Procardia: Advanced Calcium Channel Blocker for Hypertension & Angina Control
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Procardia (nifedipine) is a leading 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 coronary and peripheral vasodilation, reducing afterload and myocardial oxygen demand. This mechanism offers a targeted approach to cardiovascular symptom control, supporting long-term therapeutic goals under professional supervision.
Features
- Active ingredient: Nifedipine
- Available in extended-release tablet formulations (30mg, 60mg, 90mg)
- Once-daily dosing for consistent 24-hour plasma concentrations
- Bioavailability approximately 45-56% with extended-release profile
- Hepatic metabolism via CYP3A4 enzyme system
- Half-life of approximately 2-5 hours (immediate release) or 7+ hours (extended release)
Benefits
- Effectively lowers blood pressure through peripheral arterial vasodilation
- Reduces frequency and severity of angina episodes by decreasing myocardial oxygen demand
- Provides sustained 24-hour hemodynamic control with appropriate dosing
- May be used as monotherapy or in combination with other antihypertensive agents
- Demonstrated efficacy in diverse patient populations across clinical studies
- Supports long-term cardiovascular risk management when incorporated into comprehensive care
Common use
Procardia is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also approved for management of chronic stable angina (effort-associated angina) without evidence of vasospasm in patients who remain symptomatic despite adequate doses of beta blockers or nitrates. Off-label uses may include Raynaud’s phenomenon and certain cases of preterm labor, though these applications require careful specialist evaluation.
Dosage and direction
The recommended starting dose for hypertension or angina is 30 mg or 60 mg once daily, taken whole with a glass of water without crushing, chewing, or dividing. Dosage may be titrated upward over 7-14 day intervals based on therapeutic response and tolerability. Maximum recommended dose is 90 mg daily. Administration should be consistent regarding timing and relation to meals. Patients should be cautioned not to abruptly discontinue therapy without medical supervision. Extended-release tablets must not be substituted for immediate-release formulations on a mg-per-mg basis.
Precautions
Regular blood pressure monitoring is essential, particularly during initiation and titration periods. Patients with heart failure or significant aortic stenosis may experience worsened cardiac function. Peripheral edema, typically dose-related, may occur and should be distinguished from systemic fluid retention. Hepatic impairment requires dosage adjustment and careful monitoring. Patients should avoid grapefruit juice consumption due to CYP3A4 inhibition potentially increasing nifedipine bioavailability. Abrupt withdrawal may precipitate rebound hypertension or angina exacerbation.
Contraindications
Procardia is contraindicated in patients with known hypersensitivity to nifedipine or other dihydropyridine calcium channel blockers. Additional contraindications include patients with cardiogenic shock, significant hypotension (systolic pressure <90 mmHg), or those experiencing acute myocardial infarction with congestive heart failure. Concomitant use with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or ritonavir is contraindicated due to risk of severe hypotension.
Possible side effects
Common adverse reactions (≥5%) include peripheral edema (dose-dependent), headache, dizziness, flushing, and fatigue. Less frequent side effects (1-5%) include nausea, palpitations, muscle cramps, and constipation. Serious but rare adverse events (<1%) include hypotension, syncope, myocardial infarction, heart failure exacerbation, and gingival hyperplasia. Most side effects are dose-dependent and may diminish with continued therapy or dose reduction.
Drug interaction
Significant interactions occur with strong CYP3A4 inhibitors (clarithromycin, ketoconazole) increasing nifedipine exposure. Concurrent use with beta-blockers may potentiate hypotension and heart failure risk. CYP3A4 inducers (rifampin, phenytoin) may decrease nifedipine efficacy. Additive hypotensive effects may occur with other antihypertensives, nitrates, phosphodiesterase-5 inhibitors, or alcohol. Nifedipine may increase digoxin levels and potentiate neuromuscular blocking agents. Monitoring and dose adjustments are recommended with concomitant therapies.
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. Patients should never take a double dose to make up for a missed one. Consistency in dosing is important for maintaining stable plasma concentrations and therapeutic effect.
Overdose
Symptoms of overdose include severe hypotension, bradycardia or tachycardia, metabolic acidosis, and hyperglycemia. Cardiorespiratory monitoring and supportive measures are essential. Treatment may include intravenous calcium gluconate, vasopressors (norepinephrine preferred over dopamine), and atropine for bradycardia. Activated charcoal may be beneficial if administered within one hour of ingestion. Dialysis is not effective due to high protein binding and extensive metabolism.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in original container protected from light and moisture. Keep tightly closed and out of reach of children. Do not store in bathroom or other humid areas. Discard any medication that has expired or shows signs of physical deterioration. Do not flush medications down toilet or pour into drain unless instructed to do so.
Disclaimer
This information does not replace professional medical advice. Patients should consult their healthcare provider for personalized guidance regarding their condition and treatment. Dosage and administration should be determined by a qualified physician based on individual patient characteristics. Never initiate, modify, or discontinue medication without medical supervision.
Reviews
Clinical studies demonstrate Procardia’s efficacy with approximately 70-80% of hypertensive patients achieving blood pressure control. Angina patients typically experience 40-60% reduction in attack frequency and nitrate consumption. Most adverse effects are mild to moderate and often diminish with continued therapy. Patient satisfaction surveys indicate good tolerability and convenience of once-daily dosing, though peripheral edema remains a common reason for discontinuation in approximately 5-10% of patients.