Adalat, generic name Nifedipine, is a type of medication known as a calcium channel blocker and is prescribed as a treatment for high blood pressure.
Blood pressure is determined by the amount of blood being pumped by the heart and the resistance to blood flow in the arteries. If the arteries become narrowed, blood pressure increases as the heart is forced to work too hard to pump blood around the body. This can lead to serious health complications such as damage to blood vessels in the brain, heart and kidneys, heart failure, stroke, or kidney failure. Calcium channel blockers such as Adalat (Nifedipine) work by relaxing, and therefore expanding, the blood vessels, helping blood to flow more easily and lowering blood pressure.
The active ingredient in Adalat is Nifedipine.
The inactive ingredients in Adalat are propylene glycol, cellulose acetate, hypromellose, hydroxypropyl cellulose, polyethylene oxide, macrogol, magnesium stearate, shellac, titanium dioxide (E171), iron oxide (E172), and sodium chloride.
Your doctor will decide your dose based on your individual requirements, and will aim to prescribe the lowest dose possible. Adalat is available as short-acting, immediate-release capsules, and as long-acting, slow-release tablets or capsules. The usual starting dose for immediate-release Adalat is 5 mg taken 3 times per day, and the usual starting dose for slow-release Adalat is 10 mg twice daily, or 20 - 30 mg once per day.
Take Adalat at the same time or times each day. Swallow each tablet whole with a glass of water, with or without food. If you forget to take a tablet, do not take a double dose to make up for a missed one. If you are taking 1 tablet per day, take the dose as soon as you remember as long as it is within 12 hours of the scheduled time.
If you are pregnant, think you might be pregnant, or are planning on becoming pregnant, speak to your doctor for advice before taking Adalat. You should not take this medication if you are breastfeeding. Your doctor may tell you that you need to stop breastfeeding in order to take Adalat.
Like all medications, Adalat can cause side effects in some patients. If you notice any of the following rare but serious side effects, stop taking Adalat and contact your doctor immediately:
Severe, sudden generalised allergic reaction, including shock and swelling
Other allergic reactions causing swelling under the skin, possibly including the larynx which could be serious
Fast heart beat (tachycardia)
Shortness of breath or difficulty breathing
Mild to moderate allergic reactions
Itching, rash or hives
A skin reaction including blistering or peeling of the skin and mucosal reactions in the mouth, nose or genital area
Common side effects, which may affect up to 1 in 10 people, include:
Generally feeling unwell
Swelling of the ankles or legs
Uncommon side effects may affect up to 1 in 100 people and include:
Low blood pressure when standing up
Indigestion or upset stomach
Anxiety or nervousness
Reddening of the skin
Sensation of spinning or whirling motion (vertigo)
Increased need to urinate
Painful or difficult urination
Inability to achieve or maintain an erection
Temporary increase in certain liver enzymes
The following side effects are extremely rare affecting up to 1 in 1 000 people:
Stomach pain or distress caused by a mass of foreign material found in the stomach which may require surgical removal
Abdominal pain caused by obstruction of the gut or ulcers in the gut
A reduction in the number of white blood cells
A more severe decrease in a specific class of white blood cell
Increased blood sugar
Decreased skin sensitivity
Heartburn or indigestion
Yellowing of the skin or the whites of the eyes (jaundice)
Sensitivity to light
Small, raised areas of bleeding in the skin
Do NOT take Adalat if:
You have had a heart attack within the last month
You get a sudden angina attack
You have unstable angina
You are allergic to nifedipine or any similar medications, or to any of the ingredients of Adalat
You are taking Rifampicin
You have a liver disease that prevents your liver from working properly
You have inflammation of the bowel or intestines, such as Crohn’s disease
You have an obstruction or narrowing of your intestines
You have ever had an obstruction in the gullet
You have been told that you have a narrowing of the aortic heart valve
You have ever had a collapse caused by a heart problem, during which you become breathless and pale, and had a cold sweat and a dry mouth
You have a ‘Kock pouch’ in your gut
If your blood pressure continues to rise despite treatment
Before taking Adalat, inform your doctor and take particular care if any of the following applies to you:
You have low blood pressure and were prescribed Adalat for angina
You have a heart condition where your heart cannot cope with increased strain
You are pregnant
You are breastfeeding
You are diabetic
You are on kidney dialysis
Your liver is not working properly
When taking Adalat, tell your doctor if:
Your angina becomes worse over a matter of hours or days
You have chest pains after taking your first dose of Adalat
You notice increased breathlessness
If you notice swelling of the ankles
If you are giving a urine sample. Adalat may interfere with the results of some tests
If you are to have a barium contrast x-ray
If you are a man who has been unable to father a child, as Adalat has been shown to impair sperm function.
Before taking Adalat, tell your doctor if you are taking or have recently taken any other medications, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking or have recently taken:
Other medicines used to treat high blood pressure
Digoxin, diltiazem, quinidine or beta-blockers
Phenytoin, carbamazepine or valproic acid
Magnesium sulphate injections during pregnancy
Ketoconazole, itraconazole or fluconazole
Indinavir, nelfinavir, ritonavir, saquinavir or amprenavir
Fluoxetine or nefazodone
You can take Adalat with or without food. However, you should avoid drinking grapefruit juice while taking Adalat, beginning 3 days before treatment, as this may increase blood levels of Nifedipine.
There are a variety of treatments for high blood pressure and your doctor will be able to decide which is best for you. Other calcium channel blockers include Felodipine, which is taken in the morning and slowly releases throughout the day, Lacidipine, which may not be suitable for more severe forms of angina, and Lercanidipine, which needs to be taken on an empty stomach and is more likely to cause side effects. Alternatively, a doctor may chose to prescribe an angiotensin II receptor blocker (ARB), such as Valsartan, Candesartan and Losartan, or a angiotensin converting enzyme (ACE) inhibitor, such as Enalapril, Ramipril or Perindopril. ARBs and ACE inhibitors both work by interfering with the activity of the hormone angiotensin II, which is involved in the narrowing of blood vessels. However, these options are thought to be less effective in patients over the age of 55 and in patients of Afro-Caribbean descent. Other options are Beta-blockers, which block the angiotensin II hormone and also lower the heart rate, and diuretics, which aid the relaxing of blood vessels and are sometimes taken in combination with the ACE inhibitor Enalapril.
Alongside treatment, there are some lifestyle changes you should make to help reduce blood pressure and improve your overall wellbeing. A major cause of high blood pressure is high salt intake, so keep an eye on the salt content of any pre-prepared food you eat and try to limit your intake to below the recommended maximum of 6g per day. Cut back on saturated fats and fatty cuts of meat, and try to include plenty of fruit and vegetables, wholegrains and lean meats in your diet. If you haven’t already done so, quit smoking, and tr to reduce the amount of alcohol you drink to below 14 units per week. Exercising regularly will help to keep your heart and blood vessels in good condition and can also contribute to reducing stress, another known cause of high blood pressure. Try to reduce the impact of stress in your life by taking daily walks, spending time with friends and family and finding time to relax where possible.
Adalat begins to work immediately, but it may take a couple of weeks to take full effect. If you are taking Adalat for high blood pressure, you are unlikely to have symptoms and therefore will probably not notice the effects of Adalat. Your doctor may wish to check in with you regularly to monitor your blood pressure.
Treatment with Adalat is usually long-term, and patients often take it for the rest of their life.
If you are scheduled to undergo surgery, you should tell the surgeon beforehand that you are taking Adalat. You may be advised to come off of Adalat 36 hours before surgery to prevent your blood pressure from becoming too low.
In up to 1 in every 100 male patients, Adalat may cause problems with achieving or maintaining an erection.
There is no evidence to suggest that Adalat affects fertility.
Adalat itself will not affect your contraception. However, some types of hormonal contraception, such as the combined contraceptive pill, are not recommended for use in women with high blood pressure. Speak to your doctor for advice on which contraceptives are safest for you.
You can drink alcohol with Adalat, but it may increase the blood pressure-lowering function of the drug, making you feel dizzy or tired. It is best to avoid drinking alcohol in excess when taking this medication.