Nifedipine during pregnancy will lower the pressure and tone of the uterus. Nifedipine: nuances of using “heart” pills to maintain pregnancy Dosage and duration of use

Pregnancy is a wonderful time of waiting for your baby. The main task of the expectant mother at this time is to give birth to her baby strong and healthy, to carry her to term, protecting her from harmful influences.

Unfortunately, despite all the precautions, sometimes there are cases of mandatory use of medications. Such drugs include Nifedipine, a medical drug that is widely used in international medicine.

Indications for use of Nifedipine

Nifedipine belongs to antihypertensive drugs, that is, drugs aimed at lowering blood pressure.

The main indications for its use are:

• cardiac ischemia,
• angina symptoms,
• hypertension of various types,
• increased uterine tone in expectant mothers.

The medicine is also used for blockage of blood vessels and blood stagnation.

Coronary heart disease is a disease characterized by impaired blood supply due to damage to the heart's coronary arteries.

Angina pectoris is a clinical form of ischemic disease in which the supply of blood to the myocardium is catastrophically low.

Hypertension is a disease whose main characteristic is increased blood pressure. Hypertension can be arterial, venous, pulmonary, intra-abdominal, intracranial, portal, biliary and other systems. Arterial and renal hypertension are extremely dangerous not only for a pregnant woman, but also for her unborn baby. Nifedipine will help stabilize high blood pressure in the expectant mother better than other medications and normalize her condition.

Why is Nifedipine prescribed during pregnancy?

Uterine tone during pregnancy means preparing the woman’s body for childbirth. Yes, of course, this is a very positive moment, but only in the 9th month of pregnancy, when the baby is ready to be born. If uterine tone is observed throughout the entire period of bearing a child, and not at the end of pregnancy, this is very dangerous and threatens the life of the fetus and the health of the expectant mother. In this case, it is necessary to maintain the normal condition of the uterus with medications.

Recently, in medical practice, doctors very often began to prescribe Nifedipine during pregnancy for uterine tone. It is usually taken in combination with other medications. Nifedipine is considered to be the medication that best helps the uterus get rid of tone and maintain pregnancy.

How to take Nifedipine during pregnancy: detailed instructions and dosage

The main active ingredient of this drug is Nifedipine, in a medicinal dose of 10 mg.

It also contains some excipients, for example:

• lactose,
• cellulose,
• starch,
• gelatin,
• magnesium and others.

Taking any medication during pregnancy requires prior consultation with your gynecologist. The optimal dosage of the drug, at which the benefit to the mother will outweigh the risk to the fetus, is 10 mg, that is, one tablet 4 times a day. If such a need arises, the dose is doubled. The maximum daily dose during pregnancy is 60 mg, that is, 6 tablets for 24 hours, 10 mg each.

During pregnancy, Nifedipine tablets should be taken orally before meals with plenty of liquid. The course of treatment is prescribed by the doctor individually, depending on the physical characteristics of the pregnant woman. The tablet should be swallowed whole and not crushed or diluted in liquid.

When indicated for pregnant women, long-acting Nifedipine is used. It differs from a fast-acting drug in that the drugs begin to act within twenty-four hours, and not instantly, thereby reducing the tone of the uterus for a long time.

A very important point is the simultaneous use of calcium supplements. When calcium interacts with Nifedipine, the effect of the latter is weakened and adverse reactions occur.

In any case, before taking the pills, you should consult a gynecologist, because the methods of use and doses are prescribed individually to each pregnant woman, taking into account her capabilities and weight. The expectant mother must remember that incorrect dosing and use of any medications leads to disruption of the normal functioning of the fetus and the health of the pregnant woman.

Effect of Nifedipine during pregnancy

Any medication during pregnancy cannot be safe for both mother and child. Unfortunately, comprehensive studies of the effect of the drug during pregnancy have not been conducted, so there is no official statement that Nifedipine during pregnancy has any negative effect on the fetus.

Some experts take the liberty of asserting that the drug has embryotoxic and teratogenic effects on the fetus. Therefore, before taking pills, you should consult your doctor to determine whether the benefits will outweigh the harm from taking the drug.

If a doctor has prescribed such a potent medication to a pregnant woman, it must be taken strictly under medical supervision, because no one, not even the best qualified doctor, can predict the body’s reaction and how the drug affects it.

The expectant mother must remember that all her actions during pregnancy will, one way or another, affect the baby. While carrying a child, you need to think through every step carefully for the safety of your child.

How to cancel Nifedipine during pregnancy

If the patient experiences adverse reactions while taking Nifedipine or due to health reasons, taking the tablets becomes impossible, the drug should be discontinued and excluded from the course of treatment. Under no circumstances should you stop taking it abruptly, because the human body quickly gets used to this type of drug and addiction occurs.

Nifedipine should be eliminated gradually. If the patient took an average dose of 40 mg, that is, 4 tablets per day, 10 mg each, then on the first day of drug withdrawal the intake should be halved. The next day you should take one tablet, and on the third day you should stop taking it altogether.

In this case, the patient causes minimal harm to his body, and in the case of pregnancy, not only to himself, but also to the fetus.

Contraindications for taking Nifedipine

Every medical medicine has some contraindications for its use. If these contraindications are not taken into account or, despite them, the drug is taken, then the consequences can be unpredictable. There is the possibility of all sorts of side effects, which will then be difficult to eliminate.

There are several contraindications to taking the drug:

• patient age under 12 years;
• the drug must be excluded from the course of treatment in case of hypersensitivity to the active substance Nifedipine or the excipients contained in it;
• previous myocardial infarction
• angina pectoris, characterized by instability;
• aortic stenosis;
• It is contraindicated to use medications for people with hypovolemia, high-grade aortic stenosis, as well as when taking any drugs based on rifampicin;
• Nifedipine should definitely be excluded if the patient has heart failure or has forms of arterial hypertension and hypovolemia that are treated with hemodialysis.

Side effects of the drug Nifedipine

Taking any medication, including Nifedipine, can lead to disruption of various body systems:

• Cardiovascular - palpitations, exacerbation of angina symptoms. Peripheral edema and aortic hypotension are sometimes observed.
• Central nervous system - eclipse of clear vision and consciousness, feeling of irritability and imbalance, poor sleep.
• Digestive system - feeling of nausea, as well as constipation or diarrhea.
• Urinary system - kidney function is impaired, daily urination increases.

Nifedipine is a very popular drug among our obstetricians, as well as among our women. I read on forums that mothers prescribe it for themselves when they have high blood pressure, to reduce the tone of the uterus, and therefore to prevent the risk of pregnancy loss. But this drug is not as simple and safe as it seems.

Therefore, today we will understand what nifedipine is and why nifedipine is prescribed during pregnancy.

What is nifedipine?

The drug is based on a substance that is a blocker of slow calcium channels. Main properties: antihypertensive – lowering blood pressure and antianginal – preventing angina attacks.

What does “slow calcium channel blocker” mean?

Nifedipine blocks the channels through which calcium enters the cell, thereby slowing down the reactions responsible for muscle contraction. This drug has the strongest effect on the muscle cells of the heart and the muscles of the blood vessels. It also has a strong antispasmodic effect on the smooth muscles of internal organs.

Thus, nifedipine is able to relax vascular smooth muscles and reduce myocardial contractility, which leads to a decrease in blood pressure. Therefore, this drug is very common among people suffering from heart disease and high blood pressure. In obstetrics, it is also used to lower blood pressure during pregnancy.

In addition, nifedipine has the following property: as a relaxation of the muscles of internal organs (antispasmodic effect).

Therefore, nifedipine was previously used in obstetrics to reduce uterine tone, although The latest studies have not shown any effectiveness of this drug for tone. Currently it is only used to stop labor in cases of early labor.

In obstetrics, nifedipine is used only in two cases:

• For hypertension– persistent increase in blood pressure during pregnancy
• During acute tocolysis– suppression of contractile activity of the uterus during premature birth

Nifedipine for tocolysis

Tocolysis is a method of stopping the contractile activity of the uterus, in other words, contractions.

Obstetricians use this method to stop labor for 24-48 hours in cases where if the birth is premature or a woman in labor any deviations were identified, and she needs to be urgently transported to a specialized center.

If the birth is premature, from 22 to 36 weeks, obstetricians need to first of all increase the baby’s chances of survival; for this, corticosteroids are used all over the world. These drugs accelerate the maturation of the fetal lung surfactant system and thus reduce the risk of prenatal mortality.

That is, they give special medications that help accelerate the development of the baby’s lungs, so that when he is born, he can begin to breathe on his own.

But it takes time to introduce a full course of corticosteroids and allow the lungs to mature. Therefore, the woman is prescribed nifedipine to stop labor for 24-48 hours. During this time, it is possible to complete the administration of the course of corticosteroids and significantly increase the chance of survival of the premature newborn.

However, nifedipine can be prescribed to stop labor only under medical supervision. Doctors should continually monitor fetal pulse, blood pressure, respiration, amniotic fluid or blood loss, fetal heart rate, fluid balance, and blood glucose levels.

All this is done for a reason, the doctors in the maternity hospital will very closely monitor how the baby is feeling, and at any moment they will be able to open the operating room and perform a caesarean section. Therefore, under no circumstances should you carry out tocolysis at home and take nifedipine in order to delay childbirth!

But you should know that the outcome of childbirth will not always be positive, even if it was possible to stop the contractions and prescribe treatment.

Labor is often difficult to stop before it is clinically beneficial, and treatments powerful enough to suppress uterine contractions may have side effects on the mother or baby. The consequences may be undesirable or dangerous.

Nifedipine is prescribed to delay labor only if injections of dexamethasone, a drug that increases blood pressure (BP), are given simultaneously.

With normal blood pressure, taking large doses of nifidipine, which is an antihypertensive drug, is contraindicated, since a decrease in blood pressure has a detrimental effect on uteroplacental blood flow. May be accompanied by placental infarctions and the development of uteroplacental insufficiency.

Nifedepine for blood pressure

There are a lot of blood pressure medications, with very different effects. However, in obstetrics, a lot of research is devoted to the correct choice of blood pressure medication so as not to harm the baby and mother.

By and large, absolutely harmless medications for blood pressure simply do not exist.

If you look at the classification of drugs, the safest drugs are category A drugs. There are no blood pressure remedies in this category.

Studying a variety of studies on the consequences of using blood pressure medications, the WHO International Society for the Study of Arterial Hypertension (1999) still recommends for long-term therapy in pregnant women the use of drugs such as: adrenergic blockers - acebutolol, metoprolol, pindolol and calcium antagonists (in particular nifedepine ).

However, nifedepine is not a harmless drug, and prescribing it in the early stages is extremely risky.

Experimental studies conducted on animals have revealed the risk of:

• congenital deformities in embryos;
• growth retardation and developmental delay of the fetus;
• pathologies of the internal organs of the fetus;
• frozen pregnancy.

There have been no good quality studies on the effects on the fetus in pregnant women, although there have been isolated Russian studies that did not confirm the occurrence of teratogenic and embryotoxic effects on the fetus and newborns.

Thus, even in medical circles there is no consensus on the safety of using Nifedipine during pregnancy. And yet doctors consider it possible to prescribe the drug, but mainly in the later stages, when the most important organs of the child have already formed, and only for serious indications.

There are only two such indications:

• hypertension
• carrying out acute tocolysis

Nifedipine for uterine tone

Not a single study has confirmed that today there are drugs for the treatment of uterine hypertonicity! No no-spa, no papaverine, no magnesia, no novocaine blockade, no nifedipine.

Treatment of isthmic-cervical insufficiency is effective (application of a circular suture on the uterus, placement of a pessary and administration of progesterone), but not in the case of treating threatened miscarriage with nifedipine and other drugs.

I know that many women prescribe nifedipine for themselves, share it on forums, determine the dosage themselves, and advise each other. This situation scares me. Almost all medications during pregnancy can cause some harm. And nifedipine is no exception. In the early stages, you can seriously harm yourself and your baby. In addition, the main purpose of this drug is to reduce blood pressure; when taking it, it is very important to know what your blood pressure is, so as not to cause even more harm.

Taking nifedipine with uterine tone is useless and dangerous. Personally, as a practicing physician, I consider taking nifedipine in the early stages (1st and 2nd trimesters) unsafe. This drug may harm the fetus.

Combination of nifedipine and magnesia

Nifedipine cannot be combined with magnesium, since signs of magnesium intoxication and manifestations of cardiotoxic effects can occur even against the background of a therapeutic concentration of magnesium in plasma, therefore, a neuromuscular block can be obtained.

Magnesia preparations are not prescribed together with nifedipine to stop labor; moreover, there is strong evidence that magnesia is not able to stop labor, it only weakens uterine contractions.

Its main use is the treatment of preeclampsia, and even then short-term (use of intravenous drip injections no more than 78 hours before delivery and 48 hours after delivery).

The use of magnesia in early pregnancy is accompanied by serious side effects on the fetus and mother.

In the mother, magnesium can cause complications such as:

• nausea, hot flashes
• headache
• dizziness
• visual impairment
• respiratory and cardiac dysfunction
• as well as pulmonary edema

In addition, magnesium has no effect on uterine hypertonicity, despite the fact that magnesium droppers are prescribed very often in our hospitals.

Papaverine and genipral for uterine tone

Papaverine is one of the drugs that has no effect on the contractile activity of the uterus. It's like water, only with side effects. Therefore, it makes no sense to use it for uterine hypertonicity.

Genipral, like nifedipine, is a tocolytic, that is, it is used to stop labor. However this drug has much more serious side effects than nifedipine. Therefore, in cases where it is necessary to stop labor, it is better to use nifedipine.

For uterine hypertonicity, genipral is not effective. Therefore there is no point in taking it.

Contraindications for taking nifedipine

• hypersensitivity to the active component and other components of the drug;
• acute phase of myocardial infarction;
• low pressure;
• cardiogenic shock;
• heart failure in the stage of decompensation;
• severe aortic stenosis.

Side effects from taking the drug

• hyperemia of the skin;
• swelling and redness of the hands;
• swelling of the lower extremities (for example, ankles and legs);
• headache;
• increased fatigue;
• a sharp drop in pressure;
• heart failure;
• digestive disorders (diarrhea, constipation, nausea);
• allergic manifestations (urticaria, itching).

CONCLUSIONS:

Let’s summarize everything we discussed today regarding nifedipine:

1. This is an unsafe drug and can only be prescribed by a doctor. Under no circumstances should you prescribe it to yourself.
2. The use of nifedipine for hypertension and tocolysis is justified.
3. Cannot be combined with magnesium.
4. Neither ginepral, nor no-spa, nor magnesia, nor papaverine, nor nifedipine help with uterine hypertonicity.

Sources:

1. Murray Enkin, Mark Keirs, Mary Renfrew, James Neilson. Guide to effective care during pregnancy and childbirth. Second edition. – S.-P., 1999.
2. On the principles of labor management adopted by the World Health Organization, British Journal of Obstetrics and Gynecology, 99, 709-710, 1992.
3. Maternal health care in Canada, the USA and St. Petersburg (1993-1997).
4. Having a child in Europe / Having a baby in Europe. Copenhagen, WHO Regional Office for Europe, 1985 (Public Health in Europe, No. 26).
5. Shevchenko T.K. Current issues in obstetric pathology. M.: Medicine, 1991.
6. Chalmers B., Hofmeyr G.F. Course on teaching issues related to the birth of a child. Obstetrics and Gynecology, 10, 179-187, 1989.
7. Health in Europe. Copenhagen, WHO regional Office for Europe, 1994 (WHO Reginal Publications, European Series, No. 56).
8. Mosby's Medical, Nursing, and Allied Health. 4th edition, KN Anderson, LE Anderson, WD Glanze Eds, Mosby, St. Louis, 1994.
9. Stedman's Medical Dispensary. 26th edition, Baltimore, Williams & Wilkins, 1995.
10. The Cochrane Collaboration perinatal database. Oxford, Update Software, 1997.
11. Тhe partograph: Section 11. А users manual. Geneva, World Health Organization, 1988.
12. Webster's Medical Desk Distribution. Springfield, Merriam-Webster Inc., 1995.
13. World Health Organization. WHO recommendations on appropriate technology for obstetric care\ Appropriate technology for birth. Lancet, 2(8452): 436-437 (1985).

Nifedipine during pregnancy is one of the drugs that is used to lower blood pressure. Cardiologists often prescribe this drug, which rightfully occupies one of the leading positions among antihypertensive drugs. Prescribing the drug for the treatment of pregnant women shows positive effects. However, there is no data on a negative effect on the fetus. Since no studies have been conducted on pregnant women, the drug can only be prescribed and taken under the supervision of a physician.

Characteristics of the drug

Nifedipine belongs to the group of calcium channel blockers. It is an antihypertensive drug that has minimal side effects.

Among the additional effects provided by the drug and used during pregnancy, the following should be highlighted:

• vasodilation;
• decreased uterine tone.

Composition and mechanism of action

One tablet of Nifedipine contains:

1. The main active ingredient is nifedepine in an amount of 10 mg.
2. Excipients: wheat starch, gelatin, magnesium stearate, lactose, cellulose, talc.

The mechanism of action of Nifedipine is based on the blockade of calcium channels. At the same time, the amount of calcium in smooth muscles decreases, vasodilation occurs and peripheral vascular pressure decreases. As a result, the load on the heart becomes less, and the saturation of smooth muscles with oxygen increases significantly. Due to vasodilation, blood pressure decreases.

Nifedipine is a long-acting drug. The effect of its use is observed within 24 hours, so to achieve a therapeutic effect it is necessary to take the medicine once a day. Absorption of Nifedipine occurs in the digestive system. The maximum concentration of the drug is observed 5 hours after administration. The drug is excreted by the kidneys and urine in the form of metabolites.

Indications for use

Indications for use of Nifedepine include:

• stable angina pectoris;
• arterial hypertension;
• the drug is also effective for renal, intestinal and cholelithiasis colic.

During pregnancy, indications for use of the drug are:

• with the threat of premature birth;
• arterial hypertension in women;
• which is accompanied by an increase in blood pressure;
• angina in a pregnant woman.

Release form and price

Nifedipine is available in the form of dragees in blisters of 10 pieces. Their color is yellow due to a dye. The cost is on average 50 rubles.

Can Nifedipine be used during pregnancy and in what dosage?

Nifedipine penetrates the placental barrier to the fetus and is excreted in breast milk, so its use during pregnancy and lactation is undesirable, but possible.

Studies have not been conducted in pregnant women, so there is no data on the effect on the fetus. The drug is prescribed to women during pregnancy when the risk to the mother’s life outweighs the threat to the fetus. It is recommended to take the drug no earlier than the 16th week of pregnancy, when the formation of fetal organs is completed.

With regular use of Nifedipine, the risks of exacerbations of heart and vascular diseases are reduced. When taking the drug, the pressure decreases smoothly, without jumps, which minimizes the risk of undesirable effects on the uterus and fetus. Due to the vasodilating effect, Nifedipine improves cerebral blood flow and dilates the blood vessels of the placenta, which increases the supply of oxygen to the fetus.

The dosage and frequency of administration for each pregnant woman is selected individually by the doctor. The drug is available at the pharmacy with a prescription, which limits the possibility of self-medication. In the instructions for Nifedipine, the recommended dosage is 10 mg of the drug 2-3 times a day.

The simultaneous use of Nifedipine with drugs containing calcium weakens its effect. When combined with magnesium-containing products, muscle weakness may develop.

Features of taking Nifedipine during pregnancy

In the 1st trimester of pregnancy, Nifedipine is contraindicated, as there is no clinical data on its effects on the fetus. Dopegit is used to reduce pressure, and Papaverine is used to relieve uterine tone.

In the 2nd and 3rd trimesters, Nifedipine can be prescribed after the 16th week of pregnancy in cases where the risks for the mother are higher than for the fetus.

In order for the drug to begin to act faster, you need to drink it with plenty of water. If any side effects occur while taking the medication, you must stop taking it and consult your doctor to adjust the treatment.

Contraindications and side effects

The use of Nifedipine is contraindicated in:

• cardiogenic shock;
• porphyria;
• the presence of severe aortic stenosis;
• arterial hypotension;
• collapse;
• decompensated heart failure;
• myocardial infarction in the acute period;
• under 18 years of age;
• allergic reactions to the components of the drug.

Pregnancy and lactation are also included in the list of contraindications.

The use of Nifedipine may cause the development of some side effects.

Pregnancy is a difficult period for a woman, because serious changes occur in her body, accompanied by deterioration of health against the backdrop of weakened immunity, and the development of chronic diseases. In some cases, it is impossible to do without drug treatment. If increased uterine tone is detected, the functioning of the cardiovascular system is disrupted, Nifedipine is used during pregnancy. It is necessary to know all the properties and rules for taking this drug, what effect it has on a developing child and on the expectant mother.

Instructions for use

The medication belongs to the tocolytic group, preventing contraction of the muscular structures of the uterus. Due to this property, it is prescribed to eliminate uterine hypertonicity, resulting in the prevention of premature birth. Until recently, the drug was used by doctors only to relieve attacks of angina and lower high blood pressure.

In obstetrics, other tocolytic agents were used that have a teratogenic effect on the developing fetus. Now Nifedipine is prescribed to women bearing a child, as it is characterized by side effects that occur in extreme cases.

Effect on the woman’s body, composition

Nifedipine is an antagonist of calcium ions; when it enters the body, it has a powerful effect on the vascular system. The main component of the drug is nifedipine, which eliminates pain in the chest (angina) and stabilizes high blood pressure. When entering the bloodstream, the medication prevents the transmembrane movement of calcium along the smooth structure. However, the development of hypocalcemia is not observed, since the level of calcium ions in the venous blood is not disturbed. The active component promotes mild expansion of veins, which leads to the elimination of coronary spasm.

Calcium promotes uterine contraction, so its use is indicated to eliminate hypertonicity of this organ and unsafe pathological contractions. Under the influence of Nifedipine, the resistance of peripheral veins and arteries decreases, due to which the pressure that led to a hypertensive crisis is systematically reduced.

Important! The medication does not contribute to changes in the following blood parameters: lipid levels, the amount of uric acid, sugars.

If the drug is taken orally, it is quickly absorbed into the gastrointestinal tract, interacting with plasma proteins. Absorption varies between 60-97%, the required therapeutic dose of the active substance is concentrated in the blood after 30-90 minutes. As for the onset of action of the drug, it begins to be felt after 20 minutes, the therapeutic effect is observed for 4 to 8 hours. The release form of the medicine is represented by tablets and an injection solution for intravenous administration. Almost 80% of the drug is eliminated through the kidneys within a few hours after its use.

Interesting fact! The number of premature births, when uterine hypertonicity is observed during the gestational period from 18 to 33 weeks, is significantly reduced after treatment with Nifedipine for 7 days.

Along with the active element, the drug contains impurities in the form of magnesium stearate, wheat starch, lactose monohydrate, gelatin, saccharin, talc, polysorbate, macrogol, and dyes.

The list of auxiliary chemical elements is quite large. Some of them may negatively affect the health of a pregnant woman, which must be taken into account during treatment with Nifedipine:

1. Glycerol, which is part of the composition, can lead to upset of the digestive system and periodic attacks of headaches.
2. For galactosemia and lactose deficiency, the described medicine may worsen the patient’s condition due to the lactose it contains.
3. Yellow dyes often cause various allergic reactions, in particular swelling, hives, and asthmatic attacks.
4. If a woman has gluten intolerance or celiac disease, Nifedipine is contraindicated due to the wheat starch content.
5. Adverse reactions are enhanced by the action of natural grapefruit juice.

In what cases is Nifedipine prescribed?

This drug is widely used to prevent the following pathological processes:

• Essential primary hypertension.
• Angina pectoris.

As for pregnancy, the described medication is used for the following complications:

• Increased uterine tone.
• If there is a threat of premature birth.
• Gestosis in the late period.
• Arterial hypertension.

About contraindications

In the instructions supplied with the drug, pregnancy is one of the main contraindications. However, Nifedipine is used in gynecology when there is a real threat to the life of a developing child and the expectant mother. Other contraindications worth noting:

1. Unstable angina.
2. Minimum circulating blood volume or hypovolemia is critical.
3. Aortic stenosis.
4. History of heart attack.
5. Abnormally low blood pressure.
6. Breastfeeding period.
7. Individual intolerance to any of the components of the drug.
8. Treatment based on Rifampicin.

Practice shows that pregnant women tolerate the effects of Nifedipine normally if treatment is necessary. In comparison with drugs of a similar group, it does not provoke sweating, nausea, or attacks of shortness of breath. Only in isolated cases does a deterioration of the condition occur, in which women have to abandon Nifedipine-based therapy. From statistical data it is known that children whose mothers took the described drug during pregnancy are not susceptible to depressive syndromes and obstructive jaundice. They do not exhibit intestinal diseases; brain hemorrhages develop in exceptional cases.

Nifedipine is prescribed with extreme caution to patients who have been diagnosed with blood flow dysfunction (unstable dynamics occur) and hypotension progresses. If pathological processes in the kidneys or liver are observed, or diabetes mellitus is diagnosed, treatment based on the described medication is potentially dangerous.

Advice! At the beginning of the treatment course, when the body adapts to the action of the drug, a pregnant woman may experience general weakness, accompanied by dizziness. Over time, such symptoms disappear, but it is better to stop driving.

About side effects

If any appear, the reason for this is a sharp expansion of the veins and arteries. But after a few days, the patients’ condition usually stabilizes. Possible side effects include the following:

• Periodic headaches.
• Hyperkalemia.
• Vomiting preceded by nausea.
• Increased anxiety with sleep disturbances, manifestation of tremors in the extremities. In some cases, on the contrary, excessive drowsiness, accompanied by a feeling of weakness.
• Tachycardia with fainting.
• Deterioration of vision, in rare cases, eye hemorrhage.
• Cardiopalmus.
• Unforeseen tides.
• Heart attack.
• Hoarseness with nosebleeds.
• Jaundice, allergic rashes.
• Gastrointestinal disorders (diarrhea or constipation).
• Increased body temperature.
• Convulsive spasm in the muscles.

This list of side effects is indicated in the instructions for use of Nifedipine; it alarms any woman, especially if she is carrying a baby. In practice, such health problems occur extremely rarely.

Treatment regimen during pregnancy

The consequences of treatment for a child in the womb can be very disappointing, since the medicine passes into breast milk and is able to cross the placental barrier. Therefore, the dosage is carefully selected by the attending physician, who determines the duration of the course of treatment, taking into account the general condition of the pregnant woman and the results of a blood test.

As a standard, Nifedipine is taken 1-2 tablets 2 times a day. The maximum permissible daily dose is 6 tablets (60 mg). The therapeutic course, depending on the patient’s condition, can vary from 1 to 6 weeks. If the duration of treatment exceeds 3 months, resistance to the active substance develops.

Important! As for the bioavailability of Nifedipine, it does not change depending on the amount of food taken

1st trimester

Taking the drug in the first weeks after conceiving a child can provoke the development of complications in the form of:

• Violations of the function of internal organs.
• Congenital pathologies in a baby.
• Intrauterine death.
• Child development and growth delays.
• Fading pregnancy.

Taking Nifedipine during pregnancy (with tone) is aimed at the comprehensive elimination of hypertension, which entails oxygen starvation, heart failure, and kidney failure.

2nd and 3rd trimester

It is safer to use the described medicine for therapeutic purposes in pregnant women in the second and third trimesters. During this period, the formation of all the child’s organs for subsequent development is almost complete. But possible risks should not be discounted; accordingly, treatment is prescribed by a qualified specialist and only in emergency situations.

In some cases, there is an urgent need to extend pregnancy by 7-10 days to implement corticosteroid therapy aimed at preventing the development of complications in the baby. Such treatment based on Nifedipine is usually carried out between 24 weeks and 34 (in some cases 36) weeks of gestation.

Very often, during pregnancy, women have to deal with a situation where the doctor reports the need to take a particular medication due to poor clinical tests or diagnosis of a disease.

This frightens some patients, especially when we are talking about potent drugs intended to treat serious pathologies.

This also applies to such a well-known drug as Nifedipine, intended for the treatment of arterial hypertension and angina pectoris. During pregnancy, it can only be prescribed by a cardiologist after examination and laboratory testing of the patient’s blood.

Despite the extensive use of Nifedipine for a long time, debates regarding the possibility of using this drug during pregnancy are still ongoing.

The main active ingredient of the drug, nifedipine, has a hypotensive and antianginal effect. Its use makes it possible to achieve a pronounced therapeutic effect in pathologies of the cardiovascular system, which is manifested by a general improvement in well-being, elimination of the cause of the disease, as well as a decrease in the intensity of clinical symptoms.

After entering the body, "Nifedipine":

• blocks calcium deposition in vascular walls;
• helps to expand and improve the elasticity of blood vessels and capillaries;
• reduces the number of heart contractions;
• normalizes blood pressure;
• improves blood flow;
• reduces the need for oxygen molecules;
• normalizes the size of the heart (this is especially important for chronic heart failure);
• regulates blood pressure in arteries (for example, pulmonary);
• improves fluid circulation in all forms of atherosclerosis;
• removes excess potassium and sodium;
• has a tocolytic effect.

With prolonged use (more than 2-3 months), patients develop tolerance to nifedipine.

The drug is quickly absorbed (Nifedipine absorption is 100 percent), penetrates into the general bloodstream, and also through the blood-brain barrier.

The medicine is available in the form of tablets and solution for intravenous injection.

Indications for use of Nifedipine during pregnancy

The official instructions for the drug prohibit its use during pregnancy.

This is due to the fact that Nifedipine penetrates the placental barrier and has a teratogenic effect on the fetus, which can lead to very sad consequences, for example:

• birth defects;
• deformities;
• developmental disorders;
• growth retardation;
• pathologies of internal organs;
• intrauterine fetal death;

The use of this medicine is considered relatively safe only in the third trimester of pregnancy, when all the baby’s organs are already formed. But even in this case, the development of complications and defects in the development of the child is possible, so you should avoid using Nifedipine unless there are serious vital indications for this.

According to the FDA classification, the drug belongs to group C, that is, it has a toxic and teratogenic effect on the development and formation of the fetus.

When is it prescribed?

During pregnancy, Nifedipine can be prescribed for the following indications:

• arterial hypertension (), poorly controlled by other drugs;
• uterine tone;
• angina pectoris;
• hypertensive crisis.

It is very important to understand that the use of this powerful remedy is allowed only in the presence of extreme indications, when there is a real threat to the life and health of the mother.

If a pregnant woman suffers from high blood pressure, she should choose safer remedies that do not have such a strong negative effect on the fetus. The same applies to hypertonicity - the pharmaceutical market offers a huge number of effective antispasmodics (for example, “Drotaverine”, “”, etc.) that can cope with the problem without harming either the mother or the child.

In any case, the decision about the possibility of taking Nifedipine should be made exclusively by a doctor who has the skills to treat pregnant patients.

How to use?

The regimen for taking Nifedipine is always determined individually, since the required dosage is selected taking into account a large number of factors, especially when it comes to pregnant women. The manufacturer recommends the dosage regimen given below.

Capsules and tablets (0.1 g)

Adult patients:

1 tablet/capsule 3-4 times a day.

• Variant angina, severe form of hypertension.

2 tablets/capsules 4 to 6 times

• Hypertension.

1 tablet (if prescribed by a doctor, you can increase the dose for a single dose to 20-30 mg) 3 times a day

• Angina pectoris (according to the same scheme, the drug is prescribed for hypertensive crisis).

1-2 tablets (under the tongue or orally in capsule form), if necessary, repeat after 10 minutes

1 capsule/tablet 3 times a day

For intravenous solution

This dosage form of the drug is used primarily for the treatment of hypertensive crisis. The dosage in this case is 5 mg of the drug.

The infusion must be done by drip over 4-8 hours at a rate of 6.13-12.5 ml/hour. The maximum daily dose should not exceed 30 mg. Infusion therapy is carried out for 3 days, then the patient is transferred to oral administration.

Side effects

The use of Nifedipine is often accompanied by side effects, for example:

• disturbances in the functioning of the heart and blood vessels (facial hyperemia, fever, tachycardia, pain in the heart area, fainting);
• leukopenia;
• thrombocytopenia;
• deterioration of hearing and vision;
• bronchospasm;
• myalgia, limb tremors, convulsive syndrome;
• digestive disorders (nausea, change in stool);
• gum hyperplasia;
• numbness and swelling of the upper and lower extremities;
• (eczema, urticaria, itching).

Only a doctor should make a decision to discontinue the drug, since sudden cessation of use can lead to a deterioration in the woman’s condition and well-being.

When should you not take it?

Nifedipine should not be taken if you have a history of the following diagnoses:

• aortic valve stenosis;
• myocardial infarction (critical stage);
• cardiogenic shock;
• severe form of heart failure (stage of decompensation);
• pregnancy (first and second trimester).

Interaction with other drugs and substances

• Beta blockers.

A sharp decrease in blood pressure, increased heart failure.

• Magnesium salts.

Muscle weakness, confusion, difficulty swallowing and breathing, excessive hypotension.

• Digoxin.

Digoxin overdose (increased concentration of the substance in the blood plasma).

• Quinidine.

Increased negative inotropic effect.

• Acetylsalicylic acid.

When using a dosage not exceeding 100 mg per day, it does not affect the absorption of nifedipine.

• Drugs against epilepsy.

Reduce the effectiveness of nifedipine.

• Rifampicin.

Reduces the absorption of nifedipine.

• Diltiazem.

Suppresses the processes of metabolism (decomposition) of nifedipine after entering the body.

What to replace it with?

There are many analogues that contain nifedipine. The choice in favor of one of them must be made by a doctor, since all of these drugs are prohibited for use during pregnancy.

Analogs of "Nifedipine":

• "Depin-E";
• "Kordipin"
• "Nifesan";
• "Nifebene";
• "Farmadipin";
• "Sponif 10";
• "Procardia";
• "Cordafen";
• "Cordaflex", etc.

Nifedipine is a very serious medicine that should not be used during pregnancy. Despite the fact that some obstetricians-gynecologists prescribe it to their patients, you should always play it safe and ask whether in each specific case it is possible to do without the use of this medicine, since the life and health of the future person often depends on it.