Nisoldipine
SULAR
What it isVascular L-type calcium-channel blocker; hypertension.
Why this oneIts pronounced food effect makes administration less forgiving than amlodipine and helps explain its marginal role.
What limits itPeripheral edema and reflex tachycardia limit use; grapefruit can further raise exposure.
FDA-approved for
- hypertension (1995)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 17 mg QD | 17-34 mg QD | 34 mg QD |
| Hypertension | Age >65 or hepatic impairment | ≤8.5 mg QD | titrate to BP | 34 mg QD |
Titration ≥1 week between dose increases (increase by 8.5 mg)
Renal Undefined
Hepatic Impaired hepatic function: start ≤8.5 mg QD; monitor BP closely during titration
Instructions
- Take on an empty stomach (1 h before or 2 h after a meal)
- Swallow whole; do not bite, divide, or crush
- Avoid grapefruit products before and after dosing
Cautions
- Symptomatic hypotension, especially in elderly or hepatic impairment — monitor BP
- Dose-related peripheral edema
Adverse reactions
- Peripheral edema
- Headache
- Dizziness
- Pharyngitis
- Vasodilation
- Palpitation
Pregnancy Category C; fetotoxic (not teratogenic) in animals at maternally toxic doses; use only if benefit justifies fetal risk
Lactation Undefined
NO BOXED WARNINGS
Principal riskPeripheral edema; food raises exposure
Cost, est. cash$10–$300/month
Generic entry2008
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHypotension and edema therapeutically; overdose can cause prolonged vasodilatory or cardiogenic shock.
Mechanism of action: Nisoldipine ballicule
