high blood pressure)

Adult dosage (ages 18–64 years)

The starting dose is 30 mg or 60 mg by mouth once per day. The dosage can be increased every 7 to 14 days until the maximum dosage of 90–120 mg per day is reached.

Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for vasospastic angina

Adult dosage (ages 18–64 years)

The starting dose is 30 mg or 60 mg by mouth once per day. The dosage can be increased every 7 to 14 days until the maximum dosage of 180 mg per day is reached.

Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Dosage for chronic stable angina

Adult dosage (ages 18–64 years)

The starting dose is 30 mg or 60 mg by mouth once per day. The dosage can be increased every 7 to 14 days until the maximum dosage of 90–120 mg per day is reached.

Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Special considerations

If you have liver disease, your body may have trouble clearing nifedipine from your blood. This may cause the amount of nifedipine in your blood to be too high. Your doctor may adjust your dose to keep the amount of nifedipine in your body at a safe level.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Nifedipine oral tablet is used for long-term treatment. It comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don't take it at all: If you take this drug to treat high blood pressure, your blood pressure may increase. This can raise your risk of health problems such as heart attack or stroke. If you take this drug to treat angina, your chest pain may get worse.

If you miss doses or don't take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

dizziness
a fast heartbeat
flushing (reddening of the skin)

If you think you've taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: If you're taking this drug to treat high blood pressure, your blood pressure level should go down. Your doctor can check your blood pressure, or you can do it using a home blood pressure monitor. If you're taking this drug to treat angina, you should have less severe chest pain, less frequent chest pain, or both.

As with all medications, the costs of nifedipine can vary. To find current prices for your area, check out GoodRx.com.

Keep these considerations in mind if your doctor prescribes nifedipine oral tablet for you.

General

You can take this drug with or without food. Taking it with food may help to reduce upset stomach.
Swallow the tablets whole. Don't chew, crush, or divide them.
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.

Storage

Store drug capsules at room temperature between 59°F (15°C) and 77°F (25°C).
Store the extended-release tablets below 86°F (30°C).
Don't freeze this drug.
Keep it away from light.
Don't store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

Always carry your medication with you or in your carry-on bag.
Don't worry about airport X-ray machines. They can't hurt your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
Don't put this medication in your car's glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
This medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to keep it cold.

Self-management

Your doctor may suggest that you monitor your blood pressure at home. You will need to buy a home blood pressure monitor to do this. Your doctor can tell you where to buy this device and how to use it.

Clinical monitoring

Your doctor will check your blood pressure and perform blood tests from time to time.

Your diet

Your doctor may advise you to follow a heart-healthy diet. Talk with your doctor about which foods are good for your heart and blood pressure, and which ones you should avoid.

Hidden costs

You may need to buy a blood pressure monitor to check your blood pressure at home. Your doctor can tell you more.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Congestive heart failure warning: In rare cases, upon starting to take nifedipine, some patients without a history of heart failure have developed heart failure.
Chest pain (angina) warning: If you're taking this drug to treat angina, it can cause a temporary increase in chest pain.
Low blood pressure warning: This drug can cause very low blood pressure. This most often occurs when the drug is started, or when the dosage is increased.

Nifedipine oral tablet comes with several warnings.

Allergy warning

Nifedipine can cause a severe allergic reaction. Symptoms can include:

swelling of the face, eyes, lips, or tongue
trouble breathing
trouble swallowing

If you have these symptoms, call 911 or go to the nearest emergency room.

Don't take this drug again if you have ever had an allergic reaction to it before. Taking it again could be fatal (cause death).

Food interactions

Do not eat grapefruit or drink grapefruit juice if you're taking nifedipine. Doing so can increase the level of the drug in your body and increase your risk of side effects. Your doctor will likely tell you to avoid grapefruit at least 3 days before starting to take nifedipine.

Alcohol interaction

Don't have drinks that contain alcohol while taking this drug. Drinking alcohol while taking nifedipine can cause very low blood pressure.

Warnings for people with certain health conditions

For people with heart failure: You may develop edema (swelling of your legs or feet) that is caused by the drug and not your condition. Talk with your doctor to find out the true cause of any increased swelling you may have. Your doctor can help you decide how to manage it.

For people with liver disease: Your liver clears this drug from your blood. If your liver isn't working right, the level of nifedipine in your blood may become too high.

For people with low blood pressure: If you have episodes of low blood pressure, taking nifedipine may make these episodes worse. This may be more likely to occur when you first start taking nifedipine, or when your doctor increases your dose. Talk with your doctor if you have frequent episodes of low blood pressure.

For people with a history of gastrointestinal blockage: There have been rare reports of gastrointestinal blockage with use of the brand-name drug Procardia XL. You may be at greater risk for this blockage if you have a history of it.

For people with severe heart disease: There have been rare reports of worsening chest pain and heart attack in people who have severe heart disease. Nifedipine capsules (Procardia) should not be taken within the first week or two after a heart attack. Ask your doctor about this risk to see if nifedipine is right for you.

Warnings for other groups

For pregnant women: Nifedipine is a category C pregnancy drug. That means two things:

Research in animals has shown adverse effects to the fetus when the mother takes the drug.
There haven't been enough studies done in humans to be certain how the drug might affect the fetus.

Talk with your doctor if you're pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor if you become pregnant while taking this drug.

For women who are breastfeeding: Nifedipine may pass into breast milk and can cause serious side effects in a child who is breastfed. Tell your doctor if you are breastfeeding. You should decide whether you will stop breastfeeding or stop taking nifedipine.

For children: This medication has not been studied in children. It should not be used in people younger than 18 years.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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