Medication Guide for Adalat

Active Ingredient: Nifedipine

Adalat primarily contains the active ingredient nifedipine. Nifedipine is a calcium channel blocker used to manage certain cardiovascular conditions. The molecular formula of nifedipine is C₁₇H₁₈N₂O₆.

Mechanism of Action

Nifedipine works by inhibiting the influx of calcium ions into cardiac and smooth muscle cells. This results in the dilation of the coronary and peripheral arteries, thereby reducing myocardial oxygen demand and arterial pressure.

Indications for Use

Adalat is commonly prescribed for the management of hypertension and chronic stable angina pectoris. It may also be used for vasospastic angina and certain off-label uses as determined by a healthcare provider.

Contraindications

Adalat should not be used in patients with known hypersensitivity to nifedipine or other dihydropyridine calcium channel blockers. It is also contraindicated in patients with cardiogenic shock, significant aortic stenosis, and unstable angina without heart failure.

Dosage and Administration

The dosage of Adalat varies depending on the condition being treated. For hypertension, the initial dose is usually 10 mg twice daily. It may be titrated up to 20 mg three times a day based on patient’s response. For angina, the typical starting dose is also 10 mg twice daily.

Pharmacokinetics

Nifedipine has an oral bioavailability of approximately 45-68%. Peak plasma concentrations are usually reached within 30-60 minutes of administration. The drug is extensively metabolized in the liver and has a half-life of 2-5 hours in healthy individuals.

Potential Drug Interactions

Nifedipine may interact with other antihypertensive agents, enhancing their blood pressure-lowering effects. It also has potential interactions with digoxin, increasing its plasma levels. Cimetidine and macrolide antibiotics can increase the levels of nifedipine by inhibiting its metabolism.

Special Populations

In elderly patients, the pharmacokinetics and pharmacodynamics of nifedipine may be altered, requiring dose adjustment. In patients with hepatic impairment, clearance of the drug may be reduced, necessitating careful monitoring and potential dosage modification.

Side Effects

Common side effects of Adalat include headache, flushing, and peripheral edema. Less frequently, it may cause dizziness, fatigue, and gastrointestinal disturbances. Severe side effects, though rare, may include hypotension, syncope, and myocardial infarction.

Pregnancy and Lactation

Adalat should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nifedipine is excreted in breast milk and therefore should be used with caution in breastfeeding women.

Overdosage

In the event of an overdose, symptoms may include marked hypotension, bradycardia, and cardiac arrest. Immediate medical intervention with supportive measures and symptomatic treatment is required. Activated charcoal may be administered if within a short time post-ingestion.

Storage Conditions

Adalat should be stored at a controlled room temperature, between 15°C to 30°C. It must be kept in a tightly closed container, protected from light and moisture. Keep out of reach of children.

Dosage Forms

Adalat is available in various dosage forms including immediate-release capsules and extended-release tablets. The specific form prescribed will depend on the condition being treated and the desired pharmacokinetic profile.

Dispensing and Handling

Adalat should be dispensed in its original container. When handling the medication, ensure that it is not exposed to excessive heat or light. Pharmacists should ensure that patients understand the correct administration regimen and potential side effects.

Titration and Maintenance

Patients starting on Adalat should be closely monitored during titration. The dose should be adjusted based on therapeutic response and tolerance. Regular follow-ups are necessary to ensure the effectiveness and safety of the treatment.