# Nifedipine in Nigeria

Nifedipine has 8 active NAFDAC registrations in our October 2026 copy of the register, from 7 registration holders; 12 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/nifedipine/
- Drug class: Dihydropyridine calcium channel blocker (Hypertension)
- Also known as: Adalat, Procardia, Nifedipress
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: February 2026

## Price in Nigeria

As of October 2026, the only nifedipine our sampled online pharmacies (HealthPlus and MedPlus) list is Nifecard, at about ₦11,635. That is Nifecard's price, not the molecule's: 8 nifedipine brands are NAFDAC-registered and generic versions usually cost less, so ask a licensed pharmacy for a generic by name and check its NAFDAC number before you pay.

## What is Nifedipine?

Nifedipine is a calcium channel blocker and one of the most widely used blood pressure medications in Nigeria. It belongs to the dihydropyridine class, the same family as amlodipine, and works by blocking the influx of calcium ions through L-type calcium channels in the smooth muscle cells of blood vessel walls. Calcium is needed for muscle contraction — by blocking its entry, nifedipine causes the blood vessel walls to relax and widen (vasodilate), which lowers blood pressure and improves blood flow. Nifedipine primarily acts on blood vessels rather than the heart, making it an effective and well-tolerated antihypertensive in most patients.

Nifedipine holds a special place in Nigerian clinical practice for two important reasons. First, it is one of the oldest and most trusted calcium channel blockers available, and many experienced Nigerian doctors have decades of familiarity with it. Second, nifedipine is one of the few blood pressure medications considered safe in pregnancy — it is widely used in Nigerian obstetric units for managing hypertension in pregnancy and pre-eclampsia, conditions that are major causes of maternal death in the country. The modified-release (MR or Retard) formulations of nifedipine are preferred for chronic blood pressure management as they provide smooth, sustained blood pressure control over 12 to 24 hours.

In Nigeria, nifedipine is available under several brand names, most notably Adalat (Bayer), which is the original and most recognised brand. Adalat Retard (20mg modified-release) and Adalat LA (30mg or 60mg once-daily formulation) are commonly prescribed. Imported generics are also widely available. A critical point of clinical importance: the immediate-release (short-acting) capsule formulation of nifedipine should NOT be used for routine blood pressure management because it causes rapid, unpredictable drops in blood pressure that can be dangerous. This practice of biting into or puncturing a short-acting nifedipine capsule and swallowing or sublingual use for hypertensive emergencies is outdated and discouraged by current guidelines. Only modified-release formulations should be used for ongoing hypertension treatment.

## What is Nifedipine used for?

- Hypertension (high blood pressure) — modified-release nifedipine is a first-line antihypertensive option, particularly effective in Black patients and elderly patients
- Hypertension in pregnancy and pre-eclampsia — nifedipine is one of the few antihypertensives considered safe for use in pregnancy and is widely used in Nigerian maternity units
- Angina pectoris (chest pain from coronary heart disease) — nifedipine reduces the heart's oxygen demand and improves blood flow through coronary arteries
- Raynaud's phenomenon — nifedipine improves blood flow to the fingers and toes in this condition that causes painful constriction of small blood vessels
- Preterm labour (tocolysis) — nifedipine relaxes uterine smooth muscle and is used to delay premature delivery, giving time for corticosteroids to mature the baby's lungs
- Hypertensive emergencies — under medical supervision only, using oral administration (not sublingual)

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: For hypertension using modified-release formulations: start with 20mg to 30mg once or twice daily, adjusted according to blood pressure response. Maximum dose is typically 90mg per day. For Adalat Retard: 20mg twice daily. For Adalat LA or equivalent once-daily formulations: 30mg once daily, increased to 60mg or 90mg once daily if needed. Modified-release tablets must be swallowed whole — do NOT crush, chew, or break them as this destroys the controlled-release mechanism and can cause a dangerous rapid drop in blood pressure. For angina: similar dosing to hypertension. Take at the same time each day, with or without food.
- Children: Nifedipine is occasionally used in children for hypertension, but paediatric use should be under specialist supervision. Typical dose range is 0.25 to 0.5mg per kilogram per dose, given two to three times daily (immediate-release) or once to twice daily (modified-release). Maximum 3mg per kilogram per day or 120mg per day (whichever is lower). Paediatric dosing must be determined by a paediatrician or paediatric cardiologist.
- Elderly: Elderly patients often respond well to nifedipine as calcium channel blockers are particularly effective in this age group. However, start with a lower dose (20mg modified-release once daily) and increase gradually, as elderly patients may be more susceptible to the blood pressure-lowering effect and to side effects like dizziness and ankle swelling. Monitor blood pressure carefully during dose adjustment.

Always take modified-release nifedipine tablets whole — never crush, chew, or break them. Taking the drug at the same time each day ensures consistent blood pressure control. Nifedipine can cause ankle swelling (peripheral oedema), which is not a sign of heart failure but rather a local effect of blood vessel dilation. Grapefruit juice significantly increases nifedipine blood levels — avoid grapefruit while taking this medication. Do NOT stop nifedipine suddenly, especially if you have angina, as this can cause rebound chest pain. Your doctor will taper the dose gradually if discontinuation is necessary.

## Side effects

Common: Ankle and leg swelling (peripheral oedema) — the most common side effect, occurring in up to 30% of patients; caused by dilation of blood vessels, not heart failure; Headache — particularly common in the first few days of treatment or after dose increases; Flushing and feeling of warmth — caused by blood vessel dilation; Dizziness and lightheadedness; Palpitations (awareness of heartbeat) — usually mild and transient; Constipation — more common with higher doses.

Serious (seek medical help immediately): Severe hypotension (very low blood pressure) — causing fainting, collapse, or falls; particularly dangerous in elderly patients and when short-acting formulations are used; Reflex tachycardia — a rapid increase in heart rate as the body compensates for the drop in blood pressure; more common with short-acting nifedipine; Worsening angina or myocardial infarction — paradoxically, short-acting nifedipine can worsen heart outcomes; this is why only modified-release forms should be used; Severe allergic reaction — rare; seek emergency care for facial swelling, difficulty breathing, or widespread rash; Gingival hyperplasia (gum overgrowth) — rare, occurs with long-term use; good oral hygiene helps prevent this.

When to see a doctor: See your doctor if ankle swelling becomes bothersome or significantly limits your mobility — the dose may need adjustment or a different calcium channel blocker (like amlodipine at a different dose or an ACE inhibitor) may be substituted. Seek emergency medical attention if you experience severe dizziness or fainting, chest pain, very fast heartbeat, difficulty breathing, or significant swelling of the face, lips, or tongue. If you are pregnant and experience severe headache, visual disturbances, or upper abdominal pain while taking nifedipine, seek urgent obstetric care immediately as these may be signs of worsening pre-eclampsia.

## Warnings

Do not take if: Known allergy to nifedipine or other dihydropyridine calcium channel blockers; Cardiogenic shock — a severe condition where the heart cannot pump enough blood; Advanced aortic stenosis (severe narrowing of the aortic valve) — nifedipine can cause a dangerous drop in blood pressure in these patients; Unstable angina — short-acting nifedipine is absolutely contraindicated; modified-release may be used with caution under specialist guidance; Within 1 month of a heart attack — nifedipine should be avoided in the immediate post-myocardial infarction period; Concurrent use with rifampicin — rifampicin dramatically reduces nifedipine levels, rendering it ineffective.

Interactions: Grapefruit juice — significantly increases nifedipine levels by inhibiting its metabolism, potentially causing excessive blood pressure reduction and side effects; avoid grapefruit entirely; Rifampicin — reduces nifedipine levels so significantly that the drug becomes ineffective; alternative antihypertensives are needed for patients on TB treatment. This is highly relevant in Nigeria where TB-hypertension co-morbidity is common; Beta-blockers (atenolol, propranolol) — combining with nifedipine can cause excessive blood pressure reduction and, rarely, heart failure; use with caution under medical supervision; Digoxin — nifedipine can increase digoxin levels, risking toxicity; Phenytoin and carbamazepine — can reduce nifedipine levels by accelerating its breakdown; Cimetidine — increases nifedipine levels; monitor blood pressure if used together; Magnesium sulfate — in obstetric use, combining nifedipine with magnesium sulfate (used for eclampsia) can cause profound hypotension and neuromuscular blockade; requires very careful monitoring.

Pregnancy & breastfeeding: Nifedipine is considered one of the safest antihypertensive medications for use during pregnancy and is widely used in Nigerian obstetric practice. It is used to treat chronic hypertension in pregnancy, gestational hypertension, and pre-eclampsia. It is also used as a tocolytic agent to delay preterm labour, allowing time for corticosteroids to be administered to mature the baby's lungs. However, nifedipine should be used in pregnancy under medical supervision with regular blood pressure monitoring. The immediate-release capsule should NOT be used in pregnancy due to the risk of sudden, unpredictable drops in blood pressure. Nifedipine passes into breast milk in small amounts but is generally considered compatible with breastfeeding. The amount excreted is very small, and adverse effects in breastfed infants have not been reported at standard therapeutic doses.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Adalat (Bayer, made in Germany); Adalat Retard (Bayer, made in Germany); Nifedipress (Micro Labs, made in India); Nifecard (Sandoz/Novartis, made in Switzerland).
Full searchable brand list: https://ogbogwu.com/drugs/nifedipine/brands/

## How to verify it is genuine

1. Check for a valid NAFDAC registration number on the packaging — all nifedipine products sold in Nigeria must have this
2. Verify the NAFDAC number using the NAFDAC Green Book portal (greenbook.nafdac.gov.ng) or the NAFDAC mobile verification app
3. For Adalat (Bayer) products, check for the distinctive Bayer cross logo, consistent packaging colour scheme, and the specific tablet marking for each strength
4. Purchase from licensed pharmacies only — nifedipine is a prescription medication for a serious condition, and quality assurance is critical
5. Modified-release tablets should have a uniform, smooth coating. Reject any tablets that appear cracked, chipped, or damaged, as this may compromise the controlled-release mechanism
6. Check the expiry date and storage conditions — nifedipine is light-sensitive and should be stored in the original packaging away from direct sunlight. Products exposed to excessive heat or light may have reduced potency

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### What is the difference between nifedipine and amlodipine?

Both nifedipine and amlodipine are dihydropyridine calcium channel blockers that lower blood pressure by the same mechanism — relaxing blood vessel walls. The key differences are in their duration of action and side effect profiles. Amlodipine has a very long half-life (30 to 50 hours) and is taken once daily, providing extremely smooth blood pressure control. Nifedipine has a shorter half-life and requires modified-release formulations for once or twice daily dosing. Both cause ankle swelling, but amlodipine may cause less due to its gentler onset of action. Amlodipine has become the more commonly prescribed of the two in general practice due to its convenient once-daily dosing. However, nifedipine retains important advantages: it has a stronger evidence base in pregnancy, it is more commonly used as a tocolytic for preterm labour, and some patients who do not respond to or tolerate amlodipine may do better on nifedipine. In Nigeria, both are widely available and affordable.

### Can I take nifedipine during pregnancy?

Yes, nifedipine is one of the most commonly used and safest blood pressure medications during pregnancy. It is widely used in Nigerian obstetric practice for managing chronic hypertension in pregnancy, gestational hypertension, and pre-eclampsia. Unlike ACE inhibitors (lisinopril) and ARBs (losartan), which are absolutely contraindicated in pregnancy and can cause serious birth defects, nifedipine has an established safety record in pregnant women. It is also used to delay preterm labour (tocolysis). However, only the modified-release formulation should be used — not the short-acting capsule. Nifedipine use in pregnancy should always be under medical supervision with regular blood pressure monitoring. The alternative first-line antihypertensive for pregnancy is methyldopa, which has the longest safety track record but is less effective and has more side effects.

### Why should I not bite or chew nifedipine capsules?

Short-acting nifedipine capsules (the soft gel type) release the entire dose rapidly when bitten or punctured, causing an uncontrolled, rapid drop in blood pressure. This practice — once common in Nigerian hospitals and clinics for treating hypertensive emergencies — has been shown to be dangerous. The sudden blood pressure drop can trigger reflex tachycardia (rapid heart rate), which increases the heart's oxygen demand and can cause a heart attack or stroke, particularly in patients with underlying coronary artery disease. Several cases of fatal heart attacks and strokes have been linked to sublingual nifedipine worldwide. Current guidelines strongly discourage this practice. For hypertensive emergencies, safer alternatives exist. For routine blood pressure management, only modified-release nifedipine tablets should be used — these are designed with a special coating that releases the drug slowly and cannot be crushed, chewed, or broken.

### Can nifedipine be taken with other blood pressure drugs?

Yes, nifedipine is commonly combined with other antihypertensive medications to achieve better blood pressure control. In Nigerian clinical practice, common effective combinations include nifedipine with an ACE inhibitor (lisinopril) or ARB (losartan) — this is a well-established and complementary combination. Nifedipine can also be combined with a thiazide diuretic (hydrochlorothiazide) for additional blood pressure reduction. However, combining nifedipine with a beta-blocker (atenolol, propranolol) requires caution, as both drugs can slow heart conduction and the combination may cause excessive blood pressure lowering. Do NOT combine nifedipine with another dihydropyridine calcium channel blocker like amlodipine — these drugs work the same way and doubling up increases side effects without proportional benefit. Always follow your doctor's instructions regarding drug combinations, and report any dizziness or lightheadedness that may indicate excessive blood pressure lowering.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)