section name header

Pronunciation ⬇

nye-FED-i-peen

Classifications ⬆ ⬇

Therapeutic Classification: antianginals, antihypertensives

Pharmacologic Classification: calcium channel blockers

Indications ⬆ ⬇

BEERS REMS

Unlabeled Use:

Action ⬆ ⬇

  • Inhibits calcium transport into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction.
Therapeutic effects:
  • Systemic vasodilation, resulting in decreased BP.
  • Coronary vasodilation, resulting in decreased frequency and severity of attacks of angina.

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed after oral administration, but large amounts are rapidly metabolized, resulting in ↓ bioavailability (45–70%); bioavailability is ↑ (80%) with extended-release forms.

Distribution: Unknown.

Protein Binding: 92–98%.

Metabolism/Excretion: Mostly metabolized by the liver by the CYP3A4 isoenzyme.

Half-Life: 2–5 hr.

Time/Action Profile ⬆ ⬇

ROUTEONSETPEAKDURATION
PO20 minunknown6–8 hr
PO–ERunknown6 hr24 hr



Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: peripheral edema, bradycardia, chest pain, HF, hypotension, palpitations, syncope, tachycardia

Derm: flushing, ↑sweating, dermatitis, erythema multiforme, photosensitivity, pruritus/urticaria, rash, STEVENS-JOHNSON SYNDROME

EENT: blurred vision, disturbed equilibrium, epistaxis, tinnitus

Endo: gynecomastia, hyperglycemia

GI: ↑liver enzymes, GI obstruction, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting

GU: dysuria, nocturia, polyuria, sexual dysfunction, urinary frequency

Hemat: anemia, leukopenia, thrombocytopenia

Metab: weight gain

MS: joint stiffness, muscle cramps

Neuro: paresthesia, tremor

Resp: cough, dyspnea, shortness of breath

Misc: gingival hyperplasia

Interactions ⬆ ⬇

Drug-drug:

Drug-Natural Products:

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Adalat CC, Afeditab CR, Procardia, Procardia XL

Canadian Brand Names ⬆ ⬇

Adalat XL

Code ⬆

NDC Code