Adalat

Adalat, with its active ingredient nifedipine, is a trusted calcium channel blocker prescribed for the management of hypertension and angina. This medication works by relaxing and widening blood vessels, allowing blood to flow more easily and reducing the heart’s workload. It is available in extended-release formulations, providing consistent 24-hour control, and is a cornerstone in cardiovascular risk management protocols. Its well-established efficacy and safety profile make it a first-line choice for physicians seeking reliable antihypertensive and antianginal therapy.

Features

• Contains nifedipine, a dihydropyridine calcium channel blocker
• Available in extended-release tablets (e.g., Adalat CC) for once-daily dosing
• Multiple strengths: 30 mg, 60 mg, and 90 mg tablets
• Designed for gradual, controlled release over 24 hours
• Bioequivalent to other branded nifedipine formulations
• Manufactured under strict pharmaceutical quality standards

Benefits

• Effectively lowers high blood pressure, reducing long-term cardiovascular risk
• Decreases frequency and severity of angina attacks, improving exercise tolerance
• Provides smooth, around-the-clock blood pressure control with once-daily dosing
• Helps prevent complications associated with hypertension, including stroke and heart attack
• Generally well-tolerated with a predictable side effect profile
• Can be used as monotherapy or in combination with other antihypertensive agents

Common use

Adalat is primarily prescribed for the management of essential hypertension and chronic stable angina pectoris. In hypertension, it is used as first-line therapy or as part of combination treatment when blood pressure remains uncontrolled with monotherapy. For angina patients, Adalat reduces myocardial oxygen demand through afterload reduction and coronary vasodilation. It may also be used off-label for certain cases of Raynaud’s phenomenon and preterm labor under specialist supervision, though these uses are not FDA-approved indications.

Dosage and direction

The recommended starting dose for hypertension or angina is 30 mg once daily. Dosage may be increased gradually over 7-14 day intervals as needed. The maximum recommended dose is 90 mg daily. Tablets should be swallowed whole with a glass of water, not crushed, chewed, or divided. Administration should occur at approximately the same time each day, with or without food, though consistency in timing relative to meals is recommended. Dose titration should be based on blood pressure response and tolerability. For patients with hepatic impairment, lower starting doses and careful titration are advised.

Precautions

Regular blood pressure monitoring is essential during therapy. Patients should avoid grapefruit juice as it may increase nifedipine concentrations. Use with caution in patients with heart failure, severe aortic stenosis, or severe hypotension. Peripheral edema may occur and typically responds to diuretic therapy or dose reduction. Abrupt discontinuation should be avoided as it may cause rebound hypertension or angina exacerbation. Patients should be advised about potential dizziness, especially when rising quickly from sitting or lying positions. Dental procedures may require special consideration due to potential gingival hyperplasia.

Contraindications

Adalat is contraindicated in patients with known hypersensitivity to nifedipine or any component of the formulation. It should not be used in patients with cardiogenic shock, significant aortic stenosis, or unstable angina (unless combined with beta-blockers). The immediate-release formulation is contraindicated for hypertensive emergencies due to risk of severe hypotension and reflex tachycardia. Concomitant use with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or ritonavir is contraindicated due to significantly increased nifedipine exposure.

Possible side effect

Common side effects include peripheral edema (5-10%), headache (10-15%), dizziness (5-10%), and flushing (10-20%). Less frequently, patients may experience palpitations (2-5%), nausea (2-5%), constipation (2-5%), or fatigue (2-5%). Rare but serious adverse effects include hypotension, syncope, worsening angina, myocardial infarction, and gingival hyperplasia. Laboratory abnormalities may include transient elevations in liver enzymes. Most side effects are dose-dependent and often diminish with continued therapy or dose adjustment.

Drug interaction

Adalat interacts significantly with CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) which increase nifedipine levels, and CYP3A4 inducers (e.g., rifampin, phenytoin) which decrease efficacy. Concurrent use with beta-blockers may increase risk of heart failure or severe hypotension. Additive hypotensive effects occur with other antihypertensives, nitrates, and phosphodiesterase-5 inhibitors. Nifedipine may increase digoxin levels by 15-45%, requiring monitoring. It may decrease quinidine levels and increase theophylline concentrations. Grapefruit juice increases bioavailability by inhibiting intestinal CYP3A4.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended. Patients should be educated about maintaining consistent dosing and establishing routines to minimize missed doses. If multiple doses are missed, blood pressure should be monitored closely and the physician consulted before resuming therapy, as dose adjustment may be necessary.

Overdose

Nifedipine overdose may cause severe hypotension, bradycardia or tachycardia, metabolic acidosis, and hyperglycemia. In massive overdose, cardiac conduction abnormalities, cardiogenic shock, and pulmonary edema may occur. Management includes cardiovascular monitoring, elevation of lower extremities, and intravenous fluids for hypotension. Calcium gluconate (10%) 10-20 mL IV may reverse hypotension and myocardial depression. Vasopressors such as dopamine or norepinephrine may be required for refractory hypotension. Activated charcoal may be beneficial if administered within 1-2 hours of ingestion. Hemodialysis is not effective due to high protein binding.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container, protected from light and moisture. Keep tightly closed and away from excessive heat or humidity. Do not store in bathroom cabinets where moisture levels fluctuate. Keep out of reach of children and pets. Do not use if tablets appear discolored, damaged, or beyond the expiration date printed on the packaging. Proper disposal of unused medication through take-back programs is recommended to prevent accidental ingestion or environmental contamination.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Adalat is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary, and treatment decisions should be based on professional medical judgment considering the patient’s complete medical history, current medications, and specific health circumstances. Never adjust dosage or discontinue medication without consulting your physician. The manufacturer’s prescribing information contains the most complete and updated safety information.

Reviews

Clinical studies demonstrate Adalat’s efficacy in reducing systolic and diastolic blood pressure by 10-15 mmHg and 8-10 mmHg respectively at standard doses. In angina patients, it increases exercise tolerance and reduces nitroglycerin consumption. Long-term outcome studies show reduced cardiovascular events in hypertensive patients. Patient satisfaction surveys indicate good tolerability, though peripheral edema remains a common reason for discontinuation. Real-world evidence supports its effectiveness in diverse populations, including elderly patients and those with comorbidities. Overall, Adalat maintains a favorable benefit-risk profile in appropriate patient populations when prescribed according to guidelines.