Adalat (nifedipine) is a leading calcium channel blocker medication specifically formulated for the management of hypertension (high blood pressure) and angina. As a cornerstone in cardiovascular pharmacotherapy, it works by relaxing and widening blood vessels, allowing blood to flow more easily and reducing the heart’s workload. This prescription medication is recognized for its efficacy in both immediate and extended-release formulations, offering tailored treatment options under strict medical supervision. Its mechanism targets vascular smooth muscle, providing a focused approach to blood pressure regulation and coronary blood flow improvement.

Features

• Active ingredient: Nifedipine (30 mg, 60 mg extended-release tablets)
• Drug class: Dihydropyridine calcium channel blocker
• Formulations: Immediate-release capsules, extended-release tablets (GITS)
• Prescription-only medication requiring healthcare provider authorization
• FDA-approved for hypertension and chronic stable angina
• Manufactured under cGMP (current Good Manufacturing Practice) standards
• Multiple strength options for dose titration
• Bioavailability: Approximately 45-56% for extended-release formulation
• Half-life: Approximately 2-5 hours (immediate-release), 7 hours (extended-release)
• Metabolism: Primarily hepatic via CYP3A4 enzyme system

Benefits

• Effectively lowers systolic and diastolic blood pressure measurements
• Reduces frequency and severity of angina episodes
• Decreases myocardial oxygen demand through afterload reduction
• Provides 24-hour blood pressure control with once-daily dosing (extended-release)
• Demonstrates proven cardiovascular risk reduction in clinical studies
• Offers flexible dosing options for individualized treatment plans

Common use

Adalat is primarily prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is equally effective in treating vasospastic angina and chronic stable angina pectoris. The extended-release formulation is particularly valuable for maintaining consistent plasma concentrations, thereby ensuring smooth blood pressure control throughout the dosing interval. Cardiology specialists often utilize Adalat in patients who require specific vascular selectivity or who have demonstrated intolerance to other antihypertensive classes.

Dosage and direction

The dosage must be individualized based on therapeutic response and tolerability. For hypertension management using extended-release tablets, the typical starting dose is 30 or 60 mg orally once daily. Dosage may be increased over 7 to 14 day intervals. Maximum recommended dose is 90 mg daily. For angina treatment, initial dose is 30 mg once daily, titrated upward as needed. Tablets should be swallowed whole and not crushed, chewed, or divided. Administration with a light meal may help minimize potential gastrointestinal discomfort while maintaining consistent absorption profiles.

Precautions

Patients should undergo regular blood pressure monitoring, especially during initial titration. Abrupt withdrawal may cause rebound hypertension or angina exacerbation. Use with caution in patients with heart failure or severe aortic stenosis due to potential negative inotropic effects. Hepatic impairment requires dosage adjustment as nifedipine is extensively metabolized by the liver. Peripheral edema, a common side effect, typically responds to diuretic therapy or dosage reduction. Patients should avoid grapefruit juice consumption as it may significantly increase bioavailability.

Contraindications

Adalat is contraindicated in patients with known hypersensitivity to nifedipine or other calcium channel blockers. Additional contraindications include patients with cardiogenic shock, clinically significant aortic stenosis, or those experiencing acute myocardial infarction (especially within 4 weeks post-infarction). The medication is not recommended during pregnancy unless clearly needed and under specialist supervision. Concomitant use with strong CYP3A4 inhibitors requires careful risk-benefit assessment due to potential interaction severity.

Possible side effects

Common adverse reactions include peripheral edema (dose-dependent), headache, dizziness, flushing, and palpitations. Gastrointestinal effects may include nausea, constipation, or abdominal discomfort. Less frequently, patients may experience hypotension, syncope, fatigue, or muscle cramps. Serious but rare side effects include myocardial infarction, heart failure exacerbation, and significant hepatic enzyme elevations. Allergic reactions including rash and pruritus have been reported. Most side effects are dose-related and often diminish with continued therapy.

Drug interaction

Nifedipine interacts significantly with CYP3A4 inhibitors including ketoconazole, itraconazole, ritonavir, and clarithromycin (may increase nifedipine levels). Inducers such as rifampin, phenytoin, and carbamazepine may decrease efficacy. Concurrent use with beta-blockers requires careful monitoring for excessive hypotension or heart failure. Digitalis levels may increase with coadministration. Magnesium sulfate when used concurrently may result in neuromuscular blockade. NSAIDs may diminish antihypertensive effects. Always review full medication profile before prescribing.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Patients should never double the dose to make up for a missed administration. Consistent timing is important for maintaining therapeutic blood levels, particularly with the extended-release formulation. Setting daily reminders or using pill organizers can help maintain adherence to the prescribed regimen.

Overdose

Nifedipine overdose may manifest as severe hypotension, bradycardia, palpitations, nausea, and drowsiness. In severe cases, metabolic acidosis, hyperglycemia, and cardiogenic shock may occur. Management includes cardiovascular monitoring, elevation of lower extremities, and judicious fluid administration. Calcium gluconate infusion (10%) may help counteract calcium channel blockade. Vasopressors such as dopamine or norepinephrine may be required for refractory hypotension. Gastric lavage may be considered if presentation is early after ingestion. Activated charcoal may be effective if given within 1 hour of ingestion.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not transfer tablets to other containers as this may affect stability. Do not use if the blister pack is damaged or tablets show signs of discoloration or deterioration. Proper disposal of expired medication through take-back programs is recommended to prevent accidental ingestion or environmental contamination.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Adalat is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to therapy may vary based on clinical factors. Patients should not initiate, discontinue, or modify dosage without consulting their prescribing physician. The complete prescribing information should be reviewed before administration.

Reviews

Clinical studies demonstrate that Adalat effectively reduces systolic blood pressure by 12-15 mmHg and diastolic pressure by 8-10 mmHg in hypertensive patients. Angina patients show significant improvement in exercise tolerance and reduction in nitrate consumption. The extended-release formulation receives particular praise for its smooth pharmacokinetic profile and reduced side effect incidence compared to immediate-release formulations. Real-world evidence supports its position as a well-tolerated option in diverse patient populations when appropriately prescribed and monitored.