Procardia (nifedipine) is a trusted calcium channel blocker prescribed for the management of chronic stable angina and hypertension. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes vasodilation, reduces peripheral arterial resistance, and decreases afterload. This mechanism supports improved coronary blood flow and oxygen delivery, offering a scientifically validated approach to cardiovascular symptom management. Available in extended-release formulations, Procardia ensures consistent 24-hour therapeutic coverage, aiding long-term adherence and clinical stability.

Features

• Active ingredient: Nifedipine
• Available in extended-release tablet formulations (30mg, 60mg, 90mg)
• Once-daily dosing regimen for sustained plasma concentrations
• Bioavailability approximately 86% under fasting conditions
• Half-life ranges from 2 to 5 hours (immediate-release) and 7+ hours (extended-release)
• Metabolized primarily via CYP3A4 pathway
• Excreted largely in urine as inactive metabolites

Benefits

• Effectively lowers systolic and diastolic blood pressure through arterial vasodilation
• Reduces frequency and severity of angina episodes by improving myocardial oxygen supply
• Minimizes cardiac workload via decreased peripheral vascular resistance
• Supports long-term cardiovascular risk management with consistent daily dosing
• Compatible with many antihypertensive and antianginal combination therapies
• Enhances quality of life through reliable symptom control and reduced hospitalizations

Common use

Procardia is indicated for the management of chronic stable angina (effort-associated angina) in patients who remain symptomatic despite adequate doses of beta-blockers and/or organic nitrates, or who cannot tolerate those agents. It is also approved for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive drugs. Off-label uses may include Raynaud’s phenomenon and preterm labor suppression (under strict obstetric supervision), though these are not FDA-approved indications.

Dosage and direction

Dosage must be individualized based on clinical response and tolerability. For hypertension or angina, the typical starting dose is 30 mg or 60 mg once daily. Dosage may be increased over 7 to 14 day intervals. The maximum recommended dose is 90 mg once daily. Tablets should be swallowed whole and must not be divided, crushed, or chewed. Administer on an empty stomach (1 hour before or 2 hours after a meal). Consistency in daily timing is advised to maintain stable plasma levels.

Precautions

• Avoid abrupt discontinuation, which may precipitate rebound angina or hypertension
• Use with caution in patients with heart failure or severe aortic stenosis
• Peripheral edema is common; differentiate from worsening heart failure
• May cause symptomatic hypotension, especially in volume-depleted patients
• Monitor liver function periodically; metabolism may be impaired in hepatic insufficiency
• Not recommended in acute coronary syndromes or immediately post-MI

Contraindications

• Known hypersensitivity to nifedipine or any component of the formulation
• Patients with cardiogenic shock
• Concurrent use with strong CYP3A4 inducers or inhibitors (e.g., rifampin, ketoconazole)
• Coadministration with grapefruit juice
• Advanced aortic stenosis

Possible side effect

Common side effects (≥5%):

• Peripheral edema
• Headache
• Dizziness
• Flushing
• Fatigue

Less common (<5%):

• Nausea
• Palpitations
• Constipation
• Muscle cramps
• Hypotension

Rare but serious:

• Marked hypotension
• Heart failure exacerbation
• Severe cutaneous reactions
• Gastrointestinal obstruction (very rare, with extended-release formulations)
• Liver enzyme elevations

Drug interaction

• Strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) increase nifedipine exposure
• CYP3A4 inducers (e.g., rifampin, phenytoin) reduce nifedipine efficacy
• Beta-blockers may increase risk of heart failure or severe hypotension
• Digoxin levels may increase; monitor serum concentrations
• Cimetidine may increase nifedipine bioavailability
• Avoid concomitant use with other vasodilators or antihypertensives without careful titration

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to catch up. Resume the regular dosing schedule. Consistent daily adherence is important to maintain therapeutic effect.

Overdose

Symptoms may include severe hypotension, bradycardia or tachycardia, and metabolic acidosis. Cardiovascular support is primary: place patient in Trendelenburg position, administer IV fluids. Calcium gluconate (10%) IV may be considered. Vasopressors (e.g., dopamine or norepinephrine) can be used 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). Excursions permitted between 15–30°C (59–86°F). Keep in original container, tightly closed. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Do not disregard or delay seeking medical advice based on content provided here.

Reviews

“Procardia has been integral in managing my hypertension with once-daily convenience. Peripheral edema was noticeable initially but improved with dose adjustment.” — James L., 64

“As a cardiologist, I find nifedipine ER effective for patients with vasospastic angina. Its predictable pharmacokinetics support long-term use.” — Dr. Almeida, MD

“Significant improvement in angina frequency. No notable side effects after the first month. Blood pressure remains well-controlled.” — Margaret T., 71

“Used off-label for Raynaud’s with good effect. Patient reported reduced frequency and severity of digital attacks.” — Rheumatology Clinic Note

“Easy to tolerate compared to other CCBs. Consistent 24-hour coverage makes it a solid option for combination therapy.” — Clinical Pharmacist Review