Nifedipine

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Nifedipine (brand name Procardia) — Antihypertensive, antianginal; Dihydropyridine calcium channel blocker.

Identification

• Therapeutic class: Antihypertensive, antianginal.
• Pharmacologic class: Dihydropyridine calcium channel blocker.

Pharmacology

• Mechanism of action: Same vascular calcium blockade as amlodipine; extended-release preferred for stable dosing.
• Onset / peak / duration: Immediate-release onset about 20 minutes; ER provides 24-hour effect.
• Half-life / therapeutic level: Half-life about 2 hours (IR), longer for ER; no routine level.

Clinical use

• Indications: Hypertension, angina; off-label for Raynaud and preterm labor.
• Usual dose, route, frequency: ER 30 to 90 mg PO once daily.
• Maximum dose / adjustments: ER max 90 to 120 mg/day; avoid immediate-release for chronic hypertension due to reflex tachycardia.

Safety

• Contraindications: Cardiogenic shock, immediate-release in acute MI/unstable angina.
• Black box warning: None.
• Interactions: CYP3A4 inhibitors, grapefruit juice (food), beta blockers, other antihypertensives.
• Pregnancy / lactation: Used in some obstetric settings under specialist care.
• High-alert: No.

Adverse effects

• Common side effects: Peripheral edema, flushing, headache, dizziness.
• Serious effects to report: Severe hypotension, reflex tachycardia, worsening angina.
• Antidote / reversal: Calcium, supportive care for overdose.

Nursing process

• Assessment before administration: Blood pressure, heart rate, edema.
• Interventions during therapy: Do not crush ER tablets; ghost tablet shell may appear in stool.
• Monitor: Blood pressure, heart rate, edema.
• Evaluation / expected outcome: Controlled blood pressure and angina.

Patient teaching

• Patient teaching: Swallow ER whole; the empty shell in stool is normal.
• Notify provider if: Rapid heartbeat, fainting, chest pain.
• Administration tips: Swallow ER whole; avoid grapefruit.