This fact sheet will explain all you need to know regarding the safe administration of Nifedipine in pregnancy including dosage, pharmacodynamics, side effects, interactions, contraindications and administration. Perfect for student midwives!
BASICS: DOSAGE:
• Antihypertensive - Ca+ channel blocker • Nifedipine - Fast release - 5mg or 10mg
capsule - stat dose (Trust A, 2018)
• Used in hypertensive crisis, hypertensive
disorder and as myometrial relaxant • Nifedipine Slow release - 10mg stat dose
(EMC 2017)
• POM—must be prescribed by a doctor
• Then, 20-80mg daily divided into 12 hours
• Also used to prevent preterm labour
apart
• Presentation = soft capsules, tablets
• Maximum daily dose 80mg
(modified or prolonged release) varying
dosages depending on manufacturer
CONTRAINDICATIONS: GUIDELINES:
• Continuous use in pregnancy • Consider nifedipine only when labetalol is
• Not to be used before 20 weeks - toxicity and not tolerated or contraindicated (NICE
teratogenicity 2019)
• Hypotensive effect can reduce placental blood • BP profile (every 10 mins for 30 mins)
flow needed when first prescribed to monitor
• Hypersensitivity for rapid drop in BP (Trust A, 2018)
SIDE EFFECTS: • Manufacturer advises against use in
• Headache, flushing, dizziness, oedema, may pregnancy and breastfeeding (NICE 2019)
inhibit labour, postural hypotension
PHARMACODYNAMICS: RISK TO FETUS/NEONATE/BREASTFEEDING:
• Selective calcium channel blocker with mostly • Hypotensive effect can reduce placental
vascular effects blood flow—decrease in fetal oxygenation
• Relaxes smooth arterial muscle, causing • Some reports of toxicity and teratogenicity to
arteries to dilate, therefore reducing the fetus however very limited evidence after
resistance in the coronary and peripheral
20 weeks
circulation
• Transferred into breastmilk - not known to
• This reduces blood pressure and therefore the
cause harm however to reduce intake amount
hearts overall workload
for baby, it is recommended to wait 3-4 hours
• Eliminated 60-80% in urine, the rest is excreted in
after administration to feed (EMC 2017)
the faeces as metabolites
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