Procardia: Advanced Calcium Channel Blocker for Hypertension & Angina Control
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Procardia (nifedipine) is a prescription calcium channel blocker medication specifically formulated to manage hypertension (high blood pressure) and chronic stable angina. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, it promotes peripheral arterial vasodilation, reducing systemic vascular resistance and myocardial oxygen demand. This dual-action mechanism not only lowers blood pressure effectively but also decreases the frequency of angina episodes, supporting long-term cardiovascular stability. Available in extended-release formulations, Procardia offers sustained 24-hour therapeutic coverage, making it a cornerstone in proactive cardiovascular risk management under appropriate medical supervision.
Features
- Active ingredient: Nifedipine, a dihydropyridine calcium channel blocker
- Available in extended-release tablet formulations (30mg, 60mg, 90mg)
- Once-daily dosing regimen for consistent therapeutic coverage
- Designed for gradual drug release to maintain stable plasma concentrations
- FDA-approved for hypertension and chronic stable angina management
- Manufactured under strict pharmaceutical quality control standards
Benefits
- Effectively lowers elevated blood pressure, reducing long-term cardiovascular risk
- Decreases frequency and severity of angina attacks, improving exercise tolerance
- Promotes arterial relaxation without significantly affecting cardiac contractility
- Supports consistent 24-hour hemodynamic control with single daily dosing
- May be used as monotherapy or in combination with other antihypertensive agents
- Contributes to overall reduction in hypertension-related complications
Common use
Procardia is primarily prescribed for the management of essential hypertension, either as initial monotherapy or as part of a comprehensive antihypertensive regimen. It is equally indicated for the treatment of chronic stable angina pectoris when beta-blockers or organic nitrates are contraindicated, ineffective, or poorly tolerated. Physicians may also consider Procardia for certain off-label applications, such as Raynaud’s phenomenon or preterm labor management, though these uses require careful specialist evaluation. The medication is typically incorporated into long-term treatment plans alongside lifestyle modifications, including sodium restriction, regular physical activity, and weight management strategies.
Dosage and direction
The recommended initial dosage for hypertension or angina is typically 30 mg or 60 mg once daily, administered orally. Dosage adjustment should occur at 7- to 14-day intervals based on therapeutic response and tolerability, with maximum recommended dosage not exceeding 90 mg daily. Tablets must be swallowed whole and not crushed, chewed, or divided, as this alters the extended-release properties. Administration with or without food is acceptable, though consistency in timing relative to meals is recommended. Patients should take Procardia at approximately the same time each day to maintain steady-state concentrations. Dosage requirements may vary based on age, hepatic function, and concomitant medications, necessitating individualized titration under medical supervision.
Precautions
Regular blood pressure monitoring is essential during therapy initiation and dosage adjustments. Patients should avoid grapefruit and grapefruit juice, which may significantly increase nifedipine bioavailability. Caution is advised when rising from sitting or lying positions due to potential orthostatic hypotension. Dental procedures may require special consideration due to potential gingival hyperplasia association. Hepatic impairment necessitates dosage reduction and careful monitoring. Patients should inform healthcare providers about all medications, including over-the-counter products and supplements. Procardia should not be discontinued abruptly without medical consultation, as rebound hypertension may occur. Use in elderly patients may require lower initial doses due to decreased clearance.
Contraindications
Procardia is contraindicated in patients with known hypersensitivity to nifedipine or any component of the formulation. It must not be administered to individuals with cardiogenic shock, clinically significant aortic stenosis, or those experiencing acute myocardial infarction, particularly when associated with persistent tachycardia. The medication is contraindicated in patients with severe hypotension (systolic pressure <90 mmHg) and those concurrently taking strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or ritonavir. Use is prohibited in patients with a history of obstructive gastrointestinal motility disorders or any condition that could alter extended-release tablet transit through the GI tract.
Possible side effects
The most frequently reported adverse reactions include peripheral edema (dose-dependent), headache, dizziness, flushing, and palpitations. Gastrointestinal effects such as nausea, constipation, or diarrhea may occur. Less common side effects include fatigue, nervousness, mood changes, and muscle cramps. Rare but serious adverse effects include significant hypotension, syncope, worsening angina, myocardial infarction, and symptomatic tachycardia. Allergic manifestations including rash, pruritus, and urticaria have been reported. Laboratory abnormalities may include transient elevations in liver enzymes, though clinically apparent hepatitis is uncommon. Patients should report any persistent or severe symptoms promptly to their healthcare provider.
Drug interaction
Procardia undergoes extensive metabolism via CYP3A4, creating numerous potential interactions. Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir) significantly increase nifedipine exposure, requiring avoidance or dosage reduction. Concurrent use with beta-blockers may potentiate hypotension and heart failure risk. Quinidine levels may decrease with coadministration. Procardia may increase digoxin concentrations, necessitating monitoring. Concurrent use with magnesium sulfate may result in neuromuscular blockade. Calcium supplements may reduce therapeutic efficacy. Anticonvulsants (phenytoin, carbamazepine) may decrease nifedipine levels. Grapefruit juice must be avoided due to irreversible CYP3A4 inhibition in the gut wall.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If the next scheduled dose is due within 12 hours, the missed dose should be skipped entirely. Patients should never double the dose to compensate for a missed administration. Maintaining regular dosing schedule is crucial for consistent blood pressure control. Those who frequently forget doses should consider using pill organizers or reminder systems. If multiple doses are missed, blood pressure should be monitored closely and the healthcare provider notified for guidance on resumption of therapy.
Overdose
Nifedipine overdose manifests as severe hypotension, bradycardia or tachycardia, and metabolic acidosis. Cardogenic shock with pulmonary edema may occur. Neurological symptoms include confusion, slurred speech, and diminished consciousness. Gastrointestinal effects include nausea and vomiting. Management requires immediate medical attention with cardiovascular monitoring. Treatment is supportive and symptomatic, including Trendelenburg positioning, IV fluids, and vasopressors (norepinephrine preferred over dopamine). Calcium gluconate administration (10% solution, 10-20 mL IV) may counteract calcium channel blockade. Glucagon has been used with variable success. Hemodialysis is not effective due to high protein binding.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in the original container with the lid tightly closed. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets. Do not transfer tablets to other containers unless using approved compliance packaging. Discard any medication that appears discolored, damaged, or beyond the expiration date. Proper disposal of unused medication should follow FDA guidelines through medication take-back programs or by mixing with undesirable substance in sealed container before household trash disposal.
Disclaimer
This information provides a comprehensive overview of Procardia but does not replace professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before starting, changing, or stopping any medication. Individual therapeutic responses may vary based on specific health conditions, concomitant medications, and other factors. The prescribing physician remains the ultimate authority regarding appropriate use, dosage, and monitoring requirements for this medication. Patients should never self-medicate or adjust dosages without medical supervision.
Reviews
Clinical studies demonstrate Procardia’s efficacy in reducing systolic and diastolic blood pressure by approximately 10-15 mmHg and 5-10 mmHg respectively at standard doses. Angina frequency reduction ranges from 40-60% in most study populations. Patient satisfaction surveys indicate improved quality of life measures related to both hypertension and angina symptoms. Long-term outcome studies show consistent cardiovascular risk reduction when used appropriately within comprehensive treatment plans. Real-world evidence supports the favorable benefit-risk profile, particularly with extended-release formulations that minimize peak concentration-related side effects while maintaining therapeutic efficacy throughout the dosing interval.