Adalat CC 90mg Tablets

Nifedipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle cells. This action leads to relaxation of vascular smooth muscle, resulting in peripheral arterial vasodilation and reduction in peripheral vascular resistance, which lowers blood pressure. In angina, it reduces myocardial oxygen demand by decreasing afterload and may increase myocardial oxygen supply by dilating coronary arteries.

Serious Side Effects: Seek Medical Help Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
New or worsening chest pain
Abnormal heartbeat
Mood changes
Shortness of breath, significant weight gain, or swelling in the arms or legs
Muscle pain or cramping
Shakiness
Severe constipation or stomach pain, which may be signs of a serious bowel problem
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Dizziness, tiredness, or weakness
Headache
Flushing
Heartburn
Upset stomach
* Feeling nervous and excitable

Note: For some brands, you may notice the tablet shell in your stool. This is a normal occurrence and not a cause for concern. If you have questions, consult your doctor.

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have been diagnosed with intolerance to certain sugars, including lactose, glucose, or galactose. Some formulations of this medication may contain lactose.
If you have recently experienced a heart attack.
If you are taking any medications, including prescription and over-the-counter (OTC) drugs, natural products, or vitamins, that may interact with this medication. Specifically, certain medications used to treat HIV, infections, seizures, and other conditions should not be taken with this drug. However, this is not an exhaustive list of all potential interacting medications.

To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including prescription and OTC drugs, natural products, and vitamins, as well as any health problems you are experiencing. This will enable them to verify that it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or modify the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, be cautious when performing tasks that require alertness, such as driving, until you understand how it affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when navigating stairs.

Although rare, new or worsening chest pain can occur after initiating this medication or increasing the dose, which may increase the risk of a heart attack. This risk is particularly higher in individuals with severe heart blood vessel disease. It is crucial to discuss these potential risks with your doctor.

Regularly monitor your blood pressure as directed by your healthcare provider. Additionally, adhere to the scheduled blood work and follow-up appointments as recommended by your doctor to ensure close monitoring of your condition.

Avoid consuming grapefruit and grapefruit juice while taking this medication. If you have high blood pressure, consult your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Be aware that a long-acting form of this medication has been associated with severe stomach and bowel problems, including blockage and ulcers, which may require hospitalization. Discuss these potential risks with your doctor.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

It is vital to inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding, as you will need to discuss the benefits and risks of this medication to both you and your baby.

• Strong CYP3A4 inducers (e.g., Rifampin, Phenytoin, Carbamazepine, Phenobarbital, St. John's Wort) - may significantly reduce nifedipine plasma concentrations and efficacy.

• Strong CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir, Clarithromycin, Nefazodone, Grapefruit juice) - may significantly increase nifedipine plasma concentrations, leading to increased hypotensive effects and adverse reactions.
• Beta-blockers - may cause excessive hypotension or exacerbate angina in rare cases (though often used together cautiously).
• Digoxin - may increase digoxin levels.
• Quinidine - may decrease quinidine levels or, rarely, increase nifedipine levels.
• Cimetidine - may increase nifedipine levels.
• Fentanyl - severe hypotension has been reported with concomitant use.

• Moderate CYP3A4 inhibitors (e.g., Erythromycin, Fluconazole, Diltiazem, Verapamil) - may increase nifedipine levels.
• Alpha-blockers (e.g., Prazosin) - additive hypotensive effects.
• Magnesium sulfate (parenteral) - increased risk of hypotension and neuromuscular blockade.
• Tacrolimus - may increase tacrolimus levels.

• Theophylline - may alter theophylline levels (variable effect).
• Warfarin - no significant interaction reported, but monitor INR.

• Dizziness
• Lightheadedness
• Headache
• Flushing
• Peripheral edema (swelling of ankles/feet)
• Palpitations
• Chest pain (worsening or new onset)
• Shortness of breath

Nifedipine is Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It has been used off-label for preterm labor and severe preeclampsia, but its use for chronic hypertension in pregnancy requires careful consideration.

Nifedipine is excreted into breast milk in small amounts. The American Academy of Pediatrics considers it compatible with breastfeeding. Monitor the infant for potential adverse effects such as lethargy or poor feeding.

Safety and efficacy have not been established in pediatric patients for hypertension or angina. Use is generally not recommended.

Elderly patients may be more sensitive to the hypotensive effects of nifedipine. Start with lower doses and titrate slowly. Monitor closely for dizziness, falls, and peripheral edema.

• Adalat CC is an extended-release formulation and must be swallowed whole. Crushing or chewing can lead to rapid drug release and potentially dangerous hypotension.
• Patients may notice a 'ghost tablet' in their stool, which is the inert shell of the extended-release tablet. This is normal and does not mean the medication was not absorbed.
• Peripheral edema (swelling of ankles/feet) is a common side effect of dihydropyridine calcium channel blockers like nifedipine. It is dose-dependent and often managed by dose reduction or adding a diuretic.
• Avoid abrupt discontinuation, especially in patients with angina, as it may lead to a rebound increase in symptoms.
• Educate patients about the importance of avoiding grapefruit and grapefruit juice due to significant drug interaction.

• Other dihydropyridine calcium channel blockers (e.g., Amlodipine, Felodipine, Nicardipine)
• Non-dihydropyridine calcium channel blockers (e.g., Verapamil, Diltiazem)
• ACE inhibitors (e.g., Lisinopril, Enalapril)
• Angiotensin Receptor Blockers (ARBs) (e.g., Valsartan, Losartan)
• Beta-blockers (e.g., Metoprolol, Atenolol)
• Diuretics (e.g., Hydrochlorothiazide, Furosemide)
• Other antianginal agents (e.g., Nitrates, Ranolazine)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.