title: Safety of Immediate-Release Nifedipine.
abstract: Nifedipine immediate release (IR) is a short-acting dihydropyridine calcium channel blocker historically used for hypertensive crisis, but its use has decreased because of reports of adverse reactions such as myocardial infarction (MI), arrhythmias, and stroke. This was a retrospective evaluation of the safety of nifedipine IR in 122 patients at an academic medical center from January 1, 2009, to December 31, 2014. Patients were separated into high- and low-risk groups. High risk was defined as a medical history significant for arrhythmia, MI, or stroke. The primary outcome was a comparison of the composite incidence of nifedipine-associated adverse events including the following: new cardiology consultation, sentinel arrhythmia, stroke, MI, need for blood pressure support, transition to higher levels of care, or death. A per-dose incidence of 2.4% and per-patient incidence of 7.3% in this composite endpoint were found, with no differences between the groups. Patients received median doses of 10 mg and follow-up within 2.8 hours. There were no cases of death in either group. Although nifedipine IR may cause major adverse events, the incidence seems lower than previously believed. Future research is warranted to evaluate whether nifedipine IR may be an option to treat elevated blood pressure in hospitalized patients.
authors.affiliation: *University of Kentucky HealthCare, Hospital Pharmacy Services, Lexington, KY; †Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL; and ‡University of Illinois Hospital and Health Sciences System, Hospital Pharmacy Services, Chicago, IL.
authors.forename: Laura
authors.initials: L
authors.lastname: Means
authors.forename: Scott T
authors.initials: ST
authors.lastname: Benken
authors.forename: Eljim P
authors.initials: EP
authors.lastname: Tesoro
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000453:epidemiology; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects*; D004339:Drug Compounding; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D007022:Hypotension / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects*; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D009543:Nifedipine