Nifedipine
- Class: Dihydropyridine calcium channel blocker
- Used for: high blood pressure
- Say it: nye-FED-ih-peen
- Forms: tablet, capsule
NIFEDIPINE is a KNIFE that opens the PIPE wide — so wide the face flushes and the ankles swell.
It is the most vessel-selective of the group, with almost no effect on the heart itself. The flushing, headache and reflex fast pulse all follow directly from how wide it opens things.
Same vessel-selective family as amlodipine. The short-acting form drops pressure so abruptly that the heart races to compensate, which is why only the long-acting form is used.
Side effects
Common: flushing, headache, ankle swelling
Serious: reflex fast heartbeat
Typical dose
Modified-release 30–90 mg once daily
Short-acting capsules are not used for routine hypertension — the abrupt drop causes reflex tachycardia.
Check yourself
Why is immediate-release nifedipine avoided for a high blood pressure reading?
- The abrupt fall in pressure triggers a reflex tachycardia and can reduce organ perfusion
- It is poorly absorbed
- It causes severe constipation
- It blocks the AV node too strongly
Show answer
A. The abrupt fall in pressure triggers a reflex tachycardia and can reduce organ perfusion
Blood pressure that rose over months does not need to come down in minutes. The reflex surge of adrenaline that follows a rapid drop has caused strokes and heart attacks.
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