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Doctors' Answers to "Frequently Asked Questions" - Procardia XL

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 10/31/1999]
Question: I have been taking Nortriptyline for about 6 months after being diagnosed via Motility Study for Esophegeal Spasma. Since I was unhappy with the side effects of Noritriptyline, my physician recently switched me to ProCardia. My normal intake of calcium is 1500 mgs via food and supplemants. Is this going to be a problem since ProCardia is a calcium blocker? Do you know of any studies of the effectiveness of ProCardia in treating patients with my condition? Thanks.

Answer: Although they are in a class of drugs called calcium channel blockers, your oral calcium intake will have no effect. The calcium channel blocking is occurring in the muscle cells and has nothing to do with intake or serum levels of calcium. Calcium channel blockers are the mainstay of treatment of recurrent esophageal spasm.

[posted 08/12/1999]
Question: I have high blood pressure. I was taking Adalat 30mg. but my health insurance does not cover the brand any longer so I was put on Procardia XL (30 mg)? What is the difference? Thank you.

Answer: Same drug, different name.

Procardia & Skin Irritation   [posted 12/01/98]
Question: I have suffered SEVERE itching of extremities and chest, rashes, exfoliation of skin on face for 2 years. My dr. says Procardia XL is not the cause. I've read that 3% of patients taking this medication suffer these symptoms. I'm very sensitive to antihistamines, even antihistamine creams which were prescribed by a dermatologist for the itching. Absolutely nothing helps. 

Answer: Well, why not try another hypertensive drug and see?

Can Procardia Cause Diarrhea? [posted 10/21/98]
Question: I have had continous diarrhea for over a year 1/2. I have had every test there is to have and still nothing . I can eat and with in 2 or 3 hours my stomach is growling and rumbling have to run to the bathroom. The bowel is never formed, pure liquid. It is very frustrating. Any information or a type of diet please help.

Answer: Usually constipation, but, it does affect bowel motility. Does the diarrhea go away when you stop the Procardia? I suspect you have another problem causing the diarrhea. You need a gi evaluation.

Procardia Overdose [posted 10/6/98]
Question: What happens if there is an overdose of Procardia 30 MG? not 2-3 overdose, but 40-50 pill overdose?

Answer: The blood pressure would be very low, pulse rate might be affected.

Procardia XL and grapefruit interactions
Question: I have read several newspaper articles and seen TV documentaries concerning the effects of consuming grapefruit while taking Procardia due to the effect that the grapefruit enhances the drug's potency. My doctor was unaware of such a phenomenon. One of life's pleasures for me is 1/2 a grapefruit with breakfast. I take Procardia XL 30 one a day in the evening (for Reynaud's syndrome). Can you advise me if this is a problem?

Answer: It is only a problem if taken around the time that the Procardia is taken, a 12 hour delay shouldn't have a major effect.

Procardia XL and Pregnancy
Question: I am 39 and am planning on having a baby within the next year. I have taken Procardia XL in the past with excellent results. I stopped taking it as soon as I found out I was pregnant and everything turned out fine. However, my obstetrician prescribed 500 mg of methyldopa twice a day as he would prefer I not take the Procardia XL if planning a pregnancy. The methyldopa does not work for me. Should I be concerned about taking the Procardia XL during the first few weeks of pregnancy or are the risks negligible? My internist prescribed the Procardia XL knowing of my plans for another child. I do not suffer from hypertension during pregnancy.

Answer: You fail to mention why you are taking Procardia - for hypertension or other causes? If you are not hypertensive while pregnant, I'd stop the Procardia. The effects of pregnancy while taking a calcium channel blocker appear to be minimal, but are not well studied. Studies in rats and mice show an effect on placental size with prolongation of pregnancy duration.

Procardia XL
Question: I take 1 30mg 2x day of Procardia XL and have heard on a Canadian radio station of deaths occuring with people taking this drug. Should I be concerned?

Answer: Procardia(nifedipine) has gotten a lot of bad press lately. Most of this has centered on the short acting drug and potential problems with its use. The long lasting or XL has far fewer, if any, of the problems associated with the short acting version of the drug. I have never used the short acting drug for this reason. However, the long acting works well with no major problems to date. Because of the bad publicity, I have switched several patients from Procardia XL to other drugs.

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