Nifedipine Gastrointestinal Therapeutic System (GITS) in the treatment of coronary heart disease and hypertension.
Since the 1960s, calcium antagonists have been available for the treatment of angina pectoris and hypertension. The first of this class, nifedipine, was introduced and readily accepted as the third treatment option for angina, alongside beta-blockers and nitrates. However, the short-acting formulations of nifedipine had pharmacokinetic properties that were far from ideal and in 1995, several studies involving various dosing regimens reported possible dangerous effects in secondary prevention. Since then, large-scale, randomized controlled trials with new controlled-released formulations of nifedipine have demonstrated the effectiveness and safety of this drug. As a consequence of these results, guidelines for both hypertension and angina pectoris have been recently reconsidered, and have put the modern formulations of calcium channel blockers in a pole position. Within this group of therapeutics, nifedipine gastrointestinal therapeutic system has a unique position and it cannot be replaced by other controlled-release formulations of nifedipine, the pharmaceutical properties of which have yet to be tested in large-scale outcome trials.
Kragten
Johannes A
JA
Department of Cardiology, Institute Atrium Medical Centre Heerlen, Postbox 4446, 6401 CX Heerlen, The Netherlands. j.a.kragten@wcnnet.nl
Dunselman
Peter H J M
PH
D000959:Antihypertensive Agents / Q000191:economics; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use; D003327:Coronary Disease / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D017046:Cost Savings; D003925:Diabetic Angiopathies / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics; D015918:Infusion Pumps, Implantable; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D006113:United Kingdom
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D009543:Nifedipine