Nifedipine drug interactions

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

List of drug interactions

Beta-blockers

Long-acting nitrates

Digitalis

Coumarin anticoagulants

Cimetidine

Complete List of Drug Interactions


Beta-blockers

Experience in over 1400 patients with Nifedipine extended-release capsules in a noncomparative clinical trial has shown that concomitant administration of Nifedipine and beta-blocking agents is usually well tolerated, but there have been occasional literature reports suggesting that the combination may increase the likelihood of congestive heart failure, severe hypotension, or exacerbation of angina. Return to top

Long-acting nitrates

Nifedipine may be safely co-administered with nitrates, but there have been no controlled studies to evaluate the antianginal effectiveness of this combination. Return to top

Digitalis

Administration of Nifedipine with digoxin increased digoxin levels in nine of twelve normal volunteers. The average increase was 45%. Another investigator found no increase in digoxin levels in thirteen patients with coronary artery disease. In an uncontrolled study of over two hundred patients with congestive heart failure during which digoxin blood levels were not measured, digitalis toxicity was not observed. Since there have been isolated reports of patients with elevated digoxin levels, it is recommended that digoxin levels be monitored when initiating, adjusting, and discontinuing Nifedipine to avoid possible over- or under-digitalization. Return to top

Coumarin anticoagulants

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. Return to top

Cimetidine

A study in six healthy volunteers has shown a significant increase in peak Nifedipine plasma levels (80%) and area-under-the-curve (74%), after a one week course of cimetidine at 1000 mg per day and Nifedipine at 40 mg per day. Ranitidine produced smaller, non-significant increases. The effect may be mediated by the known inhibition of cimetidine on hepatic cytochrome P-450, the enzyme system probably responsible for the first-pass metabolism of Nifedipine. If Nifedipine therapy is initiated in a patient currently receiving cimetidine, cautious titration is advised. Return to top

Complete List of Drug Interactions

Major Interactions

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Moderate Interactions

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Minor Interactions

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The content of this page is taken from the FDA package insert for this drug and should not be edited.

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