Nisoldipine

Drug Information: Nisoldipine

Detailed information regarding Nisoldipine, a dihydropyridine calcium channel blocker commonly used in the treatment of hypertension. Nisoldipine works by selectively blocking calcium influx into vascular smooth muscle cells, resulting in vasodilation and a reduction in blood pressure. It is often formulated as an extended-release tablet to provide a gradual and sustained effect, minimizing fluctuations in blood pressure throughout the day. It’s important to use Nisoldipine under the guidance of a healthcare professional due to potential drug interactions and specific patient considerations.

Category

Antihypertensive

Mechanism of Action

Nisoldipine is a calcium channel blocker, specifically belonging to the dihydropyridine class. Its primary mechanism of action involves selectively blocking the influx of calcium ions into vascular smooth muscle cells. Calcium ions play a crucial role in muscle contraction. By inhibiting the entry of calcium through L-type calcium channels, nisoldipine reduces intracellular calcium concentration, leading to vasodilation, particularly in the arterial vasculature. This vasodilation decreases peripheral vascular resistance, resulting in a reduction in blood pressure. Nisoldipine exhibits a greater selectivity for vascular smooth muscle compared to cardiac muscle, which contributes to its effectiveness in treating hypertension with a relatively lower risk of direct cardiac effects compared to some other calcium channel blockers. The extended-release formulation of Nisoldipine ensures a gradual and sustained release of the drug, providing consistent calcium channel blockade over a 24-hour period and minimizing blood pressure fluctuations.

Clinical Uses

Nisoldipine is primarily indicated for the treatment of hypertension (high blood pressure). By relaxing and widening blood vessels, it helps to lower blood pressure, reducing the strain on the heart and decreasing the risk of cardiovascular complications such as stroke, heart attack, and kidney disease. It is often used as a first-line treatment option or in combination with other antihypertensive medications to achieve optimal blood pressure control. The extended-release formulation is designed to provide once-daily dosing, improving patient compliance and maintaining consistent blood pressure levels throughout the day. While primarily used for hypertension, Nisoldipine, like other calcium channel blockers, may be used off-label for other conditions where vasodilation is beneficial, but this is less common and requires careful medical evaluation and monitoring.

Dosage

Adults: The typical starting dose of Nisoldipine ER (extended-release) is 17 mg orally once daily. The dose may be increased gradually, usually at intervals of 1-2 weeks, to a maximum of 34-51 mg once daily, depending on blood pressure response and tolerability.

Pediatrics: The safety and efficacy of Nisoldipine in pediatric patients have not been established. It is generally not recommended for use in children.

Route of Administration: Oral, as an extended-release tablet.

Indications

* Hypertension (High Blood Pressure)

Contraindications

* Hypersensitivity to nisoldipine or other dihydropyridine calcium channel blockers.
* Severe aortic stenosis.
* Cardiogenic shock.
* Advanced heart failure.
* Use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole).

FAQ

Q: What is Nisoldipine used for?

A: Nisoldipine is used to treat hypertension (high blood pressure).

Q: How does Nisoldipine work?

A: It works by blocking calcium from entering the muscle cells of the heart and arteries, which causes the blood vessels to relax and widen, lowering blood pressure.

Q: How should I take Nisoldipine?

A: Nisoldipine should be taken exactly as prescribed by your doctor. Typically, it is taken once daily as an extended-release tablet. Do not crush or chew the tablet.

Q: What are the common side effects of Nisoldipine?

A: Common side effects include headache, flushing, dizziness, peripheral edema (swelling of the ankles and feet), and palpitations.

Q: Can I drink alcohol while taking Nisoldipine?

A: It is generally recommended to avoid or limit alcohol consumption while taking Nisoldipine, as alcohol can enhance the blood pressure-lowering effects of the drug and increase the risk of dizziness or lightheadedness.

Q: What should I do if I miss a dose of Nisoldipine?

A: If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.

Q: Are there any drug interactions with Nisoldipine?

A: Yes, Nisoldipine can interact with several other medications, including other blood pressure medications, certain antifungals (e.g., ketoconazole), and some antibiotics. It is important to inform your doctor of all medications you are taking, including over-the-counter drugs and herbal supplements.

Q: Can I stop taking Nisoldipine suddenly?

A: Do not stop taking Nisoldipine without consulting your doctor. Suddenly stopping the medication can cause a rebound increase in blood pressure.