Adalat tabletas 30mg

You should not stop using nifedipine suddenly. If you are being treated for high blood pressure, keep using this medication even if you feel well. Store at room temperature away from moisture, heat, and light. Dosage Information in more detail What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at What should I avoid? Grapefruit and grapefruit juice may interact with nifedipine and lead to unwanted side effects.

Discuss the use of grapefruit products with your doctor. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Nifedipine side effects Get emergency medical help if you have any signs of an allergic reaction to nifedipine: Call your doctor at once if you have: Common nifedipine side effects may include: This is not a complete list of side effects and others may occur.

Calcium Channel Blockers Diltiazem: Pre-treatment of healthy volunteers with 30 mg or 90 mg t. The corresponding Cmax values of nifedipine increased by factors of 2. Caution should be exercised when co-administering diltiazem and nifedipine and a reduction of the dose of nifedipine should be considered.

Verapamil, a CYP3A inhibitor, can inhibit the metabolism of nifedipine and increase the exposure to nifedipine during concomitant therapy.

Blood pressure should be monitored and reduction of the dose of nifedipine considered. In healthy volunteers receiving single dose of 20 mg nifedipine ER and benazepril 10 mg, the plasma concentrations of benazeprilat and nifedipine in the presence and absence of each other were not statistically significantly different. A hypotensive effect was only seen after co-administration of the two drugs. The tachycardic effect of nifedipine was attenuated in the presence of benazepril.

In vitro studies show significant inhibition of the formation of oxidized irbesartan metabolites by nifedipine. However, in clinical studies, concomitant nifedipine had no effect on irbesartan pharmacokinetics. No significant drug interaction has been reported in studies with candesartan cilexitil given together with nifedipine.

Because candesartan is not significantly metabolized by the cytochrome P system and at therapeutic concentrations has no effect on cytochrome P enzymes, interactions with drugs that inhibit or are metabolized by those enzymes would not be expected. Beta-blockers Adalat CC was well tolerated when administered in combination with beta-blockers in hypertensive patients in a placebo-controlled clinical trial.

However, there have been occasional literature reports suggesting that the combination nifedipine and beta-adrenergic blocking drugs may increase the likelihood of congestive heart failure, severe hypotension or exacerbation of angina in patients with cardiovascular disease. Clinical monitoring is recommended and a dose adjustment of nifedipine should be considered. Hypotension is more likely to occur if dihydropryridine calcium antagonists such as nifedipine are co-administered with timolol.

Healthy volunteers participating in a multiple dose doxazosin-nifedipine interaction study received 2 mg doxazosin q. In the presence of doxazosin, AUC and Cmax of nifedipine were increased by factors of 1. Compared to nifedipine monotherapy, blood pressure was lower in the presence of doxazosin.

Blood pressure should be monitored when doxazosin is co-administered with nifedipine, and dose reduction of nifedipine considered. The simultaneous administration of nifedipine and digoxin may lead to reduced clearance resulting in an increase in plasma concentrations of digoxin. Since there have been isolated reports of patients with elevated digoxin levels, and there is a possible interaction between digoxin and Adalat CC, it is recommended that digoxin levels be monitored when initiating, adjusting and discontinuing Adalat CC to avoid possible over- or under- digitalization.

There have been rare reports of increased prothrombin time in patients taking coumarin anticoagulants to whom nifedipine was administered. However the relationship to nifedipine therapy is uncertain. Platelet Aggregation Inhibitors Clopidogrel: No clinically significant pharmacodynamic interactions were observed when clopidrogrel was co-administered with nifedipine.

Co-administration of nifedipine did not alter the exposure to tirofiban importantly. Other Diuretics, PDE5 inhibitors, alpha-methyldopa: Nifedipine may increase the blood pressure lowering effect of these concomitantly administered agents. Non-Cardiovascular Drugs Antifungal Drugs Ketoconazole, itraconazole and fluconazole are CYP3A inhibitors and can inhibit the metabolism of nifedipine and increase the exposure to nifedipine during concomitant therapy. Blood pressure should be monitored and a dose reduction of nifedipine considered.

In healthy volunteers receiving a single dose of 10 mg nifedipine, AUC and Cmax of nifedipine after pretreatment with omeprazole 20 mg q.

Pretreatment with or co-administration of omeprazole did not impact the effect of nifedipine on blood pressure or heart rate.

The impact of omeprazole on nifedipine is not likely to be of clinical relevance. In healthy volunteers the exposure to neither drug was changed significantly in the presence of the other drug. Five studies in healthy volunteers investigated the impact of multiple ranitidine doses on the single or multiple dose pharmacokinetics of nifedipine. Two studies investigated the impact of coadministered ranitidine on blood pressure in hypertensive subjects on nifedipine.

Co-administration of ranitidine did not have relevant effects on the exposure to nifedipine that affected the blood pressure or heart rate in normotensive or hypertensive subjects. Five studies in healthy volunteers investigated the impact of multiple cimetidine doses on the single or multiple dose pharmacokinetics of nifedipine. Two studies investigated the impact of coadministered cimetidine on blood pressure in hypertensive subjects on nifedipine.

In normotensive subjects receiving single doses of 10 mg or multiple doses of up to 20 mg nifedipine t. The Cmax values of nifedipine in the presence of cimetidine were increased by factors ranging between 1. The increase in exposure to nifedipine by cimetidine was accompanied by relevant changes in blood pressure or heart rate in normotensive subjects.

Hypertensive subjects receiving 10 mg q. The interaction between cimetidine and nifedipine is of clinical relevance and blood pressure should be monitored and a reduction of the dose of nifedipine considered. Simultaneous administration of cisapride and nifedipine may lead to increased plasma concentrations of nifedipine.

Erythromycin, a CYP3A inhibitor, can inhibit the metabolism of nifedipine and increase the exposure to nifedipine during concomitant therapy. The impact of multiple oral doses of mg rifampin on the pharmacokinetics of nifedipine after a single oral dose of 20 mg nifedipine capsule was evaluated in a clinical study.

Twelve healthy male volunteers received a single oral dose of 20 mg nifedipine capsule on study Day 1. Starting on study Day 2, the subjects received mg rifampin once daily for 14 days. On study Day 15, a second single oral dose of 20 mg nifedipine capsule was administered together with the last dose of rifampin.

Antiviral Drugs Amprenavir, atanazavir, delavirine, fosamprinavir, indinavir, nelfinavir and ritonavir, as CYP3A inhibitors, can inhibit the metabolism of nifedipine and increase the exposure to nifedipine. Caution is warranted and clinical monitoring of patients recommended. Blood pressure should be monitored and a reduction of the dose of nifedipine considered. Fluoxetine, a CYP3A inhibitor, can inhibit the metabolism of nifedipine and increase the exposure to nifedipine during concomitant therapy.

Valproic acid may increase the exposure to nifedipine during concomitant therapy. Phenytoin, Phenobarbital, and Carbamazepine: Nifedipine is metabolized by CYP3A. Phenobarbital and carbamazepine are also inducers of CYP3A. Alternative antihypertensive therapy should be considered in patients taking phenytoin, phenobarbital, and carbamazepine.

In patients taking dolasetron by the oral or intravenous route and nifedipine, no effect was shown on the clearance of hydrodolasetron. Tacrolimus has been shown to be metabolized via the CYP3A system. Nifedipine has been shown to inhibit the metabolism of tacrolimus in vitro. Tell your doctor if you are on a low-salt diet. Pregnancy and breast-feeding If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

You may be able to use Adalat LA but only after special consideration and agreement by your doctor. Do not take Adalat LA if you are breast-feeding. If you need to take Adalat LA, you should stop breast-feeding before you start taking this medicine. Adalat LA may make you feel dizzy, faint, extremely tired or have visual disturbances. Do not drive or operate machinery if you are affected in this way. This may be more likely when you first start treatment, if you change tablets, or if you have drunk alcohol.

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. Your doctor will decide how much you should take. Do not bite, chew or break them — if you do they will not work properly.

If you have difficulty swallowing tablets, consult your doctor as he or she may wish to change your medicine. Take your dose at the same time each day, preferably in the morning. Take your tablets with a glass of water. Do not take them with grapefruit juice. You can take Adalat LA with or without food.

You may see what looks like a complete tablet in the toilet or in your stools.

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