Adult: 20 mg daily as a single dose or in 2 divided doses; may be increased to 20 mg bid as necessary to control resistant hypertension.
Elderly: Initially, 10 mg daily.
Hepatic impairment: Initially, 5-10 mg once daily.

Special Populations: Patients with hepatic impairment: Initially, 10 mg daily.
Unstable angina pectoris, actue MI (<4 wk). Pregnancy and lactation.
Warnings / Precautions
Elderly, hepatic impairment.
Adverse Reactions
Hypotension, flushing, oedema, dizziness, palpitation, fatigue, headache, nausea, bloating, diarrhoea, paraesthesias, tachycardia, asthenia, drowsiness, angina, MI, irritability, respiratory disorders, hypersensitivity reactions, increased urine output, elevated LFTs, myalgia, tremor, blood count changes, gingival hyperplasia.
Overdose Reactions
Symptoms: Flushing, headache, BP reduction with circulatory collapse, changes in heart rate (tachycardia, bradycardia). Management: Initially, gastric lavage with subsequent activated charcoal. Dopamine or noradrenaline may be used for excessive hypotension. Atropine or orciprenaline may be used for bradycardia.
Drug Interactions
Effects may be enhanced by other antihypertensives. Increased sodium excretion with diuretics at the start of treatment. May prolong effects of pancuronium, vecuronium. May increase digoxin levels. Reduced levels/effects with rifampicin, phenytoin, carbamazepine or phenobarbitone. Levels/effects may be increased with cimetidine, valproic acid, erythromycin, troleandomycin, clarithromycin, roxithromycin, ketoconazole, itraconazole, fluconazole, nefazodone, protease inhibitors, quinupristin or dalfopristin.
See Below for More nitrendipine Drug Interactions
Lab Interactions
Increases plasma catecholamine, urinary aldosterone levels and alkaline phosphatase levels.
Food Interactions
Concentration may be increased with grapefruit juice.
Mechanism of Actions
Nitrendipine relaxes coronary vascular smooth muscles by inhibiting calcium ions from entering the slow channels or select voltage-sensitive areas of vascular smooth muscles and myocardium during depolarisation. It also increases myocardial oxygen delivery in patients with vasospastic angina.
Absorption: Well absorbed from the GI tract (oral).
Distribution: Protein-binding: 98%.
Metabolism: Extensive first-pass effect.
Excretion: Via urine (as metabolites), via faeces (remaining dose); 10-22 hr (elimination half-life).
Should be taken with food. (Take after meals.)
Storage Conditions
Oral: Protect from light.
ATC Classification
C08CA08 - nitrendipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
Oral: Protect from light.
Available As
  • Nitrendipine 10 mg
  • Nitrendipine 20 mg
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