Adalat, with its active ingredient nifedipine, is a trusted calcium channel blocker prescribed for the management of hypertension and angina. This medication works by relaxing and widening blood vessels, allowing blood to flow more easily and reducing the heart’s workload. It is a cornerstone in cardiovascular therapy, offering reliable and effective control for patients requiring long-term management of high blood pressure and chest pain associated with coronary artery disease. Its well-established efficacy and safety profile make it a preferred choice among healthcare providers worldwide.

Features

• Active ingredient: Nifedipine
• Drug class: Calcium channel blocker (dihydropyridine)
• Available formulations: Extended-release tablets, immediate-release capsules
• Standard strengths: 10 mg, 20 mg, 30 mg, 60 mg
• Administration: Oral
• Prescription status: Requires medical prescription

Benefits

• Effectively lowers high blood pressure, reducing the risk of stroke, heart attack, and kidney damage.
• Relieves angina (chest pain) by improving blood flow to the heart muscle and decreasing its oxygen demand.
• Helps prevent future cardiovascular events through consistent blood pressure management.
• Supports long-term vascular health by maintaining flexible and relaxed blood vessels.
• Can be used as monotherapy or in combination with other antihypertensive agents for tailored treatment.
• Extended-release formulations allow for once-daily dosing, improving adherence and convenience.

Common use

Adalat is primarily indicated for the treatment of hypertension (high blood pressure) and chronic stable angina (chest pain due to coronary artery disease). It may also be used off-label for certain cases of Raynaud’s phenomenon and preterm labor under strict medical supervision. The medication is suitable for adult patients and, in specific circumstances, may be prescribed for pediatric hypertensive patients based on specialist evaluation. It is often incorporated into comprehensive cardiovascular risk management plans that include lifestyle modifications.

Dosage and direction

Dosage must be individualized based on the patient’s condition, response to therapy, and concomitant medications. For hypertension, the typical starting dose for extended-release tablets is 30 or 60 mg once daily, which may be titrated upward over 7-14 day intervals. The maximum recommended dose is 90 mg daily. For angina, initial dosing is typically 30 mg once daily, with a maximum of 120 mg daily. Tablets should be swallowed whole with a glass of water, without crushing, chewing, or dividing. Administration with or without food is acceptable, but consistency is recommended. Grapefruit juice should be avoided as it may increase drug levels.

Precautions

Patients should be monitored regularly for blood pressure response and potential adverse effects. Caution is advised in patients with heart failure, severe aortic stenosis, or severe hypotension. Hepatic impairment requires dosage adjustment and careful monitoring. Abrupt discontinuation should be avoided as it may precipitate rebound hypertension or angina. Patients should be advised to avoid alcohol as it may potentiate vasodilation and hypotension. Use during pregnancy only if clearly needed and under specialist supervision. Breastfeeding is not recommended during treatment.

Contraindications

Adalat is contraindicated in patients with known hypersensitivity to nifedipine or other calcium channel blockers. It should not be used in patients with cardiogenic shock, significant aortic stenosis, or unstable angina (except when managed in hospital settings). Concomitant use with strong CYP3A4 inhibitors such as ketoconazole, ritonavir, or clarithromycin is contraindicated due to the risk of severe hypotension. The immediate-release formulation is contraindicated for hypertensive emergencies due to the risk of precipitous blood pressure drops.

Possible side effects

Common side effects (affecting >1% of patients) include peripheral edema, headache, dizziness, flushing, and fatigue. Less frequently, patients may experience palpitations, nausea, constipation, or muscle cramps. Serious but rare adverse effects include hypotension, syncope, heart failure exacerbation, and gingival hyperplasia. Allergic reactions including rash and pruritus may occur. Patients should report any signs of severe hypotension (fainting, extreme dizziness), significant swelling, or symptoms suggesting myocardial ischemia.

Drug interaction

Nifedipine is metabolized primarily by CYP3A4, resulting in numerous potential interactions. Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir) significantly increase nifedipine levels. Inducers (e.g., rifampin, phenytoin, St. John’s wort) may decrease efficacy. Concurrent use with other antihypertensives may potentiate blood pressure lowering. Beta-blockers may increase risk of heart failure exacerbation. Grapefruit juice inhibits CYP3A4 and should be avoided. Use with quinidine, digoxin, or warfarin may require dosage adjustments and monitoring.

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. Doubling the dose to make up for a missed one is not recommended as it may increase the risk of adverse effects such as hypotension. Patients should be educated on maintaining consistent dosing times to ensure stable blood pressure control.

Overdose

Symptoms of overdose include severe hypotension, bradycardia or tachycardia, confusion, and syncope. In cases of significant overdose, cardiogenic shock with pulmonary edema may occur. Management involves cardiovascular monitoring and supportive care, including elevation of lower extremities and administration of IV fluids. Calcium gluconate infusion may be considered to counteract calcium channel blockade. Vasopressors such as dopamine or norepinephrine may be required for refractory hypotension. Gastric lavage may be beneficial if ingestion was recent.

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 where moisture levels fluctuate. Keep out of reach of children and pets. Do not use beyond the expiration date printed on packaging. Properly discard any unused or expired medication through take-back programs or following FDA-recommended disposal methods.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Adalat is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Dosage, indications, and precautions may vary based on individual patient factors. Always consult with a physician for proper diagnosis and treatment recommendations. Do not initiate, adjust, or discontinue medication without medical guidance.

Reviews

Clinical studies and patient reports consistently demonstrate Adalat’s effectiveness in blood pressure control and angina management. Many patients experience significant improvement in symptoms with minimal side effects when properly dosed. Healthcare providers appreciate its predictable pharmacokinetics and flexibility in dosing. Some patients report satisfaction with the once-daily formulation for its convenience. Critical reviews often note the importance of careful titration to manage peripheral edema, which remains the most frequently reported side effect. Overall, Adalat maintains a positive reputation in cardiovascular therapeutics for its established efficacy and safety profile.