Adalat: Advanced Calcium Channel Blocker for Hypertension Control
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Adalat (nifedipine) is a trusted calcium channel blocker prescribed for the management of hypertension and angina. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, Adalat promotes vasodilation, reduces peripheral resistance, and decreases myocardial oxygen demand. This medication offers a well-established mechanism for cardiovascular protection, supported by decades of clinical use and evidence. It is available in multiple formulations, including extended-release options, to suit individual therapeutic needs and improve adherence.
Features
- Active ingredient: nifedipine
- Available in immediate-release and extended-release formulations
- Standard dosages: 10 mg, 20 mg, 30 mg, 60 mg tablets
- Proven calcium channel blocker mechanism
- Suitable for monotherapy or combination treatment
Benefits
- Effectively lowers blood pressure, reducing the risk of stroke, heart attack, and kidney damage
- Decreases frequency and severity of angina episodes by improving myocardial oxygen supply
- Offers flexible dosing with extended-release formulations for 24-hour coverage
- Well-tolerated profile with a long history of safe use in diverse patient populations
- Contributes to long-term cardiovascular risk reduction when used as prescribed
Common use
Adalat is primarily indicated for the management of essential hypertension and chronic stable angina. It may also be used off-label for certain cases of Raynaud’s phenomenon and preterm labor under specialist supervision. The medication is often incorporated into broader antihypertensive regimens, particularly when first-line agents require supplementation or when specific hemodynamic effects are desired.
Dosage and direction
Dosage must be individualized based on clinical response and tolerability. For hypertension: initial dose is typically 30-60 mg once daily for extended-release formulations, adjustable at 7- to 14-day intervals. Maximum dose is 90-120 mg daily. For angina: initial dose is 30-60 mg daily, with maximum of 120 mg daily. Tablets should be swallowed whole, not crushed or chewed, and may be taken with or without food. Consistency in administration time is recommended for optimal therapeutic effects.
Precautions
Patients should avoid grapefruit and grapefruit juice during treatment, as they may significantly increase nifedipine bioavailability. Blood pressure and heart rate should be monitored regularly, especially during dosage adjustments. Use with caution in patients with heart failure, severe aortic stenosis, or severe hypotension. Abrupt discontinuation should be avoided due to risk of rebound hypertension or angina exacerbation. Hepatic impairment may require dosage adjustment.
Contraindications
Adalat is contraindicated in patients with known hypersensitivity to nifedipine or other dihydropyridines. It should not be used in patients with cardiogenic shock, clinically significant aortic stenosis, or acute myocardial infarction (especially within 4 weeks). The extended-release formulation is contraindicated in patients with gastrointestinal narrowing or obstruction. Concomitant use with strong CYP3A4 inhibitors should be avoided.
Possible side effect
Common side effects include peripheral edema (7-29%), headache (10-22%), dizziness (4-12%), flushing (10-20%), and nausea (6-12%). Less frequently, patients may experience palpitations, fatigue, constipation, or muscle cramps. Serious but rare adverse effects include hypotension, syncope, heart failure exacerbation, gingival hyperplasia, and severe skin reactions. Most side effects are dose-dependent and often diminish with continued therapy.
Drug interaction
Nifedipine is metabolized primarily by CYP3A4, resulting in numerous potential interactions. Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) may significantly increase nifedipine levels. Inducers (rifampin, phenytoin, carbamazepine) may decrease efficacy. Concurrent use with beta-blockers may increase risk of heart failure or severe hypotension. Additive hypotensive effects may occur with other antihypertensives, nitrates, or phosphodiesterase-5 inhibitors. Monitor closely when used with digoxin (may increase levels) or quinidine (may decrease levels).
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, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Patients should be educated on maintaining consistent dosing patterns to ensure stable blood pressure control.
Overdose
Symptoms may include severe hypotension, bradycardia or tachycardia, confusion, nausea, and syncope. Management involves cardiovascular monitoring and supportive care, including Trendelenburg positioning and IV fluids. Calcium gluconate (10%) IV may be administered to counteract calcium channel blockade. Vasopressors such as dopamine or norepinephrine may be necessary for refractory hypotension. Hemodialysis is not effective due to high protein binding.
Storage
Store at room temperature (15-30°C or 59-86°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. Keep all medications out of reach of children and pets. Do not use beyond the expiration date printed on packaging.
Disclaimer
This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Dosage and administration should be determined by a physician based on individual patient characteristics. Never adjust medication regimen without medical supervision.
Reviews
Clinical studies demonstrate Adalat’s efficacy in reducing systolic and diastolic blood pressure by approximately 10-15 mmHg and 5-10 mmHg respectively. Long-term outcome trials show consistent cardiovascular risk reduction. Patient satisfaction surveys indicate good tolerability, though peripheral edema remains a common reason for discontinuation. The extended-release formulation shows improved adherence rates compared to immediate-release versions.