Headaches nifedipine

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

Diltiazem inhibits calcium influx via voltage-operated channels and therefore decreases intracellular calcium ion. This decreases smooth muscle tone. Diltiazem dilates both large and small arteries and also inhibits a-adrenoceptor activated calcium influx. It differs from verapamil and nifedipine by its use dependence. In order for the blockade to occur, the channels must be in the activated state. Diltiazem has no significant affinity for calmodulin. The side effects are headache, edema, and dizziness. 

Short-acting nifedipine may rarely cause an increase in the frequency, intensity, and duration of angina in association with acute hypotension. This effect may be obviated by using sustained-released formulations of nifedipine or other dihydropyridines. Other side effects of dihydropyridines include dizziness, flushing, headache, gingival hyperplasia, and peripheral edema. Side effects due to vasodilation such as dizziness, flushing, head-... 

The H2RAs are generally well tolerated. The most common adverse effects are headache, somnolence, fatigue, dizziness, and either constipation or diarrhea. Cimetidine may inhibit the metabolism of theophylline, warfarin, phenytoin, nifedipine, and propranolol, among other drugs. 

Hypertensive crises are characterized initially by headache, but can evolve to include neck stiffness, chest discomfort, palpitations, confusion, and, ultimately, hemorrhage or stroke. Treatment of MAOI-associated hypertension may include a watch-and-wait stance by the patient if the symptoms are mild. Some patients have the ability to check and monitor their own blood pressure. Others may consult with a physician for blood pressure checks and observation, but if symptoms are severe, the patient may need to go to an emergency room or self-medicate. Standard emergency room treatment is intravenous phentolamine, an a-adrenergic blocker, continuous monitoring and management until blood pressure is normalized without medication. Some doctors will provide patients with small doses of chlorpromazine or nifedipine to treat hypertension if a problem arises. 

Self-medication of a MAOI-induced hypertensive crisis is controversial. In a hypertensive crisis the lack of access to medical services may lead to even greater complications. A small dose of medication taken as part of a larger plan to blunt the rise in blood pressure may prevent serious complications. However, headache is common, has multiple causes, and patients may not accurately identify a headache due to hypertension without a blood pressure check. In addition, selfadministration of nifedipine, especially sublingually, may result in needless and perhaps dangerous drops in blood pressure. 

In a randomized, controlled study of cyclic iloprost or nifedipine in 46 patients with systemic sclerosis, the predictable adverse effects of iloprost (headache, nausea and vomiting, and diarrhea) were common but quickly resolved after the end of the infusion (5). They rarely required a temporary dose reduction. Hypotension occurred less often than with nifedipine. 

Nifedipine [nye FED i peen] functions mainly as an arteriolar vasodilator. This drug has minimal effect on cardiac conduction or heart rate. Nifedipine is administered orally and has a short half-life (about 4 hours) requiring multiple dosing. The vasodilation effect of nifedipine is useful in the treatment of variant angina caused by spontaneous coronary spasm. Nifedipine can cause flushing, headache, hypotension, and peripheral edema as side effects of its vasodilation activity. The drug may cause reflex tachycardia if peripheral vasodilation is marked resulting in a substantial decrease in blood pressure. 

Indications. An indication for nifedipine is angina pectoris (p.318). In angina pectoris, it is effective when given either prophylacti-cally or during acute attacks. Adverse effects are palpitation (reflex tachycardia due to hypotension), headache, and pretibial edema. 

CALCIUM CHANNEL BLOCKERS IMATINIB t plasma concentrations of imatinib when is co-administered with dilti-azem, nifedipine or verapamil, t risk of toxicity (e.g. abdominal pain, constipation and dyspnoea) and of neurotoxicity (e.g. taste disturbances, dizziness, headache, paraesthesias and peripheral neuropathy) Due to inhibition of hepatic metabolism of imatinib by the CYP3A4 isoenzymes by diltiazem Monitor for clinical efficacy and for the signs of toxicity listed along with convulsions, confusion and signs of oedema (including pulmonary oedema). Monitor electrolytes and liver function, and for cardiotoxicity... 

A 16-year-old man with neurofibromatosis type 1, a malignant pheochromocytoma with lung and bone metastases, and candidiasis of the gastrointestinal tract with fungemia was taking nifedipine for arterial hjrper-tension. The fungal infection responded to fluconazole, but three attempts to withdraw the fluconazole resulted in recurrence of headache, palpitation, and increased blood pressure. 

Nifedipine long-acting 30-90 1 (tachycardia), dizziness, headache. 

Heart block is a contraindication for the nondihydropyridines. The most common side effects are bradycardia and heart block (for the nondihydropyridines). Peripheral edema and headache are also common. Nondihydropyridines exacerbate bradycardic effects of /S-blockers, and verapamil raises digoxin serum concentrations by 70%. Diltiazem raises cyclosporine serum concentrations. Intravenous calcium salts inhibit the pharmacologic effect of CCBs. Generic formulations or similar products, but not necessarily generic equivalents to the original brand names, are available for verapamil, nifedipine, and diltiazem. 

Nicardipine (Cardene) Similar to nifedipine Chronic, stable angina. Hypertension. Peripheral edema, palpitations, angina, dizziness, headache, flushing, asthenia. 

Nifedipine can cause hypotension, reflex tachycardia, peripheral edema, flushing, light-headedness and headache... 

Two patients taking verapamil and two taking nifedipine developed increased adverse effects (oedema, headaches, nausea, flushing, orthostatic hypotension) due to the concurrent use of fluoxetine. Fluoxetine appears to increase nimodipine levels, whereas nimodipine may decrease fluoxetine levels. Fluoxetine does not appear to alter lercanidipine pharmacokinetics. 

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