Procardia


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Procardia

 [pro-kahr´de-ah]
trademark for preparations of nifedipine, a coronary vasodilator used in treatment of angina pectoris and hypertension.

nifedipine

Adalat CC, Adalat LA (UK), Adalat P.A., Adalat Retard (UK), Adalat XL, Adipine (UK), Afeditab CR, Angiopine (UK), Apo-Nifed, Calchan (UK), Cardilate MR (UK), Coracten (UK), Fortipine (UK), Gen-Nifedical, Hypolar Retard (UK), Neozipine XL (UK), Nifediac CC, Nifedical XL, Nifedipress MR (UK), Nifopress MR (UK), Novo-Nifedin, Nu-Nifed, Procardia, Procardia XL, Slofedipine (UK), Tensipine (UK), Valni Retard (UK), Valni XL (UK)

Pharmacologic class: Calcium channel blocker

Therapeutic class: Antianginal, anti-hypertensive

Pregnancy risk category C

Action

Inhibits calcium transport into myocardial and vascular smooth muscle cells, suppressing contractions. Dilates main coronary arteries and arterioles and inhibits coronary artery spasm, increasing oxygen delivery to heart and decreasing frequency and severity of angina attacks.

Availability

Capsules: 5 mg, 10 mg, 20 mg

Tablets (extended-release): 10 mg, 20 mg, 30 mg, 60 mg, 90 mg

Indications and dosages

Vasospastic (Prinzmetal's) angina; chronic stable angina

Adults: Initially, 10 mg P.O. (immediate-release) t.i.d. titrated over 7 to 14 days; usual effective range is 10 to 20 mg t.i.d., not to exceed 180 mg/day. Patient may be switched to extended-release at nearest equivalent of immediate-release daily dosage (for instance, 30-mg immediate-release dose may be switched to 90-mg extended-release dose). Total extended-release dosage should not exceed 90 mg/day.

Hypertension

Adults: 30 to 60 mg/day P.O. (extended-release only) titrated over 7 to 14 days to a maximum of 120 mg/day

Off-label uses

• Aortic regurgitation

• Heart failure

• Migraine

• Prevention of labor

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• chronic renal insufficiency

• hypotension, aortic stenosis, heart failure, significant left ventricular dysfunction (especially when used with beta-adrenergic blockers), peripheral edema

• elderly patients

• pregnant or breastfeeding patients (safety not established)

• children (safety not established).

Administration

• Give immediate-release form with or without food. If GI upset occurs, give with meals, but never with grapefruit or grapefruit juice.

• Don't crush or break extended-release tablet. Make sure patient swallows it whole. Give on empty stomach, and not with grapefruit or grapefruit juice.

• Know that Procardia XL and Adalat CC are not equivalent because of their pharmacokinetic differences.

• Be aware that only extended-release tablets are used to treat hypertension.

Adverse reactions

CNS: headache, dizziness, fatigue, asthenia, paresthesia, vertigo

CV: peripheral edema, chest pain, hypotension

EENT: epistaxis, rhinitis

GI: nausea, constipation

GU: urinary frequency, erectile dysfunction

Musculoskeletal: leg cramps

Skin: flushing, rash

Interactions

Drug-drug. Beta-adrenergic blockers: increased risk of heart failure, severe hypotension, or angina exacerbation

Cimetidine: increased nifedipine blood level

Coumarin anticoagulants: increased prothrombin time

Digoxin: increased risk of digoxin toxicity

Quinidine: decreased quinidine blood level

Drug-diagnostic tests. Antinuclear antibody, direct Coombs' test false-positive results

Drug-food. Grapefruit, grapefruit juice: increased nifedipine blood level and effects

Drug-herbs. Ephedra (ma huang), yohimbine: antagonism of nifedipine effect

Ginkgo, ginseng: increased nifedipine blood level

St. John's wort: decreased nifedipine blood level

Drug-behaviors. Alcohol use: additive hypotension

Patient monitoring

• Monitor vital signs and cardiovascular status. Stay alert for chest pain and edema.

• Watch for rash.

Patient teaching

• Tell patient he may take immediate-release form with or without meals. If GI upset occurs, tell him to take it with meals, but never with grapefruit or grapefruit juice.

• Caution patient not to crush or break extended-release tablets. Tell him to swallow them whole. Advise him to take on empty stomach, and not with grapefruit or grapefruit juice.

• Inform patient that angina attacks may occur 30 minutes after a dose. Explain that these attacks are usually temporary and don't mean that drug should be withdrawn.

Tell patient to report rash immediately.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, balance, and alertness.

• Instruct patient to consult prescriber before taking herbs or over-the-counter drugs (especially cold remedies).

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

Procardia

(prō-kär′dē-ə)
A trademark for the drug nifedipine.

Procardia®

Nifedipine, see there.
References in periodicals archive ?
This is the generic version of Pfizer's Procardia XL Tablets, a treatment for angina and/or hypertension.
After all, how could one resist the cleverly named calcium channel blocker "Procardia"?
"I have patients who've been on Procardia now for 15 years and are doing very well," Dr.
Another group of widely prescribed cardiovascular medications are calcium antagonists, such as Procardia and verapamil.
Morehouse issued orders that if the patient's blood pressure rose above 160/95, Procardia, a medication used to decrease blood pressure, be given.
A common scenario involves a patient who is taking heart drugs called calcium channel blockers (Procardia) and drinks grapefruit juice.
Of the calcium channel blockers, nicardipine (Cardene) and nifedipine (Adalat, Procardia) have been tried the most and are safe in pregnancy but there is little information on first-trimester use.
These products, and those under FDA review including Procardia XL and Dilacor XR, will contribute to our future growth.
A September 1999 study by the House Government Reform and Oversight Committee staff found that Americans pay 81 percent more than do Canadians on the top ten drugs--including Zocor, Prilosec, Procardia, Zoloft, and Norvasc--most widely used by seniors.
Sustained-release agents such as nifedipine (Procardia XL) are considered long-acting agents.
It is probabilistic and in fact, often predictable, that when a patient is given a drug like procardia for hypertension, his/her blood pressure will decrease.
Doctors most commonly prescribe Nifedipine (Procardia) and nitropaste or nitroglycerin.