Nifedipine is mainly used for the treatment of angina pectoris and high blood pressure. It is widely used in clinical practice. Therefore, it is necessary to pay special attention to compatibility with drugs and foods in order to avoid affecting the therapeutic effect or causing harm to the body.
I. Avoid combination with the following drugs
1. amiodarone: combined can further inhibit sinus rhythm or increase atrioventricular block; inhibition of CYP3A4, increase the plasma concentration of nifedipine, aggravate the adverse reactions of nifedipine.
2. Oral contraceptives, cimetidine, cisapride, erythromycin, clarithromycin, itraconazole, fluconazole, diltiazem, cyclosporine, ravine, saquinavi, ritonavir, quinupristin / dalfopristin: inhibition of CYP3A4, increased nifedipine plasma concentration, aggravate adverse reactions of nifedipine.
3. β-adrenoceptor blocking drugs: can effectively treat angina or hypertension, but may lead to severe hypotension or bradycardia.
4. fentanyl: In the use of fentanyl anesthesia, combined with calcium channel blockers and beta-adrenergic receptor blockers can cause severe hypotension.
5. Magnesium: When magnesium is used for the treatment of premature delivery, combined with nifedipine can cause significant hypotension and neuromuscular block.
6. Buflomedil: It can increase the hypotensive effect of buflomedil, and should monitor the blood pressure and heart rate and adjust the dose accordingly.
7. digoxin: can inhibit the removal of digoxin kidney or extra-renal clearance, can cause increased digoxin plasma concentration, increased toxicity. Digoxin toxicity should be monitored and the dosage adjusted accordingly.
8. Metformin: The plasma concentration of metformin may be increased moderately. Combined use may increase the risk of hypoglycemia. Blood glucose should be closely monitored.
9. Tacrolimus: It can competitively inhibit the metabolism of tacrolimus and increase the toxicity of tacrolimus, such as nephrotoxicity, hyperglycemia, and hyperkalemia.
10. Theophylline: The plasma concentration of theophylline can be changed and the plasma concentration of theophylline should be monitored.
11. Non-steroidal anti-inflammatory drugs or oral anti-coagulation drugs: It may increase gastrointestinal bleeding.
12. quinidine: can reduce the efficacy of quinidine, but also to increase the adverse reactions of nifedipine.
13. rifampicin: rifampicin can induce nifedipine metabolism, reduce the antihypertensive effect of nifedipine.
14. Famotidine: Famotidine has no significant effect on the pharmacokinetics of nifedipine, but it can attenuate the inotropic effect of nifedipine by reducing cardiac output and stroke volume.
15. Ephedra: Ephedrine contains ephedrine and pseudoephedrine, which can reduce the efficacy of antihypertensive drugs.
II. Avoid use with the following foods
Grapefruit juice: Flavone analogues in grapefruit juice inhibit the CYP enzyme system and increase the plasma concentration of nifedipine. Combination can lead to severe hypotension, myocardial ischemia or aggravate adverse reactions caused by vasodilation.