Nifedipine with Melatonin Interaction Details
Brand Names Associated with Nifedipine
- Adalat®
- Adalat® CC
- Afeditab® CR
- Nifedical® XL
- Nifedipine
- Nifeditab® CR
- Procardia®
- Procardia® XL
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 20, 2023
Interaction Effect
Increased blood pressure
Interaction Summary
Patients with well-controlled hypertension managed by NIFEdipine monotherapy experienced an increase in blood pressure and heart rate when melatonin was administered concomitantly.
Severity
Minor
Onset
Rapid
Evidence
Established
How To Manage Interaction
Close monitoring of blood pressure is advised with appropriate dose adjustment of NIFEdipine or withdrawal of melatonin.
Mechanism Of Interaction
Competition with NIFEdipine for calcium channels
Literature Reports
A) Melatonin 5 milligrams (mg) significantly increased blood pressure and heart rate in 47 patients with hypertension controlled by NIFEdipine in a randomized, double-blinded, placebo-controlled, cross-over trial. After a 4-week washout period with placebo, subjects were randomly assigned to receive either placebo or immediate release melatonin 5 mg at 2230 hours for 4 weeks, followed by a 4 week washout period, then patients were crossed over for another 4 weeks of treatment with melatonin or placebo. NIFEdipine GITS (Gastrointestinal Therapeutic System) 30 mg or 60 mg was taken daily at 0830 as monotherapy by all patients for at least 3 months prior to the study, and their clinic blood pressure was less than 140/90 mmHg. At the end of each 4 week treatment period, patients underwent 24 hour noninvasive ambulatory blood pressure monitoring on usual working days, beginning at 0800 and taking measurements every 15 minutes throughout the 24 hours. Systolic blood pressure increased an average of 6.5 mmHg (p less than 0.001); diastolic blood pressure increased an average of 4.9 mmHg (p less than 0.01); heart rate increased an average of 3.9 beats/minute (p less than 0.05). Morning drowsiness was reported in 15 subjects taking melatonin compared with 2 placebo subjects (p less than 0.01). Weakness was reported by 10 subjects taking melatonin compared with 3 placebo subjects (p less than 0.05) .
Nifedipine Overview
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Nifedipine is used to treat high blood pressure and to control angina (chest pain). Nifedipine is in a class of medications called calcium-channel blockers. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood and oxygen to the heart.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.