Procardia: Advanced Calcium Channel Blocker for Hypertension & Angina Control
Procardia
| Product dosage: 30mg | |||
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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, reduces systemic vascular resistance, and decreases myocardial oxygen demand. This dual-action mechanism not only helps in controlling blood pressure but also alleviates chest pain associated with coronary artery disease. Available in extended-release formulations, Procardia offers sustained 24-hour therapeutic coverage, supporting consistent cardiovascular management with once-daily dosing. It is commonly prescribed as part of a comprehensive treatment plan that may include lifestyle modifications.
Features
- Active ingredient: nifedipine
- Available in extended-release tablet formulations (30mg, 60mg, 90mg)
- Once-daily dosing for consistent blood concentration
- Belongs to the dihydropyridine class of calcium channel blockers
- FDA-approved for hypertension and chronic stable angina management
- Designed for gradual drug release to maintain steady-state plasma levels
Benefits
- Effectively lowers elevated blood pressure, reducing long-term cardiovascular risk
- Decreases frequency and severity of angina episodes, improving exercise tolerance
- Promotes vasodilation without significantly affecting cardiac contractility
- Supports adherence through convenient once-daily dosing
- May be used as monotherapy or in combination with other antihypertensive agents
- Contributes to overall cardiovascular protection when integrated into a managed treatment plan
Common use
Procardia is primarily indicated for the management of hypertension, either as monotherapy or in combination with other antihypertensive drugs. It is also prescribed for the treatment of chronic stable angina pectoris in patients who remain symptomatic despite adequate doses of beta blockers or nitrates, or who cannot tolerate those agents. Off-label uses may include Raynaud’s phenomenon and certain cases of preterm labor, though these applications require careful specialist supervision. The medication is typically incorporated into long-term treatment regimens aimed at reducing cardiovascular morbidity and mortality.
Dosage and direction
The recommended starting dose for hypertension or angina is 30 mg or 60 mg once daily, taken orally. Dosage may be adjusted based on therapeutic response and tolerability, typically at 7- to 14-day intervals. The maximum recommended dose is 90 mg daily. Tablets must be swallowed whole and should not be divided, crushed, or chewed. Administration with or without food is acceptable, though consistency in timing relative to meals is advised. Dose titration should be gradual, particularly in elderly patients or those with hepatic impairment. Blood pressure response should be monitored periodically to determine the optimal maintenance dose.
Precautions
Patients should be cautioned about potential hypotension, especially during initial titration or when increasing the dose. Peripheral edema, which is dose-dependent, may occur and typically presents as ankle or foot swelling. Regular monitoring of blood pressure and heart rate is recommended. Abrupt withdrawal should be avoided as it may lead to rebound hypertension or increased angina. Use with caution in patients with heart failure or severe aortic stenosis. Hepatic impairment may require dosage adjustment due to altered metabolism. Patients should avoid grapefruit juice as it may increase nifedipine plasma concentrations.
Contraindications
Procardia is contraindicated in patients with known hypersensitivity to nifedipine or any component of the formulation. It should not be used in patients with cardiogenic shock or those who have experienced hemodynamic instability after acute myocardial infarction. Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) is contraindicated due to the risk of significantly increased nifedipine exposure. The immediate-release formulation is contraindicated for hypertensive emergencies due to the risk of severe hypotension and reflex tachycardia.
Possible side effect
Common adverse reactions include peripheral edema (dose-related), headache, dizziness, flushing, and fatigue. Less frequently, patients may experience palpitations, nausea, constipation, or muscle cramps. Serious side effects requiring medical attention include significant hypotension, worsening angina, heart failure symptoms, marked edema, or severe skin reactions. Laboratory abnormalities may include transient elevations in liver enzymes. Most side effects are dose-dependent and often diminish with continued therapy or dose reduction.
Drug interaction
Nifedipine is metabolized primarily by CYP3A4, resulting in numerous potential interactions. Strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) may significantly increase nifedipine levels. Inducers (e.g., rifampin, carbamazepine) may decrease efficacy. Concurrent use with beta-blockers may increase risk of heart failure or severe hypotension. Grapefruit juice should be avoided. Use with digoxin may increase digoxin levels requiring monitoring. Magnesium sulfate may potentiate neuromuscular blockade. NSAIDs may diminish antihypertensive effect.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended. Patients should be educated on maintaining consistent dosing timing to ensure optimal therapeutic coverage and avoid fluctuations in blood pressure control.
Overdose
Signs of overdose include severe hypotension, bradycardia or tachycardia, and metabolic acidosis. Cardiovascular support is paramount, with careful monitoring of vital signs and cardiac function. Treatment is primarily supportive and symptomatic. Activated charcoal may be administered if ingestion was recent. Intravenous calcium gluconate may be considered to counteract calcium channel blockade. Vasopressors may be required for refractory hypotension, with dopamine or norepinephrine being preferred. Given the extended-release formulation, prolonged monitoring may be necessary.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), with excursions permitted between 15-30°C (59-86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Tablets should not be removed from blister packs until immediately before administration. Keep out of reach of children and pets. Do not use if tablets appear damaged or discolored. Properly dispose of expired or unused medication according to FDA-recommended disposal methods.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Procardia is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual response to therapy may vary. Patients should not initiate, adjust, or discontinue medication without consulting their physician. Full prescribing information, including boxed warnings where applicable, should be reviewed before use. The content provided here is not exhaustive and may not include all relevant information for safe and effective use.
Reviews
Clinical studies demonstrate Procardia’s efficacy in reducing systolic and diastolic blood pressure by approximately 8-15 mmHg and 5-10 mmHg, respectively, with once-daily dosing. In angina patients, it has shown to increase exercise tolerance and reduce nitroglycerin consumption. Many clinicians note its particular usefulness in elderly hypertensive patients and those with isolated systolic hypertension. Some reports mention peripheral edema as a limiting factor in dose escalation. Overall, it is considered a valuable option in cardiovascular management when appropriately selected and monitored.