Nifedipine

Provider Level

RN/Paramedic

Class

Calcium channel blocker

Mechanism of Action

Inhibits calcium ion influx across cardiac and smooth muscle cells, causing coronary and peripheral vasodilation, decreasing systemic vascular resistance and myocardial oxygen demand.

Indications

Severe hypertension, angina pectoris, tocolytic in premature labor.

Contraindications

Hypotension, cardiogenic shock, hypersensitivity, acute myocardial infarction.

Routes

PO, SL

Onset / Duration

Onset: 20 minutes (PO). Duration: 4 to 8 hours (immediate release).

Adverse Effects

Headache, dizziness, flushing, hypotension, reflex tachycardia, nausea.

Precautions & Interactions

Monitor blood pressure and ECG closely. Use caution in patients with heart failure or concomitant beta-blocker therapy.

Special Considerations

Sublingual administration of immediate-release nifedipine is generally discouraged due to the risk of severe, uncontrolled hypotension leading to ischemic events. Authorized for RN/Paramedic use only.