Nifedipine Dosages: Your GoodRx Guide

Nifedipine is a calcium channel blocker (CCB) that’s FDA approved to treat chest pain and high blood pressure (hypertension). It can also be used off-label to treat many other conditions, including pulmonary arterial hypertension (PAH), high blood pressure during pregnancy, and Raynaud’s phenomenon.

Nifedipine is available in two oral forms: an extended-release (ER) tablet (Procardia XL) and an immediate-release (IR) oral capsule (Procardia). If you’ve been prescribed either of these medications, you may wonder what the best dosage is for you. We’ll discuss common nifedipine dosages here. But be sure to follow your healthcare provider’s instructions, even if they are different from what’s discussed below.

What’s the typical nifedipine dosage for adults?

Nifedipine dosages vary depending on which form of the medication you’re taking.

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Generally, the ER tablets only need to be taken once daily. The IR capsules are usually taken three or four times a day because they don’t last as long in the body.

Nifedipine ER tablets and IR capsules should be swallowed whole. Do not cut, crush, or chew the pills. You can take your dose(s) at any time of the day, with or without food. But it’s best to be consistent and take nifedipine at the same time each day.

Chest pain

Nifedipine can be used to treat two types of chest pain (angina): vasospastic angina and chronic stable angina. Vasospastic angina is chest pain that usually occurs when you’re at rest. Stable angina is usually triggered by physical activity or emotional stress.

For both types of angina, the starting dosage of nifedipine IR is 10 mg three times a day. Typical maintenance dosages range from 10 mg to 30 mg three or four times a day. The maximum dosage is 180 mg daily. But typically, dosages over 120 mg a day aren’t needed. 

For nifedipine ER tablets, the starting dosage is 30 mg or 60 mg once daily. The maximum dosage is 120 mg once daily, but most people don’t need more than 90 mg.

Keep in mind: For either nifedipine IR and ER, your dosage may be increased over 1 to 2 weeks if your chest pain doesn’t improve with the starting dosage. Sometimes, if your symptoms are severe, your healthcare provider may increase your dosage more quickly. 

Hypertension

CCBs are considered first-choice medications for hypertension. But only nifedipine ER tablets are approved for hypertension. The starting dosage is 30 mg or 60 mg once daily. Your dosage may be increased every 1 to 2 weeks if your blood pressure is still too high. The maximum recommended dosage is 120 mg once daily.

Your healthcare provider may ask you to check your blood pressure at home to determine how well nifedipine is working. It can take a couple of weeks or more to reach the best dosage for you.

Pulmonary arterial hypertension (off-label use)

Nifedipine may be an effective medication for some adults and children with PAH. This condition occurs when you have high blood pressure in the arteries (a type of blood vessel) of the lungs.

Typically, nifedipine ER is recommended over nifedipine IR for PAH. For adults, the dosage may be 120 mg to 240 mg per day. (Though, some experts recommend a lower nifedipine IR dosage of 40 to 180 mg per day, in divided doses.) For children who are over 1 year old, a common dosage of nifedipine ER is 2 mg to 3 mg per kilogram of body weight per day. The maximum dosage of nifedipine ER for children is 180 mg a day.

High blood pressure during pregnancy (off-label use)

The American College of Obstetricians and Gynecologists (ACOG) recommend nifedipine ER as a first-choice medication for the treatment of hypertension during pregnancy. This is defined as a blood pressure of 140/90 mm Hg or higher. The usual dosage of nifedipine ER for this condition is the same as those for general high blood pressure, with a maximum dosage of 120 mg a day.

Hypertension during pregnancy can be dangerous if it isn’t treated. It can progress to preeclampsia or eclampsia. Preeclampsia is when high blood pressure causes damage to other organs. And eclampsia is when extremely high blood pressure during pregnancy leads to serious outcomes, like seizures or coma, in the pregnant person.

Raynaud’s phenomenon (off-label use)

Raynaud’s phenomenon is when a person’s fingers or toes turn different colors due to certain triggers, like feeling cold or stressed. This happens because normal blood flow is interrupted, and blood can’t reach these parts of the body.

If lifestyle changes don’t improve Raynaud’s phenomenon, medications can help. CCBs like nifedipine may be a first-choice option. Dosages may range from 10 mg to 80 mg per day.

Can you switch from nifedipine IR to nifedipine ER?

If your healthcare provider recommends switching from nifedipine IR capsules to the ER tablets, they’ll try to match your new dosage as closely as possible to your old one. For example, if you’re taking 30 mg nifedipine IR three times daily, your provider will likely switch you to 90 mg nifedipine ER once daily.

One benefit of nifedipine ER is that it only has to be taken once a day. If that’s something you’re interested in, let your healthcare provider know.

Are there any dosage adjustments for medical conditions?

If you have liver problems, you may experience higher than usual blood levels of nifedipine. This can lead to an increased risk of side effects. So your healthcare provider may start you at a lower dosage.

Some medications and substances (like grapefruit juice) may interact with nifedipine. These medications and substances may increase or decrease levels of nifedipine in the body. So before starting treatment with nifedipine, ask your provider and pharmacist to review all the medications and supplements you take. This will help them check for drug interactions.

What happens if you miss a dose of nifedipine?

If you miss a dose of nifedipine, take the medication as soon as you remember. But this only applies if you still have hours until your next scheduled dose. If it’s almost time for your next dose, skip the missed one. Then, resume your usual dosing schedule.

Don’t take two doses at once to make up for a missed one. This increases your risk of side effects.

What should you do if you take too much nifedipine?

If you take too much nifedipine, let your healthcare provider know. Accidentally taking an extra dose may not cause serious problems but it’s good to double-check. Taking too much nifedipine can raise the risk of side effects, including:

• Low blood pressure

• Heart palpitations

• Dizziness or fainting

• Flushing (reddening of the skin)

• Nervousness

• Nausea and vomiting

• Swelling (edema)

These symptoms may be more or less severe depending on how much nifedipine is ingested. If you or a loved one has taken a large amount of nifedipine, medical treatment might be needed. Call Poison Control at 1-800-222-1222 or 911 for emergency care.

How to save on nifedipine

Nifedipine IR and ER are available as brand-name medications. But you can also find them as lower-cost generics. GoodRx may be able to help you save over 70% off the average retail price of generic nifedipine IR and ER. 

At certain pharmacies, nifedipine IR may be as low as $27.88 and nifedipine ER may be as low as $27.53 with a free GoodRx coupon.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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