Adalat CC

Name: Adalat CC

What special precautions should I follow?

Before taking nifedipine,

  • tell your doctor and pharmacist if you are allergic to nifedipine, any other medications, or any of the ingredients in nifedipine. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, you are taking or plan to take. Be sure to mention any of the following: acarbose (Precose); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), and ketoconazole (Nizoral); beta blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), propranolol (Inderal, Innopran, in Inderide), and timolol ); carbamazepine (Carbatrol, Epitol, Tegretol); cimetidine (Tagamet); digoxin (Lanoxin); diltiazem (Cardizem); doxazosin (Cardura); erythromycin (E.E.S., E-Mycin, Erythrocin); fentanyl (Actiq, Duragesic, Fentora); flecainide (Tambocor); HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); metformin (Glucophage); nefazodone; phenobarbital; phenytoin (Dilantin, Phenytek); quinidine (in Nuedexta); quinupristin and dalfopristin (Synercid); rifampin (Rifadin, in Rifamate, in Rifater, Rimactane); rifapentine (Priftin); tacrolimus (Astagraf SL,Prograf); valproic acid (Depakene); and verapamil (Calan, Covera, Verelan, in Tarka). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John's wort.
  • tell your doctor if you have or have ever had a narrowing or blockage of your digestive system or any other condition that causes food to move through your digestive system more slowly; or heart, liver, or kidney disease. Also tell your doctor if you have had a myocardial infarction (MI) within the last 2 weeks.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking nifedipine, call your doctor.
  • talk to your doctor about the safe use of nifedipine capsules if you are 65 years of age or older. Older adults should not usually take nifedipine capsules because they are not as safe as other medications that can be used to treat the same condition.
  • if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking nifedipine.
  • ask your doctor about the safe use of alcoholic beverages while you are taking nifedipine. Alcohol can make the side effects from nifedipine worse.

Side effects

Headache, dizziness, nausea, flushing, constipation, leg/muscle cramps, or sexual problems may occur. To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: swelling of the ankles/feet, shortness of breath, unusual weakness/tiredness.Tell your doctor immediately if any of these rare but very serious side effects occur: fast/slow/irregular heartbeat, fainting, mental/mood changes, swollen/tender gums, vision changes.Although this medication is effective in preventing chest pain (angina), some people who already have severe heart disease may rarely develop worsening chest pain or a heart attack after starting this medication or increasing the dose. Get medical help right away if you experience: worsening chest pain, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to other calcium channel blockers (e.g., felodipine, amlodipine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (e.g., congestive heart failure, aortic stenosis), liver problems, kidney problems, a certain metabolic disorder (porphyria).Before having surgery, tell your doctor or dentist that you are taking this medication.This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.Nifedipine passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

What is the most important information I should know about Adalat CC (nifedipine)?

You should not use nifedipine if you have severe coronary artery disease, or if you have had a heart attack within the past 2 weeks.

Precautions While Using Adalat CC

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

You should not use this medicine if you are also taking certain other medications such as carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), or St. John's Wort. Using these medicines together can cause serious problems. Make sure your doctor knows all of the medications you are taking.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. These symptoms are more likely to occur when you begin taking this medicine, or when the dose is increased.

This medicine may cause fluid retention (edema) in some patients. Tell your doctor right away if you have bloating or swelling of the face, arms, hands, lower legs, or feet; tingling of the hands or feet; or unusual weight gain or loss.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests. This medicine may affect the results of certain medical tests.

Grapefruits and grapefruit juice may increase the effects of nifedipine by increasing the amount of this medicine in your body. You should not eat grapefruit or drink grapefruit juice while you taking this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

If OVERDOSE is suspected

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Adalat CC, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Adalat CC. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using Adalat CC.

Review Date: October 4, 2017

Contraindications

Concomitant administration with strong P450 inducers, such as rifampin, are contraindicated since the efficacy of nifedipine tablets could be significantly reduced. (See PRECAUTIONS, Drug Interactions.) 

Nifedipine must not be used in cases of cardiogenic shock.

Adalat is contraindicated in patients with a known hypersensitivity to any component of the tablet.

Adalat CC Dosage and Administration

Dosage should be adjusted according to each patient’s needs. It is recommended that Adalat CC be administered orally once daily on an empty stomach. Adalat CC is an extended release dosage form and tablets should be swallowed whole, not bitten or divided. In general, titration should proceed over a 7-14 day period starting with 30 mg once daily. Upward titration should be based on therapeutic efficacy and safety. The usual maintenance dose is 30 mg to 60 mg once daily. Titration to doses above 90 mg daily is not recommended.

If discontinuation of Adalat CC is necessary, sound clinical practice suggests that the dosage should be decreased gradually with close physician supervision.

Co-administration of nifedipine with grapefruit juice is to be avoided (See CLINICAL PHARMACOLOGY and PRECAUTIONS).

Care should be taken when dispensing Adalat CC to assure that the extended release dosage form has been prescribed.

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Nifedipine Breastfeeding Warnings

Immediate-release formulations: Benefit to mother should outweigh risk to the infant. Extended-release formulations: Use is contraindicated. -Some experts recommend: Breastfeeding is not recommended during use of this drug. Excreted into human milk: Yes Comments: -This drug is considered compatible with breastfeeding by the American Academy of Pediatrics. -Some experts recommend delaying breast feeding/milk expression for 3 to 4 hours for patients receiving immediate-release formulations.

Nifedipine Identification

Substance Name

Nifedipine

CAS Registry Number

21829-25-4

Drug Class

Antihypertensive Agents

Calcium Channel Blockers

Vasodilator Agents

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