nisoldipine (redirected from Syscor)

nisoldipine /ni·sol·di·pine/ (ni-sol´dĭ-pēn) a calcium channel blocker used in the treatment of hypertension.

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nisoldipine,

a calcium channel blocker.

indications It causes vasodilation and is prescribed, either alone or in combinations, for the management of hypertension.

contraindications Factors that prohibit its use include hypersensitivity to nisoldipine or other dihydropyridine calcium channel blockers. High-fat meals and grapefruit juice should be avoided because these foods can cause sudden increases in the blood levels of the drug.

adverse effects Fluid retention, headache, nausea, dizziness, pharyngitis, shortness of breath, cough, and palpitations are among the more common adverse effects.

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nisoldipine

Sular, Syscor (UK)

Pharmacologic class: Calcium channel blocker

Therapeutic class: Antihypertensive

Pregnancy risk category C

Action

Suppresses calcium transport into vascular smooth muscle cells. This suppression inhibits vasoconstriction and dilates coronary arteries, improving myocardial oxygen uptake.

Availability

Tablets (extended-release): 10 mg, 20 mg, 30 mg, 40 mg

⊘Indications and dosages

➣ Hypertension

Adults: Initially, 20 mg P.O. daily as a single dose; may increase by 10 mg daily q 7 days, up to 60 mg daily. Usual range is 20 to 40 mg daily.

Contraindications

• Hypersensitivity to drug or dihydropyridine calcium channel blockers

Precautions

Use cautiously in:
• heart failure and left ventricular dysfunction, hepatic impairment, renal disease, coronary artery disease, hypotension
• concurrent phenytoin use
• elderly patients
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give with meals, but not with high-fat meals, grapefruit, or grapefruit juice.
• Don't crush or break extended-release tablets. Make sure patient swallows them whole.
• Know that drug may be given alone or with other antihypertensives.

Route	Onset	Peak	Duration
P.O.	Unknown	6-12 hr	24 hr

Adverse reactions

CNS: headache, dizziness

CV: peripheral edema, chest pain, vasodilation, hypotension, palpitations

EENT: pharyngitis, sinusitis

GI: nausea

Skin: rash

Interactions

Drug-drug. Cimetidine: increased nisoldipine blood level

Phenytoin, other CYP3A4 inducers: decreased nisoldipine blood level and efficacy

Drug-food. Grapefruit juice: significantly increased drug blood level and effects

High-fat meal: decreased drug blood level

Drug-herbs. Ephedra (ma huang), yohimbine: antagonism of nimodipine effects

St. John's wort: decreased nimodipine blood level

Drug-behaviors. Alcohol use: increased hypotensive effects

Patient monitoring

• Check vital signs and ECG.
• Monitor fluid intake and output. Watch for peripheral edema.

Patient teaching

• Tell patient to swallow extended-release tablets whole and not to crush or break them.
• Advise patient to take with food, but not high-fat food. Recommend small, frequent meals.
• Instruct patient to avoid high-fat meals, alcohol, grapefruit, and grapefruit juice.
• Tell patient to immediately report irregular heart beat, shortness of breath, swelling, pronounced dizziness, rash, or chest pain.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, herbs, and behaviors mentioned above.