Nifedipine Dosing and Administration

Dosing Guidelines

• The maximum dose of nifedipine is 180 mg daily for the extended-release formulation, while the immediate-release formulation has a maximum daily dose of 90 mg, as recommended by the American College of Cardiology and American Heart Association 1, 2
• The American Academy of Pediatrics recommends an initial dose of 0.25-0.5 mg/kg per day and a maximum dose of 3 mg/kg per day up to 120 mg/day for pediatric patients 3, 4
• The American College of Cardiology recommends that immediate-release nifedipine should not be used for hypertension or angina without concomitant beta-blockade due to risk of adverse cardiovascular events 1, 5

Safety Considerations

• Common side effects of nifedipine include hypotension, dizziness, flushing, nausea, constipation, and edema, as reported by the American College of Cardiology 1, 2
• The American Academy of Pediatrics notes that tachycardia may occur, particularly with immediate-release formulations 4
• The European Society of Cardiology advises that immediate-release nifedipine should be avoided in unstable angina/NSTEMI except with concomitant beta blockade 1, 2

Special Populations

• The American Academy of Pediatrics recommends careful monitoring when using nifedipine for hypertension management in children 4
• The European Society of Cardiology suggests that in patients with unstable angina/NSTEMI, nifedipine should only be used when patients are already receiving adequate doses of nitrates and beta blockers 1, 5
• The American College of Cardiology recommends that for pulmonary hypertension, high doses (120-240 mg daily) may be required in patients who demonstrate vasoreactivity 7, 8