Nifedipine adverse reactions

The answer is e. (Hardman, pp 858-874.) Because verapamil, a Ca channel blocker, has a selective depressing action on AV nodal tissue, it is an ideal drug for both immediate and prophylactic therapy of supraventricular tachycardia (SVT). Nifedipine, another Ca channel blocker, has little effect on SAT Lidocaine and adenosine are parenteral drugs with short ha If-lives and, thus, are not suitable for prophylactic therapy. Procainamide is more suitable for ventricular arrhythmias and has the potential for serious adverse reactions with long-term use. 

Vetrovec GW, Parker VE. Alternative medical treatment for patients with angina pectoris and adverse reactions to beta blockers. Usefulness of nifedipine. Am J Med 1986 81(4A) 20-7. 

The neurotoxic adverse reactions cited above for lithium and verapamil contrast with two other case reports describing uneventful concurrent use.i2 i3 Variable reports of altered serum-lithium levels have also occurred. This unpredictability emphasises the need to monitor the effects closely where it is thought appropriate to give lithium and verapamil. Only a couple of isolated reports of neurotoxicity have been reported with lithium and diltiazem, and their general relevance is uncertain, but bear them in mind in the event of an unexpected response to treatment. Some limited data suggest that nifedipine may slightly reduce lithium clearance, and the clinical relevance of this is again uncertain. 

A 40-year-old man from Ghana presented with 6 months of burning sensation in his penis mostly present during urination and sexual intercourse [23 ]. After careful examination of medications, an extended-release preparation of nifedipine (nifedipine XL) was found to be probably related to the adverse effect. Dysuria disappeared after several days of wash-out from nifedipine, and recurred upon restarting nifedipine XL. The pathophysiology of this drug adverse reaction is unknown and has never been reported with non-XL nifedipine. 

Gingival hyperplasia, similar to that seen with phenytoin and ciclosporin, is a rare but well-recognized adverse effect of nifedipine (88). It has also been reported in patients taking felodipine (89,90), nitrendipine (SEDA-16, 200), and verapamil (91), suggesting that this adverse effect is a class effect. Only one case of gingival hyperplasia related to calcium channel blockers was reported to the Norwegian Adverse Drug Reaction Committee up to 1991, despite their widespread use (92). However,... 

SED-13, 513) (SEDA-18, 215) (SEDA-22, 216). Three cases of skin reactions (hypersensitivity syndrome reaction, pruritic exanthematous eruption, and acute generalized exanthematous pustulosis) possibly induced by diltiazem have been described and the literature on skin reactions associated with calcium antagonists has been reviewed. The number of diltiazem-induced cutaneous events was significantly greater than those induced by either nifedipine or verapamil. However, there was no difference in the proportion of serious cutaneous adverse events due to any of these three drugs (11). 

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