Nisoldipine (Oral)

Nisoldipine is a calcium channel blocker that is used in the treatment of high blood pressure.

Overview

In the US, nisoldipine is sold under the brand name, Sular. It is a prescription only drug that comes in the form of extended-release tablets.

Nisoldipine can be used on its own or in combination with certain other drugs as a treatment for patients who suffer from high blood pressure (hypertension).

High blood pressure can cause serious health complications if it is allowed to continue for a long period of time without appropriate treatment. Hypertension causes increased pressure on the arteries and the heart. The blood vessels, heart, kidneys, and brain may all be damaged, increasing the risk of disease and heart attacks. If high blood pressure is properly controlled, the patient's risk of developing these conditions is much reduced.

Nisoldipine is one of a group of medicines called calcium channel blockers. It works by disrupting the transfer of calcium into the cells of the blood vessels and heart. The result is a relaxation of the blood vessels and an increase in the oxygen and blood supply to the patient's heart, reducing its workload.

Conditions treated

  • High blood pressure (hypertension)

Type of medicine

  • Calcium channel blocker
  • Extended-release tablets

Side effects

Nisoldipine is very effective in treating high blood pressure, but it can sometimes cause unwanted side effects. You may not experience any of these effects, but if you do, you may need to seek medical advice.

Tell your GP right away if you notice any of the following side effects after you begin using nisoldipine.

  • Unusual weight gain or loss
  • Tingling of hands or feet
  • Swelling of the arms, legs, face, lips, throat, or tongue
  • Sweating
  • Shortness of breath
  • Rash
  • Rapid weight gain
  • Headaches
  • Reddening or flushing of skin, especially on neck and face
  • Feelings of body warmth or heat
  • Rapid, pounding, irregular, or racing pulse or heartbeat
  • Feeling dizzy, faint, or lightheaded
  • Chest tightness
  • Chest pain
  • Swelling or bloating of the arms, face, hands, feet, or lower legs

There are some effects that can be caused by nisoldipine that do not generally require any further medical intervention. These effects usually go away by themselves as your body gets used to the new medicine. In addition, your GP may be able to suggest ways in which you can prevent or manage the effects. If any of the side effects listed below persist or become particularly annoying, check with your GP:

  • Voice changes
  • Trouble swallowing
  • Swollen, tender glands in neck
  • Stuffy nose
  • Runny nose
  • Pain or tenderness around cheekbones and eyes
  • Hoarseness
  • Heartbeat sensations
  • Fever
  • Dryness or soreness of throat
  • Cough
  • Congestion
  • Body aches or pains

There may be other effects that have been reported by patients that are not listed in this guide. If you notice anything else odd while you are taking nisoldipine, check with your GP.

Dosage

Your GP may recommend that you change your diet and implement weight control measures, as well as using nisoldipine to treat your high blood pressure. In particular, you may be told to reduce the amount of sodium (salt) in your diet. Do not radically change your diet without asking your doctor for advice first.

Many people who suffer from high blood pressure will not even realize that they have a health problem, and the majority actually feel completely normal. For this reason, it is therefore very important that you continue to take this medicine exactly as you have been told to, even if you feel fine.

Patients should be aware that nisoldipine will not provide a cure for your high blood pressure, although it will help to control it. If you want to keep your reduce your blood pressure and keep it down, you must take this medicine regularly and for the rest of your life. Remember that failing to treat your high blood pressure could result in serious health conditions later in life, including stroke, heart attack, heart disease, and kidney problems.

Continue to take this medication exactly as you have been told to, even if you feel well. Do not take a higher dose or take it more frequently than you have been instructed to. Nisoldipine works most effectively if the levels of the drug are constant in your blood stream. In order to achieve this, take your dose of nisoldipine at the same every day and do not miss out any doses.

Do not chew, crush or break the extended-release tablets; swallow them whole. Patients are advised that they should take this medication on an empty stomach to avoid certain gastric side effects.

The dose of nisoldipine that you are prescribed will not necessarily be the same for every patient. You should stick to your GP's dosage instructions or those that are printed on the dispensary product label. The information contained in this guide is based on the recommended average for this drug. If your dosage instructions are different, do not alter the dose unless you are expressly instructed to by your GP.

The size of the dose you take will depend on how strong the medication is. In addition, the frequency of use, the number of daily doses that you take, and the total duration of your course of treatment with nisoldipine will depend on the medical condition for which you are being treated.

To treat hypertension extended-release tablets:

  • Adults: Take 10 mg to 20 mg once daily. Your GP may decide to adjust this dose if required.
  • Children: The use and dose rate of this medicine will be determined by your child's GP.

If you forget to take your scheduled dose of nisoldipine, you must take it as soon as you can. If it is almost time for your next dose, leave that one out and revert to your usual schedule. Do not take twice the prescribed dose.

Interactions

Drug interactions

There are some drugs that should never be used at the same time, as this could cause interactions to take place. In other cases, it may be appropriate to use two or more medicines albeit at an adjusted dose or frequency rate as instructed by your GP.

You must tell your GP if you are taking any of the medicines that are mentioned in this section of the guide. Your GP may still decide to use nisoldipine, but may do so at an adjusted dose rate or may change the dose of one of your other drugs.

It is not recommended that you use nisoldipine with any of the following medications, but this may be necessary under some circumstances. If you are prescribed both drugs together, your GP may adjust the dose or frequency of use of one or both of them:

  • Primidone
  • Mibefradil
  • Lacosamide
  • Ketoconazole
  • Itraconazole
  • Idelalisib
  • Fluconazole
  • Digoxin
  • Dantrolene
  • Conivaptan
  • Cobicistat
  • Clopidogrel
  • Clarithromycin
  • Ceritinib
  • Amiodarone

It is not recommended that you use nisoldipine with any of the following drugs, as this could increase the risk of certain side effects. However, this may be necessary in your case. If you are prescribed both drugs together, your GP may adjust the dose or frequency of use of one or both of them:

  • Cimetidine
  • Rifampin
  • Quinupristin
  • Quinidine
  • Phenytoin
  • Indinavir
  • Fosphenytoin
  • Dalfopristin

Other interactions

Some drugs must not be used with particular foodstuffs, or when consuming alcohol or using tobacco. All these incidences can trigger an interaction between them and the medicine you are taking. The interactions mentioned in this guide are based on their possible significance in relation to nisoldipine and the list is not exhaustive.

Using nisoldipine with any of the following could cause a higher risk of some side effects, but this could be unavoidable in some circumstances. If you use nisoldipine with these substances, your GP may suggest changing the dose you take or the frequency with which you use the medication. Alternatively, your GP may give you specific instructions about using alcohol, tobacco or particular foodstuffs.

You must not drink grapefruit juice or eat grapefruit while you are using nisoldipine, as this could increase the effects of the medication.

Some pre-existing medical conditions can affect how nisoldipine works on the body. Be sure to tell your GP about any other health problems you have, especially those that are mentioned in this guide.

Nisoldipine should be used with caution in patients who have any of the following conditions, as its use could present a heightened risk of serious side effects:

  • Low blood pressure
  • Coronary artery disease
  • Congestive heart failure

Nisoldipine should be used with caution in patients who have a history of liver disease, as its effects could be exacerbated due to the slower removal of the drug from the patient's body.

Warnings

When deciding to use any medicine, you should consider the risks versus the benefits of doing so. This is a decision that you should arrive at following full discussions with your GP. In the case of nisoldipine, you should consider the following points.

You must tell your GP if you have ever had an allergic reaction to nisoldipine or to any other medication. Also tell your treating physician if you have a known allergy to any particular food groups, food dyes, preservatives, or animal by-products. It is a good idea to read the product label to ensure that you are not allergic to any of the constituents.

It has not been established through research that nisoldipine presents any notable risk to pediatric patients. However, if you are concerned about using this drug to treat your child, you should discuss its use with your GP before you start giving the drug to your child.

It has not been established through research that nisoldipine presents any notable risk to geriatric patients. However, old people are deemed more prone to age-related liver, heart, or kidney problems that may necessitate adjustment in the dose of nisoldipine. If you have concerns in this regard, check with your GP.

Pregnant women should exercise caution when using nisoldipine as this drug does present a very small risk to the unborn baby. You should discuss the use of this medicine while you are pregnant with your GP.

There is no evidence to show that nisoldipine can be passed to a nursing infant through its mother's breast milk. However, you may wish to err on the side of caution if you are breastfeeding and choose an alternative feeding solution for your child while you are using this medicine. Your GP or midwife will be able to offer you more advice in this regard.

You must attend your GP on a regular basis for check-ups while you are using nisoldipine. These visits are important to allow your doctor to make sure that the drug is working as anticipated and to discuss any side effects that it may be causing.

Your doctor will also want to check your blood regularly while you are using nisoldipine. You may also be asked to monitor your blood pressure yourself at home. If you notice any fluctuations or alterations in your recommended blood pressure, check with your GP right away.

Some patients may experience low blood pressure (hypotension) while they are using nisoldipine. If you experience any of the signs noted below,, check with your doctor right away:

  • Blurred vision
  • Dizziness
  • Confusion
  • Feeling dizzy, faint, or lightheaded when rising suddenly from a prone or seated position
  • Sweating profusely
  • Feeling unusually weak or tired

Nisoldipine can cause dizziness, fainting, or lightheadedness in some people. If you are affected in this way, do not drive, operate machinery, or undertake any other activity that could be risky.

You should not take nisoldipine with a meal that is very high in fat or when eating grapefruit or grapefruit products, as this may cause the levels of this drug to increase in your body.

Storage

You should keep your prescription of nisoldipine in a sealed container at room temperature, away from sources of heat, direct sunlight, and moisture. Do not allow the drug to freeze.

Be sure to keep your prescription medication well out of the reach of pets and children. If a pet does eat any of your nisoldipine tablets or capsules, contact your emergency vet right away.

Do not retain any nisoldipine that has become out of date or that you no longer require. Do not throw your unused medicines out with your trash where it could be found by children or pets.

Ask your pharmacist or GP for instructions on how best to dispose of any unwanted medicines.

Summary

Nisoldipine is a calcium channel blocker. It can be used alone or with other drugs to control high blood pressure (hypertension).

Although the drug is very effective in controlling the blood pressure, it will not provide a cure for your condition and you may have to take it for the rest of your life.

Throughout the course of your treatment with nisoldipine, you will need to have regular blood tests and blood pressure checks to make sure that the drug is working as desired and is not causing any unwanted side effects.