Page 153 - 2026 SMOG

NIFEDIPINE (PROCARDIA)
Class/Mechanism of Action
• Antianginal Agent, Calcium Channel Blocker
Inhibits movement of calcium ions across cell membranes of smooth muscle and myocardium,
resulting in relaxation of coronary vascular smooth muscle and vasodilation as well as reduced
peripheral vascular resistance (reducing blood pressure).
Indications
• Labeled Indications
˚ Chronic stable or vasospastic angina
• Off-Label Indications
˚ Prevention and treatment of high-altitude pulmonary edema
Contraindications
• Hypersensitivity to nifedipine or any component of the formulation
• Cardiogenic Shock
• ST-elevation myocardial infarction
• Do not use for acute anginal episodes; may precipitate myocardial infarction.
Adverse Reactions/Precautions
• Symptomatic hypotension and reflex tachycardia may occur, resulting in angina and/or MI in
patients with coronary heart disease
• Peripheral edema
• Unstable angina/non-ST-elevation myocardial infarction: not recommended in the absence of a
beta-blocker
• Pregnancy: Category C
• Lactation: Yes, not recommended
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
High Altitude Pulmonary Edema High Altitude Pulmonary Edema
(Off-Label use) (Off-Label use)
• PO • PO
˚ 30mg (Extended Release) q12hr ˚ 1.5mg/kg/day (Extended Release;
preferred dosing; max SINGLE dose:
OR
20mg (Immediate Release) q8hr 30mg)
Pulmonary Hypertension ˚ 0.5mg/kg q8hr (Immediate Release;
(Off-Label use) max SINGLE dose: 20mg/dose)
• PO Note: Treatment is only necessary if the
˚ 30mg (Extended Release) once daily; may response to oxygen and/or descent is poor
increase cautiously to 120–240mg/day
Note: Do not use for acute anginal episodes;
may precipitate myocardial infarction

2026 Standard Medical Operating Guidelines (SMOG) • 145