Medication Monday: Nifedipine


Medication Mondays are BACK! 💊 Today I’m talking about nifedipine, a calcium channel blocker.

Is it safe when lactating? 👍🏻 
Is it safe when pregnant? 👍🏻
Is it safe for baby? 👍🏻
Is is safe for SUPPLY? 👍🏻

Nifedipine is a calcium channel blocker. It is used for high blood pressure, high blood pressure emergency during pregnancy and/or postpartum, and Raynaud’s phenomenon.

Nifedipine works by relaxing the smooth muscle of the heart, dilating (relaxing) the blood vessels of the heart, and dilating the peripheral (away from the heart) blood vessels. These actions decrease blood pressure. 

Nifedipine works within 20 minutes of administration depending on the formulation. It comes in immediate release and extended/controlled release formulations. It has a half-life of 2-5 hours. Common side effects include peripheral edema, headache, and nausea. 

Nifedipine can be used during pregnancy, but it is not first-line therapy. Methyldopa and labetalol are used more often, but the specific blood pressure agent used will depend greatly on individual factors and will need to be tailored to the individual’s circumstances. Nifedipine has not been directly studied in pregnancy, but it has been studied in animal studies. Nifedipine does cross the placenta and an increase in intrauterine growth restriction, premature delivery, and caesarean birth have been reported following use in pregnancy. Oral nifedipine is one of the preferred agents for chronic high blood pressure during pregnancy and for acute-onset severe blood pressure during pregnancy and postpartum. High blood pressure during pregnancy and postpartum can turn serious and potentially deadly rather quickly, so it is important to remember that treatment (medication or non-medication interventions) will almost always outweigh the risks of the intervention. 

Nifedipine can be used safely in lactation. It has a relative infant dose of 0.3% to 3.2%, so little of it transfers to breastmilk. No adverse effects in breastfed infants have been reported per Infant Risk and LactMed. Nifedipine can be used for postpartum high blood pressure or Raynaud’s phenomenon of the nipple. 

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