Calcium Channel Blocker (Dihydropyridine)
Pregnancy: C
Nifedipine (Raynaud's)
Brand names: Adalat LA, Adalat Retard
Adult dose
Dose: 5–20 mg three times daily (IR) or 30–90 mg once daily (MR)
Route: oral
Frequency: three times daily (IR) or once daily (MR)
Max: 90 mg/day
Avoid short-acting formulations for hypertension (reflex tachycardia); MR preferred; first-line for Raynaud's phenomenon
Paediatric dose
Dose: 0.25 mg/kg
Route: oral
Frequency: three times daily
Max: 3 mg/kg/day (max 90 mg/day)
Concentration: 5 mg/5 mL liquid (special order) mg/ml
Used in hypertensive crises and Raynaud's in specialist paediatric settings
Dose adjustments
Renal
No dose adjustment required
Hepatic
Reduce dose in hepatic impairment
Paediatric weight-based calculator
Used in hypertensive crises and Raynaud's in specialist paediatric settings
Clinical pearls
- First-line pharmacotherapy for Raynaud's phenomenon — reduces frequency and severity of attacks
- Short-acting capsule should NOT be used for hypertension (reflex tachycardia, increased CV events — HINT trial)
- Biting capsule to release for acute hypertension is now discouraged — safety concern
Contraindications
- Cardiogenic shock
- Unstable angina (short-acting)
- Acute MI within 1 month (short-acting)
- Porphyria
Side effects
- Flushing
- Headache
- Ankle oedema
- Palpitations/tachycardia (short-acting)
- Gingival hyperplasia (chronic use)
Interactions
- Grapefruit juice (increases levels)
- Rifampicin (reduces levels)
- Beta-blockers (additive effect)
- Digoxin (increased levels)
- Tacrolimus/ciclosporin (increased levels)
Monitoring
- Blood pressure
- Heart rate
- Ankle oedema
- LFTs (if liver disease)
Reference: BNFc; BNF 86; BSR Raynaud's guidelines; HINT trial. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs