Procardia (nifedipine) is a leading calcium channel blocker medication designed to manage hypertension and chronic stable angina. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes vasodilation, reduces peripheral resistance, and decreases myocardial oxygen demand. This prescription medication offers a targeted mechanism of action suitable for long-term cardiovascular management under professional supervision. Available in extended-release formulations, Procardia ensures consistent 24-hour blood pressure control and angina prophylaxis with once-daily dosing.

Features

• Active ingredient: nifedipine
• Available in 30mg, 60mg, and 90mg extended-release tablets
• Once-daily dosing regimen
• GITS (Gastrointestinal Therapeutic System) technology for controlled release
• FDA-approved for hypertension and chronic stable angina
• Bioavailability approximately 86% under fasting conditions
• Peak plasma concentration reached in 6 hours post-dose
• Half-life of approximately 17-20 hours

Benefits

• Significantly reduces systolic and diastolic blood pressure through arterial vasodilation
• Decreases frequency and severity of angina episodes by improving myocardial oxygen supply-demand ratio
• Provides 24-hour therapeutic coverage with single daily administration
• Demonstrates minimal effect on cardiac conduction tissue at therapeutic doses
• Shows particular efficacy in elderly hypertensive patients
• May be used as monotherapy or in combination with other antihypertensive agents

Common use

Procardia is primarily prescribed for the management of essential hypertension and prophylaxis of chronic stable angina pectoris. Off-label uses include Raynaud’s phenomenon and preterm labor suppression (though other nifedipine formulations may be preferred for obstetric use). The medication is typically incorporated into comprehensive cardiovascular risk reduction strategies that may include lifestyle modifications and additional pharmacotherapy.

Dosage and direction

Initial dosage for hypertension or angina is typically 30mg or 60mg once daily, taken whole with water without crushing, chewing, or dividing. Dosage may be titrated upward over 7-14 day intervals based on therapeutic response and tolerability. Maximum recommended daily dose is 90mg. Administration should occur at approximately the same time each day, with or without food, though consistency in administration relative to meals is recommended. Tablets must be swallowed whole to maintain the extended-release properties.

Precautions

Regular blood pressure monitoring is essential, especially during initial titration. Abrupt withdrawal may cause rebound hypertension or angina exacerbation. Use cautiously in patients with heart failure, severe aortic stenosis, or hepatic impairment (consider dose reduction). Peripheral edema, typically dose-dependent, may occur. Patients should avoid grapefruit juice consumption as it may increase nifedipine bioavailability. Orthostatic hypotension may occur, particularly in volume-depleted patients.

Contraindications

Known hypersensitivity to nifedipine or other dihydropyridine calcium channel blockers. Concomitant use with strong CYP3A4 inhibitors in patients with hypertension or angina. Patients with cardiogenic shock or those who have experienced myocardial infarction within the preceding 4 weeks. Severe hypotension (systolic pressure <90 mmHg). Unstable angina except when part of a comprehensive management strategy under close supervision.

Possible side effect

Common (≥5%): peripheral edema (dose-related), headache, dizziness, flushing, fatigue. Less common (1-5%: palpitations, nausea, constipation, muscle cramps. Rare (<1%): gingival hyperplasia, hypotension, syncope, transient blindness at peak plasma levels. Laboratory abnormalities may include transient elevations in liver enzymes. Most adverse effects are dose-dependent and often diminish with continued therapy.

Drug interaction

Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin) may significantly increase nifedipine exposure. Concurrent use with beta-blockers may increase risk of heart failure exacerbation. May potentiate effects of other antihypertensive agents. Quinidine levels may decrease with coadministration. Digitalis levels may increase requiring monitoring. Phenytoin metabolism may be affected. Avoid concomitant use with rifampin or other CYP3A4 inducers.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistency in dosing time is important for maintaining stable plasma concentrations.

Overdose

Symptoms may include severe hypotension, bradycardia or tachycardia, metabolic acidosis, and hyperglycemia. Management includes cardiovascular monitoring, Trendelenburg positioning, and IV fluids for hypotension. Calcium gluconate administration (10% solution, 10-20 mL IV) may reverse cardiovascular effects. Vasopressors may be required for refractory hypotension. Hemodialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not remove tablets from blister packaging until immediately before administration. Do not store in bathroom cabinets where humidity may affect stability.

Disclaimer

This information is 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 provider. Individual response to therapy may vary. Patients should consult their physician for personalized medical advice and report any adverse effects promptly.

Reviews

Clinical studies demonstrate Procardia’s efficacy in reducing blood pressure by 12-15 mmHg systolic and 8-10 mmHg diastolic in hypertensive patients. Angina frequency reduction of 40-60% has been observed in stable angina patients. The extended-release formulation shows improved tolerability compared to immediate-release nifedipine with reduced incidence of reflex tachycardia. Long-term studies indicate maintained efficacy over 12-24 months of therapy with appropriate dose adjustment.