Nifedipine instructions for administration
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Instructions for administration
Overview
Angina patients
Discontinuation
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Co-administration with other antianginal drugs
Overview
Dosage must be adjusted according to each patient's needs. Therapy for either hypertension or angina should be initiated with 30 or 60 mg once daily. Nifedipine extended-release tablets should be swallowed whole and should not be bitten or divided. In general, titration should proceed over a 7–14 day period so that the physician can fully assess the response to each dose level and monitor blood pressure before proceeding to higher doses. Since steady-state plasma levels are achieved on the second day of dosing, if symptoms so warrant, titration may proceed more rapidly provided the patient is assessed frequently. Titration to doses above 120 mg are not recommended. Return to top
Angina patients
Angina patients controlled on Nifedipine immediate-release capsules alone or in combination with other antianginal medications may be safely switched to Nifedipine extended-release tablets at the nearest equivalent total daily dose (e.g., 30 mg t.i.d. of Nifedipine immediate-release capsules may be changed to 90 mg once daily of Nifedipine extended-release tablets). Subsequent titration to higher or lower doses may be necessary and should be initiated as clinically warranted. Experience with doses greater than 90 mg in patients with angina is limited. Therefore, doses greater than 90 mg should be used with caution and only when clinically warranted. Return to top
Discontinuation
No "rebound effect" has been observed upon discontinuation of Nifedipine extended-release tablets. However, if discontinuation of Nifedipine is necessary, sound clinical practice suggests that the dosage should be decreased gradually with close physician supervision. Return to top
Co-administration with other antianginal drugs
Sublingual nitroglycerin may be taken as required for the control of acute manifestations of angina, particularly during Nifedipine titration. Return to top
Adapted from the FDA Package Insert.