Procardia

Procardia (nifedipine) is a prescription calcium channel blocker medication specifically formulated to manage hypertension (high blood pressure) and treat angina (chest pain). By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it produces potent vasodilation, reducing peripheral vascular resistance and myocardial oxygen demand. This targeted mechanism of action allows for effective blood pressure control and angina prophylaxis, supporting long-term cardiovascular health with a well-established efficacy and safety profile.

Features

• Active ingredient: Nifedipine
• Available in extended-release tablet formulations (30mg, 60mg, 90mg)
• Once-daily dosing regimen for consistent 24-hour therapeutic coverage
• FDA-approved for hypertension and chronic stable angina
• Proven bioavailability with predictable pharmacokinetics

Benefits

• Effectively lowers systolic and diastolic blood pressure, reducing long-term cardiovascular risk
• Decreases frequency and severity of angina episodes, improving exercise tolerance and quality of life
• Minimizes peripheral vascular resistance without significantly affecting cardiac contractility
• Offers smooth 24-hour blood pressure control with single daily dosing
• Well-tolerated profile with extensive clinical documentation
• May be used as monotherapy or in combination with other antihypertensive agents

Common use

Procardia is primarily indicated for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also prescribed for the management of chronic stable angina (effort-associated angina) in patients who remain symptomatic despite adequate doses of beta blockers or nitrates, or who cannot tolerate those agents. Off-label uses may include Raynaud’s phenomenon and certain cases of preterm labor, though these applications require specialized medical supervision.

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 7-14 day intervals based on therapeutic response and tolerability. The maximum recommended daily dose is 90 mg. 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 daily timing is recommended to maintain steady-state plasma concentrations.

Precautions

Regular blood pressure monitoring is essential, particularly during dosage titration. Patients should avoid grapefruit and grapefruit juice, which may increase nifedipine plasma concentrations. Use with caution in patients with heart failure or severe aortic stenosis due to potential negative inotropic effects. Hepatic impairment requires dosage adjustment as nifedipine is extensively metabolized by the liver. Elderly patients may exhibit increased sensitivity and require lower initial dosing. Abrupt discontinuation should be avoided due to risk of rebound hypertension or angina exacerbation.

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 (particularly with hemodynamic instability). Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) is contraindicated due to dramatically increased nifedipine exposure. The immediate-release formulation is contraindicated for hypertensive emergencies.

Possible side effects

Common side effects (≥5% incidence) include peripheral edema, headache, dizziness, flushing, and fatigue. Less frequently reported effects (1-5%) include palpitations, nausea, constipation, and muscle cramps. Serious adverse reactions may include hypotension (particularly with initial dosing or dosage increases), syncope, worsening angina, and heart failure exacerbation. Allergic reactions including rash and pruritus occur rarely. Symptomatic hypotension typically responds to dosage reduction or temporary discontinuation.

Drug interaction

Nifedipine may potentiate the effects of other antihypertensive agents, requiring dosage adjustment. CYP3A4 inhibitors (macrolide antibiotics, azole antifungals, HIV protease inhibitors) significantly increase nifedipine concentrations. Concomitant use with beta-blockers may increase risk of heart failure exacerbation and hypotension. Nifedipine may increase digoxin levels by approximately 15%, necessitating monitoring. Quinidine levels may decrease with concurrent administration. Calcium supplements may reduce nifedipine efficacy.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling doses to make up for a missed dose is not recommended as it may increase the risk of adverse effects, particularly hypotension.

Overdose

Nifedipine overdose may manifest as severe hypotension, bradycardia, and reflex tachycardia. Cardogenic shock, metabolic acidosis, and hyperglycemia may occur in severe cases. Gastric lavage may be beneficial if performed soon after ingestion. Activated charcoal may reduce absorption. Cardiovascular support with fluids and vasopressors (e.g., calcium gluconate, dopamine) is the mainstay of treatment. Calcium infusion (10% calcium gluconate 10-20 mL IV) may help reverse cardiac effects. Bradycardia may require atropine or cardiac pacing.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container, protected from light and moisture. Keep tightly closed and away from excessive heat or humidity. Do not store in bathroom cabinets where moisture levels fluctuate. Keep out of reach of children and pets. Properly discard any medication that is outdated or no longer needed.

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 medication may vary. Patients should consult their healthcare provider for personalized medical advice, including potential risks and benefits specific to their medical condition. Never adjust dosage or discontinue medication without consulting a physician.

Reviews

Clinical studies demonstrate that Procardia effectively reduces blood pressure in 60-70% of patients with mild to moderate hypertension. Angina frequency shows 40-50% reduction in controlled trials. Patient satisfaction surveys indicate high adherence rates due to once-daily dosing convenience. Most common patient-reported benefits include improved exercise tolerance and reduced headache frequency associated with hypertension. Peripheral edema remains the most frequently cited reason for discontinuation, affecting approximately 10-15% of patients at higher doses.