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Publication Type: Safety Notice
Single or Multiple Incident: Multiple
Date: 1/18/2021 12:00:00 AM
Country: Australia
This Safety Notice discusses the patient safety incidents which may occur with administration of different formulations of nifedipine. Nifedipine is a dihydropyridine calcium channel blocker most commonly used to treat hypertension and angina. It is also used off-label as a tocolytic in pre-term labour. Oral formulations can be given once, twice or three times daily depending on their duration of action. In NSW, the nifedipine immediate release tablet (medium acting) is the preferred first line agent for tocolysis and is also commonly used for acute hypertension in pregnancy. Nifedipine modified release tablet (long acting), is recommended for treatment of preeclampsia, gestational or chronic hypertension in pregnancy. Internationally, these formulations have varying naming conventions which increases the risk of inadvertent administration of the wrong formulation. For example, products referred to as ‘modified/controlled/slow release’ tablets in Australia are long acting and administered once daily, while internationally this may refer to tablets which are medium acting. Immediate release capsules (short acting) are absorbed more rapidly than tablets and can put patients at increased risk of sudden reductions in blood pressure. Nifedipine medium acting tablets are preferred to short acting capsules. The alert provides a table listing products according to their duration of action and availability.

Additional Details

Medication/Gas/Fluid:
nifedipine modified release tablets (Adalat Oros®, Addos XR®, Adifin XL®, APO®) nifedipine immediate release tablets (Nifelat®) nifedipine immediate release capsules (AL®, Adalate®) calcium channel blockers

Rules / Policies / Procedures
  1. Nifedipine medium acting tablets are preferred to short acting capsules.
  2. Modified release tablets should not be crushed, broken or chewed.

Discontinuation of nifedipine immediate release products (update)