Procardia (nifedipine) is a leading calcium channel blocker prescription medication designed for the effective management of chronic stable angina and hypertension. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes coronary and peripheral arterial vasodilation, reducing afterload and myocardial oxygen demand. This mechanism supports sustained blood pressure control and decreases angina frequency, offering a reliable therapeutic option for cardiovascular health maintenance under professional supervision.

Features

• Active ingredient: Nifedipine
• Available in extended-release tablet formulations
• Dosage strengths: 30mg, 60mg, and 90mg
• FDA-approved for hypertension and chronic stable angina
• Once-daily dosing convenience
• Prescription-only medication

Benefits

• Effectively lowers elevated blood pressure, reducing long-term cardiovascular risk
• Decreases frequency and severity of angina episodes, improving exercise tolerance
• Minimizes peripheral vascular resistance without significantly affecting cardiac contractility
• Provides 24-hour therapeutic coverage with single daily dosing
• Well-established safety profile with decades of clinical use
• Compatible with comprehensive cardiovascular treatment plans

Common use

Procardia is primarily prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is equally indicated for the treatment of chronic stable angina pectoris when beta-blockers or organic nitrates are not tolerated or prove ineffective. The medication works by relaxing coronary arteries and systemic arterioles, improving myocardial oxygen delivery while reducing cardiac workload. Clinical studies demonstrate its efficacy in diverse patient populations, though individual response should be monitored through regular blood pressure checks and clinical assessment.

Dosage and direction

The recommended initial dosage for hypertension or angina is 30mg or 60mg once daily, taken orally with a glass of water. Tablets should be swallowed whole and not crushed, chewed, or divided. Dosage may be titrated upward over 7-14 day intervals based on therapeutic response and tolerability, with maximum recommended daily dose not exceeding 120mg. Administration should occur at approximately the same time each day to maintain consistent plasma concentrations. Patients should be advised that the tablet shell may pass unchanged in stool—this is normal and does not indicate reduced drug absorption.

Precautions

Patients should undergo baseline hepatic function assessment before initiation and periodically during therapy, as nifedipine is extensively metabolized by the liver. Blood pressure and heart rate should be monitored regularly, particularly during dosage adjustments. Caution is advised in patients with heart failure or severe aortic stenosis due to potential negative inotropic effects. Peripheral edema, typically dose-related, may develop and should be distinguished from worsening heart failure. Grapefruit juice should be avoided as it may significantly increase drug bioavailability. Abrupt discontinuation should be avoided to prevent rebound hypertension or angina exacerbation.

Contraindications

Procardia is contraindicated in patients with known hypersensitivity to nifedipine or other dihydropyridine calcium channel blockers. It must not be administered to individuals with cardiogenic shock, clinically significant aortic stenosis, or those experiencing acute myocardial infarction (particularly within the first 4 weeks). Concurrent use with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or ritonavir is contraindicated due to risk of severe hypotension. The medication is not recommended for patients with severe hypotension (systolic pressure <90 mmHg) or decompensated heart failure.

Possible side effects

Common adverse reactions (occurring in >5% of patients) include peripheral edema, headache, dizziness, flushing, and fatigue. Less frequently (1-5%), patients may experience palpitations, nausea, constipation, or muscle cramps. Serious but rare side effects (<1%) include hypotension, syncope, myocardial infarction, heart failure exacerbation, and marked elevation of liver enzymes. Allergic reactions including rash and pruritus have been reported. Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment. Patients should report persistent or severe symptoms promptly.

Drug interaction

Nifedipine is metabolized primarily by CYP3A4, creating significant interaction potential. Strong CYP3A4 inhibitors (clarithromycin, ketoconazole, ritonavir) may dramatically increase nifedipine concentrations, requiring dosage reduction or alternative therapy. Concurrent use with beta-blockers may potentiate hypotension and heart failure risk. CYP3A4 inducers (rifampin, phenytoin, carbamazepine) may reduce nifedipine efficacy. Grapefruit juice increases bioavailability by inhibiting intestinal CYP3A4. Additive hypotensive effects may occur with other antihypertensives, nitrates, phosphodiesterase-5 inhibitors, or alcohol. Digitalis levels may increase slightly with concomitant use.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If the next scheduled dose is due within 12 hours, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to compensate for a missed administration. Consistent daily adherence is important for maintaining stable blood pressure control and angina prevention. Those frequently missing doses should discuss adherence strategies with their healthcare provider, as inconsistent dosing may lead to therapeutic failure or blood pressure variability.

Overdose

Nifedipine overdose may manifest as severe hypotension, bradycardia or tachycardia, metabolic acidosis, and hyperglycemia. In cases of suspected overdose, immediate medical attention is required. Management includes cardiovascular monitoring, elevation of lower extremities, and administration of intravenous fluids. Calcium gluconate (10% solution) may be administered intravenously to counteract calcium channel blockade. Vasopressors such as dopamine or norepinephrine may be necessary for refractory hypotension. As nifedipine is highly protein-bound, dialysis is not effective. Gastric lavage may be considered if presentation is early after ingestion.

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 has expired or is no longer needed through medication take-back programs or according to FDA-recommended disposal methods. Do not flush medications down the toilet unless specifically instructed.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Procardia is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary, and only your physician can determine the appropriate treatment based on your specific medical condition, concurrent medications, and overall health status. Never initiate, adjust, or discontinue medication without consulting your healthcare provider. Report any adverse effects or concerns promptly to your physician.

Reviews

Clinical studies demonstrate that Procardia effectively reduces systolic and diastolic blood pressure by an average of 10-15 mmHg and 5-10 mmHg respectively at maintenance doses. Angina frequency shows 40-60% reduction in most patients within 2-4 weeks of therapy. Patient satisfaction surveys indicate improved quality of life measures related to reduced angina symptoms and convenient once-daily dosing. Cardiology guidelines continue to include nifedipine as a recommended option for both hypertension and angina management, particularly when other agents are contraindicated or poorly tolerated. Long-term follow-up studies support its sustained efficacy and safety profile in appropriately selected patients.