Comprehensive Product Description: Adalat

Adalat (generic name: Nifedipine) is a prescription calcium channel blocker used to treat high blood pressure (hypertension) and angina (chest pain). It works by relaxing blood vessels, improving blood flow, and reducing the workload on the heart. Available in immediate and extended-release formulations, Adalat effectively lowers blood pressure and reduces the frequency of anginal attacks.

Adalat

Nifedipine

Procardia

Nifediac

Afeditab CR

Adalat CC (Controlled Release)

Nifecard

Nifelat

Therapeutic Class: Antihypertensive, Antianginal

Pharmacologic Class: Calcium Channel Blocker (Dihydropyridine Class)

Nifedipine – A dihydropyridine calcium channel antagonist

Mechanism of Action (Mode of Action):
Nifedipine inhibits the influx of calcium ions through L-type calcium channels in vascular smooth muscle and cardiac muscle. This results in:

Vasodilation of peripheral arteries

Reduced systemic vascular resistance

Lowered arterial blood pressure

Improved oxygen supply to cardiac tissue
The drug has minimal direct effect on myocardial contractility or conduction, making it suitable for long-term cardiovascular therapy.

Hypertension (high blood pressure)

Chronic stable angina pectoris

Vasospastic (Prinzmetal’s) angina

Off-label: Raynaud's phenomenon, preterm labor (tocolysis), esophageal spasm

Standard Dosing Guidelines
Hypertension (Extended-Release Tablets):

Initial dose: 30–60 mg orally once daily

Maintenance dose: 30–90 mg once daily

Maximum dose: 120 mg/day

Angina (Immediate-Release Capsules):

10–20 mg three times daily

Maximum dose: 180 mg/day
Note: Immediate-release forms are generally not recommended for long-term use due to increased cardiovascular risk.

Administration Tips:

Take on an empty stomach, at least 1 hour before or 2 hours after a meal

Do not chew or crush extended-release tablets

Maintain consistent dosing time

Prescribing & Storage Information:
Prescription required in most countries

Store at room temperature (15–25°C)

Protect from moisture and light

Available in capsule (immediate-release) and tablet (extended-release) forms

Common Side Effects:
Headache

Dizziness

Flushing

Swelling of ankles/feet (peripheral edema)

Constipation

Less Common Side Effects:
Palpitations

Fatigue

Nausea

Rash

Hypotension

Worsening angina (especially on initiation)

Gingival hyperplasia

Liver enzyme elevation

Rare: myocardial infarction in high-risk patients using IR formulations
:
Do not stop suddenly—may trigger rebound angina

Use cautiously in heart failure patients

Monitor blood pressure and liver function periodically

Avoid grapefruit juice—increases plasma nifedipine levels

Not recommended in patients with aortic stenosis or unstable angina

Major Interactions
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): Increase nifedipine levels

CYP3A4 inducers (e.g., rifampin, carbamazepine): Reduce effectiveness

Beta-blockers: Additive blood pressure-lowering effect

Digoxin: Monitor for toxicity if used concurrently

Grapefruit Juice: Avoid – inhibits metabolism

Pregnancy & Lactation:
Pregnancy Category C: May be used if benefits outweigh risks (used in some cases for preeclampsia or preterm labor)

Lactation: Minimal excretion in breast milk; generally considered safe

Multiple RCTs (e.g., Syst-Eur, INSIGHT) support efficacy of calcium channel blockers including nifedipine in reducing stroke risk, cardiovascular events, and mortality in hypertensive patients

AHA and ESC guidelines include Adalat (nifedipine) as first-line agent for management of essential hypertension

Frequently Asked Questions (FAQs)
Q1. What is Adalat used for?
Adalat is prescribed for high blood pressure and chronic angina to improve blood flow and reduce cardiovascular strain.

Q2. How quickly does Adalat work?
Immediate-release capsules start working within 20–30 minutes, while extended-release tablets provide gradual effect over 24 hours.

Q3. Can Adalat be taken with other blood pressure medications?
Yes, often used with ACE inhibitors, ARBs, or diuretics, but should be monitored for hypotension.

Q4. Are there lifestyle changes needed while on Adalat?
Yes, follow a low-sodium diet, regular exercise, and smoking cessation for best results.

Q5. What should I do if I miss a dose?
Take it as soon as you remember. Skip it if it’s almost time for the next dose. Do not double up.

Q6. Is long-term use of Adalat safe?
Yes, when monitored properly, Adalat is effective and safe for long-term cardiovascular health.