Procardia (nifedipine) is a prescription calcium channel blocker medication specifically formulated to manage hypertension (high blood pressure) and chronic stable angina. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes peripheral arterial vasodilation, reducing systemic vascular resistance. This mechanism effectively lowers blood pressure and decreases myocardial oxygen demand, offering a targeted approach to cardiovascular management. Available in extended-release formulations, Procardia provides sustained 24-hour therapeutic coverage, supporting consistent hemodynamic control and improved patient compliance.

Features

• Active ingredient: Nifedipine
• Drug class: Dihydropyridine calcium channel blocker
• Available formulations: Extended-release tablets (30mg, 60mg, 90mg)
• Administration: Oral
• Duration of action: 24-hour controlled release
• FDA-approved indications: Hypertension, chronic stable angina

Benefits

• Effectively lowers systolic and diastolic blood pressure through arterial vasodilation
• Reduces frequency and severity of angina episodes by decreasing myocardial oxygen demand
• Provides 24-hour therapeutic coverage with once-daily dosing
• Demonstrates selective vascular activity with minimal cardiac contractility effects
• May be used as monotherapy or in combination with other antihypertensive agents
• Extended-release formulation maintains consistent plasma concentrations

Common use

Procardia is primarily prescribed for the management of essential hypertension in adults, either as monotherapy or in combination with other antihypertensive medications. It is also indicated for the treatment of chronic stable angina (effort-associated angina) in patients who remain symptomatic despite adequate doses of beta blockers or nitrates, or who cannot tolerate these agents. The medication may be used off-label for certain vasospastic disorders, including Raynaud’s phenomenon, under specialist supervision.

Dosage and direction

The recommended starting dose for hypertension or angina is 30 mg or 60 mg once daily. Dosage may be titrated upward over 7-14 day intervals based on therapeutic response and tolerability. The maximum recommended dose is 90 mg once daily. Tablets must be swallowed whole and not crushed, chewed, or divided. Administration should occur at approximately the same time each day, with or without food. Patients should avoid grapefruit juice during treatment as it may increase nifedipine bioavailability. Dosage adjustments are necessary in elderly patients and those with hepatic impairment.

Precautions

Regular blood pressure monitoring is essential, especially during initiation and titration. Abrupt withdrawal may cause rebound hypertension or angina exacerbation. Use with caution in patients with heart failure or severe aortic stenosis due to potential negative inotropic effects. Peripheral edema, typically dose-dependent, may occur and usually responds to diuretic therapy. Patients should be advised to rise slowly from sitting or lying positions to minimize orthostatic hypotension. Dental professionals should be informed of Procardia use due to potential gingival hyperplasia.

Contraindications

Procardia is contraindicated in patients with known hypersensitivity to nifedipine or other calcium channel blockers. It must not be used in patients with cardiogenic shock, clinically significant aortic stenosis, or those who have experienced hypotension after initial dosing. The medication is contraindicated in patients with acute myocardial infarction, including during the acute phase and for 8 days following. Concomitant use with strong CYP3A4 inhibitors requires careful risk-benefit assessment.

Possible side effects

Common side effects (≥5% incidence) include peripheral edema (10-30%), headache (10-20%), dizziness (5-10%), flushing (5-10%), and fatigue (5-7%). Less frequent adverse reactions include nausea (3-5%), palpitations (2-5%), and constipation (2-4%). Serious but rare side effects include hypotension (<2%), syncope (<1%), myocardial infarction (<0.5%), and severe dermatological reactions. Most side effects are dose-dependent and often diminish with continued therapy.

Drug interaction

Procardia undergoes extensive CYP3A4 metabolism, resulting in significant interactions with CYP3A4 inhibitors (ketoconazole, ritonavir, erythromycin) which increase nifedipine concentrations, and inducers (rifampin, phenytoin, St. John’s wort) which decrease efficacy. Concurrent use with beta-blockers may potentiate hypotension and heart failure. Additive hypotensive effects occur with other antihypertensives, nitrates, and phosphodiesterase-5 inhibitors. Procardia may increase digoxin levels by 15-45% requiring monitoring. Grapefruit juice increases bioavailability by inhibiting intestinal CYP3A4.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If remembered near the time of the next scheduled dose, the missed dose should be skipped. Patients should never double the dose to make up for a missed administration. Consistent daily dosing is crucial for maintaining therapeutic blood levels and optimal cardiovascular protection.

Overdose

Nifedipine overdose manifests as severe hypotension, bradycardia or tachycardia, metabolic acidosis, and hyperglycemia. In massive overdoses, cardiac conduction abnormalities and cardiogenic shock may occur. Management includes cardiovascular monitoring, elevation of lower extremities, and intravenous calcium gluconate (10% solution, 10-20 mL). Vasopressors (norepinephrine, dopamine) may be necessary for refractory hypotension. Activated charcoal may be beneficial if administered within 1-2 hours of ingestion. 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 store in bathroom cabinets where humidity may affect stability. Discard any medication that has expired or shows signs of physical deterioration.

Disclaimer

This information does not replace professional medical advice. Procardia is available by prescription only and should be used under appropriate medical supervision. Individual response to therapy may vary based on clinical factors. Patients should consult their healthcare provider for personalized dosage recommendations and management of side effects. Never adjust dosage or discontinue medication without medical guidance.

Reviews

Clinical studies demonstrate Procardia’s efficacy in reducing systolic blood pressure by 12-15 mmHg and diastolic pressure by 8-10 mmHg in hypertensive patients. Angina frequency reduction of 40-60% has been observed in stable angina patients. Most patients report satisfactory blood pressure control with once-daily dosing. Common patient-reported benefits include convenient dosing schedule and reduced angina symptoms. Some users report peripheral edema as a limiting factor, though this often responds to dose adjustment or combination therapy. Overall satisfaction rates range from 70-85% in long-term users when appropriately titrated.