Nifedipine XR

Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension, angina

PBSCCBAdalat OROS, Adefin XL, Nifehexal30 mg tabletS4+1

Max Dose

120 mg/day

Half-life

15 h (XR)

Edema

COMMON

IR Form

AVOID

Rapid Summary

Overview

Potent dihydropyridine CCB. The extended-release (XR/OROS) formulation is safe and effective for BP control, but immediate-release forms are dangerous in hypertension.

Maximum Dose

Max 120 mg/day (XR formulations only).

Clinical Focus

Never use short-acting sublingual or chewed nifedipine for hypertensive urgencies due to risk of fatal cerebral/myocardial ischemia.

Bottom Line

Nifedipine XR is a potent antihypertensive safe in pregnancy (gestational hypertension), but short-acting/sublingual nifedipine must never be used due to risk of stroke and MI.

Formulation & Access

Brand Names

Adalat OROS, Adefin XL, Nifehexal

Oral Routes

Extended-release tablets (30 mg, 60 mg). OROS tablets leave a 'ghost' shell in stool.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, angina.

Off-Label

OFF

Tocolysis in premature labour, Raynaud's phenomenon, High-altitude pulmonary oedema.

Clinical Place

Widely used in pregnancy-induced hypertension where ACEi/ARBs are strictly contraindicated.

Quick reference

Class & Role

Calcium Channel Blocker — Potent dihydropyridine CCB.

Route / Formulation

Extended-release tablets (30 mg, 60 mg). OROS tablets leave a 'ghost' shell in stool. (Adalat OROS, Adefin XL, Nifehexal)

Usual Dose & Max

PO 30-60 mg OD. May titrate up to Max 120 mg/day.

Key Indication Doses

Hypertension (XR): PO 30-60 mg OD. May titrate up to Max 120 mg/day. Chronic Stable Angina: PO 30-60 mg OD. Pregnancy HTN (Specialist): PO 20-30 mg (XR) OD or BD depending on the specific product release kinetics.

Best Uses

Nifedipine XR is a potent antihypertensive safe in pregnancy (gestational hypertension), but short-acting/sublingual nifedipine must never be used due to risk of stroke and MI.

Avoid / Cautions

Acute STEMI (within 8 days), cardiogenic shock, severe aortic stenosis. Pregnancy Category C, but XR widely used as standard of care in maternal medicine.

Key Risks

Cardiovascular: Peripheral oedema. MODERATE — Reflex tachycardia, flushing, hypotension. Gastrointestinal: Constipation, gingival hyperplasia (more common than amlodipine).

Key Interactions

CYP3A4 inhibitors significantly increase levels (avoid grapefruit juice). Magnesium sulfate (used in pre-eclampsia) plus nifedipine can cause profound neuromuscular blockade and hypotension.

Monitoring

Regular BP and HR monitoring. Check for lower limb oedema. No specific routine laboratory tests required.

Clinical Pearl

Warn patients taking Adalat OROS that the empty tablet shell will pass through the GI tract and appear intact in their stool—this is normal and the drug has been absorbed.

Access

Adalat OROS, Adefin XL, Nifehexal30 mg tablet

Brand: Adalat OROS, Adefin XL, Nifehexal
Formulation: Extended-release tablets (30 mg, 60 mg)

Nifedipine XR

Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension, angina

PBSCCBAdalat OROS, Adefin XL, Nifehexal30 mg tabletS4+1

Max Dose

120 mg/day

Half-life

15 h (XR)

Edema

COMMON

IR Form

AVOID

Rapid Summary

Overview

Potent dihydropyridine CCB. The extended-release (XR/OROS) formulation is safe and effective for BP control, but immediate-release forms are dangerous in hypertension.

Maximum Dose

Max 120 mg/day (XR formulations only).

Clinical Focus

Never use short-acting sublingual or chewed nifedipine for hypertensive urgencies due to risk of fatal cerebral/myocardial ischemia.

Bottom Line

Nifedipine XR is a potent antihypertensive safe in pregnancy (gestational hypertension), but short-acting/sublingual nifedipine must never be used due to risk of stroke and MI.

Formulation & Access

Brand Names

Adalat OROS, Adefin XL, Nifehexal

Oral Routes

Extended-release tablets (30 mg, 60 mg). OROS tablets leave a 'ghost' shell in stool.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, angina.

Off-Label

OFF

Tocolysis in premature labour, Raynaud's phenomenon, High-altitude pulmonary oedema.

Clinical Place

Widely used in pregnancy-induced hypertension where ACEi/ARBs are strictly contraindicated.

Quick reference

Class & Role

Calcium Channel Blocker — Potent dihydropyridine CCB.

Route / Formulation

Extended-release tablets (30 mg, 60 mg). OROS tablets leave a 'ghost' shell in stool. (Adalat OROS, Adefin XL, Nifehexal)

Usual Dose & Max

PO 30-60 mg OD. May titrate up to Max 120 mg/day.

Key Indication Doses

Best Uses

Nifedipine XR is a potent antihypertensive safe in pregnancy (gestational hypertension), but short-acting/sublingual nifedipine must never be used due to risk of stroke and MI.

Avoid / Cautions

Acute STEMI (within 8 days), cardiogenic shock, severe aortic stenosis. Pregnancy Category C, but XR widely used as standard of care in maternal medicine.

Key Risks

Cardiovascular: Peripheral oedema. MODERATE — Reflex tachycardia, flushing, hypotension. Gastrointestinal: Constipation, gingival hyperplasia (more common than amlodipine).

Key Interactions

CYP3A4 inhibitors significantly increase levels (avoid grapefruit juice). Magnesium sulfate (used in pre-eclampsia) plus nifedipine can cause profound neuromuscular blockade and hypotension.

Monitoring

Regular BP and HR monitoring. Check for lower limb oedema. No specific routine laboratory tests required.

Clinical Pearl

Warn patients taking Adalat OROS that the empty tablet shell will pass through the GI tract and appear intact in their stool—this is normal and the drug has been absorbed.

Access

Adalat OROS, Adefin XL, Nifehexal30 mg tablet

Brand: Adalat OROS, Adefin XL, Nifehexal
Formulation: Extended-release tablets (30 mg, 60 mg)