Nifedipine Foods

For patients who have difficulty swallowing dilti-azem, tablets can be crushed and mixed with food or liquids. However, the patient should swallow the sus-tained-released tablets whole and not chew or divide them. When nifedipine is ordered sublingually, the capsule is punctured with a sterile needle and the liquid squeezed under the tongue or in the buccal pouch. 

Significant food interactions observed with a nifedipine modified-release... 

Drug/Food interactions Nifedipine, amlodipine, and verapamil may be administered without regard to meals. 

Schug BS, Brendel E, Chantraine E et al. (2002) The effect of food on the pharmacokinetics of nifedipine in two slow release formulations pronounced lag-time after a high fat breakfast. Br J Clin Pharmacol 53 582-588 Stoepel K, Heise A, Kazda S (1981) Pharmacological studies of the antihypertensive effect of nitrendipine. Arzneimit-tel Forsch 31 2056-2061... 

Besides UV absorbers and food colorants, use of opacifiers is another way of photostabilizing photosensitive tablets. The protecting effect of yellow, red and black iron oxide could be shown for tablets containing the antiviral drug sorivudine, as well as molsidomine and nifedipine tablets (15). Iron oxides were found to be more effective than titanium dioxide, especially if the drug is particularly sensitive to radiation of wavelengths between 400 and 420 nm (e.g., nifedipine), where titanium dioxide shows an "absorption gap" (Thoma K, Aman W. In preparation) (4). 

Thoma and Klimek (115) also found that the natural food colorant curcumin as well as Fast Yellow, chrysoine, apocarotinol, and, cochineal Red A photostabi-lized solutions of nifedipine and nitrofurazone. They also found that vanillin and methyl gallate could stabilize solutions of dihydroergotamine. These authors also found that furosemide was stabilized by the addition of vanillin, haloperidol by benzyl alcohol, and vanillin and thiothixene by quinosol and vanillin. 

Schug BS, Brendel E, Wonnemann M, Wolf D, Wargenau M, Dingier A, Blume HH. Dosage form-related food interaction observed in a marketed once-daUy nifedipine formulation after a high-fat American breakfast. Eur J Clin Pharmacol 2002 58(2) 119-25. 

Abrahamsson, B., M. Alpsten, B. Bake, U. E. Jonsson, M. Lepkowska-Eriksson, and A. Larsson. (1998b). Drug absorption from nifedipine hydrophilic matrix extended-release (ER) tablet—Comparison with an osmotic pump tablet and effect of food./. Controlled Release 52 301-310. 

No adverse interactions appear to occur with clopidogrel and alu-minium/magnesium hydroxide, atenolol, cimetidine, digoxin, food, insulin, nifedipine, oestrogens, phenobarbital, phenytoin or tolbutamide. 

Some modified-release preparations of felodipine, nifedipine, and nisoldipine show markedly increased levels when given with food, particularly when high in fat. The bioavailability of lercanidipine is markedly increased by food, and it should therefore be given on an empty stomach. Manidipine should be given with food, as this improves its absorption. Food modestly decreases the rate and extent of absorption of nimodipine capsules. Food had no effect on the absorption of amlodipine, bepridil, diltiazem, isradipine, or verapamil in the studies cited. 

Reitbeig DP, Love SJ, Quercia GT, Zinny MA. Effect of food on nifedipine pharmacokinetics. Clin Pharmacol Ther ( 9S7) 42, 72-5. 

Challenor VF, Wdler EXj, Gruchy BS, Renwick AG, Geoige CF. Food and nifedipine phar-macckinetics. BrJ Clin Pharmacol ( 9ZT) 23,248-9. 

Rimoy GH, Idle JR, BhaskarNK, Rubin PC. The influence of food on the pharmacokinetics of biphasic nifedipine at steady state in normal subjects. BrJ Clin Pharmacol (1989) 28,... 

Hypertensive reactions have been controlled by intravenous phen-tolamine, phenoxybenzamine, intramuscular chlorpromazine, labetalol or sublingual nifedipine. The manufacturers of phenelzine state that on the basis of present evidence, slow intravenous injection of phentolamine is recommended. However, it is advisable to refer to current guidelines on the management of hypertensive crises for up-to-date advice. See also Importance and Management under MAOIs or RIMAs + Tyramine-rich foods , p.II53. 

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