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General Category => Preterm Labor: Anything and Everything => : Alice November 22, 2012 at 08:57 AM

: Nifedipine/Procardia - your experiences?
: Alice November 22, 2012 at 08:57 AM
Hi,

I'm in the UK and have had two previous premature births.   I am now six weeks pregnant and want to plan carefully to avoid another.  In the UK tocolytics such as nifedipine/Procardia are not used to halt labour for longer than 24-48 hours, but I know that in the US and Canada women are given a maintenance dose to take at home, and I'm going to try to find a doctor here who will prescribe it off label. 

I'd be very, very grateful if anyone here could tell me about their experiences taking it, specifically:

1. How many weeks pregnant were you when you were first prescribed it, and how long did you take it?

2. When did you end up delivering your baby?

3.  Why were you prescribed it?  Were you already having lots of contractions, or was it a preventative measure because you had previous preterm births?

4.  What dose were you given?

5.  Any other thoughts?

Many thanks for any information you can give me.

Alice
: Re: Nifedipine/Procardia - your experiences?
: stacem628 November 23, 2012 at 10:34 PM
1. I took nifedipine starting just after 24 weeks for my twin pregnancy.  I took it consistently 2x a day for 3 weeks.
2. I delivered at 27 weeks-- though that was due to an infection I contracted/my son contracted that necessitated labor.
3. I was admitted to the hospital just shy of 24 weeks due to a shortened cervix and an ultrasound discovered slight contractions, so it was intended to stop those, though I did not feel them.
4. Sorry!  I can't remember!
5. The nifedipine seemed to do the "trick" at the time while I was taking it because contractions were not an issue afterwards during my daily monitoring.  However, the dose i was on caused me to have extremely lowered blood pressure which caused me to pass out a few times.

Good luck!
: Re: Nifedipine/Procardia - your experiences?
: iza_bel_2000 November 23, 2012 at 11:17 PM
Hi there,

I took nifedipine for months. I had a placenta previa which started bleeding at 23 weeks. Each bleed would start bad contractions we had to calm down and also my doc was trying to prevent any Braxton Hicks to prevent further bleeds. I was on total bed rest till the end of my pregnancy as I kept on having bleeds (6 major ones a few smaller and 2 so bad I had to have blood transfusions to keep us going) I took the nifedipine at it max dosage from week 23 to 37 and 5 days where my beautiful baby boy was delivered healthy and over 3,5 kg by c_section.
If I remember well I took 2 pills of nifedipine every  6 hours. And had to take it by the clock if not I would start contracting. My doc also put me at about 26 weeks on a high dose of magnesium which helped a lot with the contractions as it seamed nifedipine was not enough. I also took progesterone started with a shot then 2 pills a day till delivery. I stopped all meds a bit more than 12 h prior to going to hospital for my c-section... I don't know if its the nifedipine or all the " cocktail" I was on that whole time while lying in bed but it did save us from a premature birth for sure... My son is 6 month and doing great. I was afraid that so many meds would have side effects but so far so good nothing we noticed...
Hope you can get the care you need, I am French so if ever you feel like you don't maybe you could try to get help in France...
Good luck to you and you LO all my best wishes
Izabela 
: Re: Nifedipine/Procardia - your experiences?
: iza_bel_2000 November 23, 2012 at 11:21 PM
Ahhh yes while taking it I did feel sometimes light headed but my blood pressure was never too low and I did not have any other side effects than red chicks from it...
: Re: Nifedipine/Procardia - your experiences?
: Alice November 24, 2012 at 04:30 AM
stacem628 - So sorry for the loss of Connor James.  Thank you for taking the time to reply, that's really helpful to know.
: Re: Nifedipine/Procardia - your experiences?
: Alice November 24, 2012 at 04:32 AM
iza_bel_2000 -  Thanks for the info, that's incredible and very encouraging that you made it to 37+4.  I hadn't even considered France as an option because I don't speak much French and didn't know nifedipine was also in use there, but I have French friends here in London who can perhaps help, so I'll definitely bear that in mind if I struggle to get doctors here to help.
: Re: Nifedipine/Procardia - your experiences?
: ficaelinn November 24, 2012 at 02:01 PM
1. I received my first dose at 30 weeks with my 2nd. Because of a negative FFn, I wasn't yet on bedrest, and only took occasionally when I had regular contractions. At 31 weeks I had more serious preterm labor with sudden shortening of my cervix and a positive FFn. I took it every day (can't remember how often-I think it was either every 6 or 8 hours?) until DS was born at 34+2.

2. 34+2.

3.  Both reasons. DD was born at 31 weeks for no apparent reason, making me high risk. They took my regular contractions very seriously even before the positive FFn. Great hospital/OB practice--proactive without forcing me into anything. If I didn't have a previous premature birth, they probably would have held off on the procardia until the positive FFn.

4.  Sorry, can't remember.

5.  The procardia did seem to help lessen my contractions, especially in the first 2 weeks I was using it. It's difficult to make any scientific conclusion from my case, though--both because it's just a sample of 1, and I was also on 17p shots. However, I won't hesitate to use it again if and when my doctors recommend it.

Good luck!!
: Re: Nifedipine/Procardia - your experiences?
: Alice November 25, 2012 at 05:44 AM
Many thanks for the info, Ficaellin, and best of luck with your pregnancy!
: Re: Nifedipine/Procardia - your experiences?
: kinderroomcafe November 25, 2012 at 06:05 AM
I was on it from week 21-23  but had to stop due to blood pressure issues. I had to hold the walls to walk.  I generally have low blood pressure, so it was just awful for me to be on. People with normal BP seem to do fine tho.
: Re: Nifedipine/Procardia - your experiences?
: iza_bel_2000 November 25, 2012 at 01:04 PM
Hi again,
I live and got care for my previa in Istanbul Tukey, so i don't really know the position of French practicians toward this drug. I kniw of some friends with complicated pregnancies who got 2 nd opinions and very good advice consulting in France with high risk obgn... That is why I mentioned it...
?ts worth looking into if ever you do not get answers you need in UK... Again good luck and hope you will see this pregnancy till the late weeks :))
: Re: Nifedipine/Procardia - your experiences?
: brittany88 November 25, 2012 at 11:52 PM
Yup... i am currently on procardia. I have been on it for 4 weeks now (23 weeks). I take it every 6 hours. Thats right 4x a day!!! I hate hate hate it... i am starting to have big issues with my blood pressure and i am not sure if its because i am on blood pressure meds when my blood pressure has always been fine. I am pregnant with identical boys. I was on albutarol 4x a day but i went into preterm on it and was in hospital for almost a week so they changed it to procardia. I will be taking this medication up until the day that i deliver...
: Re: Nifedipine/Procardia - your experiences?
: Alice November 26, 2012 at 03:19 AM
Thanks for the info, Britanny88, and I will have my fingers crossed for you to go all the way!
: Re: Nifedipine/Procardia - your experiences?
: meghancruz November 28, 2012 at 12:21 PM
Hi Alice,
I have been taking Niphedipine for about 5 weeks now. I was hospitalized at 25 weeks with a funneling cervix and my doctor was going to give it to me then. However, I wasn't cotnracting so I was sent home without it. A week later when I was 26w2d I started feeling cramping so I went to L&D. I had started contracting so I was put on 24hr magnesium which, thankfully, stopped the contracting. As soon as that dose was over I was started on niphedipine: 10mg every 6 hours. I stayed in the hospital for over a week, but was sent home because my cervical length has been steady. However, I have never stopped contracting fully. The niphedipine really seems to help. I can often tell when I am due for my next pill because I start to feel crampy. I take it at 10 and 4 (both am and pm) and I don't mind waking at 4am for it because it seems to be working so well. I am now one day shy of 31 weeks and my cervix is still holding steady. BTW I am also getting progesterone shots once a week.

Thankfully the side effects have been minimal. For the first week or so I could feel the drop in blood pressure. I was generally around 100/55 which is pretty low for me. However, I was monitored in the hospital and they didn't seem concerned by the numbers. I never felt dizzy or faint and I was on bedrest anyhow so feeling a little weak was in some ways insignificant. Since then I have had some mild headaches every few days which tylenol seems to knock out. All in all I would say the benefits I have experienced have far outweighed any of these minor negatives.

Also, I was concerned that the niphedipine might not be good for the baby. Both my OB and the perinatal specialist I have been seeing are not at all concerned about the effects of the drug on my baby and I have a lot of trust in them.

I hope that helps and I hope you can get the care you need.
: Re: Nifedipine/Procardia - your experiences?
: Alice November 28, 2012 at 12:28 PM
meghancruz, thanks for giving so much detail, that's really interesting.  And congratulations for making it to 31 weeks, as I'm sure you're well aware, outcomes are good from around then onwards - my 33 weeker is an enormous, totally healthy ball of joy!   I have my fingers crossed for you to make it even further.

The responses I'm getting here are really convincing me that it's worth going all out to find a consultant willing to prescribe nifedipine if I have hundreds of early contractions again.
: Re: Nifedipine/Procardia - your experiences?
: BedriddenMommy January 27, 2013 at 12:24 AM
Hey there! I'm Sara, mom of 1 rowdy 25weeker boy Kohen who is now 2 and healthy. We're expecting #2 a girl. Yay! Because Kohen was born so enexpectedly at 25.5wks I had to take some extra precautions this go around. At 16wks my Dr decided to do a trans hag ultrasound and measure my cervix. At that time he found my cervix was measuring extremely short and would never carry a full term baby. I was rushed straight to the hospital to have a cerclage put in and sent home on strict bedrest with vaginal progesterone (once nightly) macrobid (an antibiotic to keep me safe from UTI's and other bacterial infections associated with preganancy also taken once nightly) and the procardia 10mgs every 6hrs. With the procardia Ive mostly encountered hot flashes and dizziness. It was at my last appointment at 24wks I told them I'd been noticing quite random painless contractions. This is when they started me on 20mgs of procardia every 8hrs. The first night I took it I rested well and didn't think Anthony about taking my morning dowager. However- I made a mistake. I forgot to eat first and then I took a shower. About 25 mind after I had taken the medicine I nearly fainted. It was so scary. My mistake. I now warn everyone. Eat eat eat BEFORE you take 20mg and lay for at least an hour afterwards for those side effects to wear off. I notice the "shakes" and a fast paced heart have effected me with the 20mg. But laying or sleeping is your saving grace. I'm shooting to make it to at least 36wks. Bed rest is not easy, but I'm keeping that little angel in my mind. Everything is for her. Hope this was some help to you.
: Re: Nifedipine/Procardia - your experiences?
: Alice January 28, 2013 at 03:59 AM
Hi Sara, 

Many thanks for the info, if I do end up taking Procardia I will be really careful about eating with it - good tip.   Here's hoping we all go to 36 weeks, but if not it's very heartening to hear your 25 weeker is fine.  Best of luck.

Alice
: Re: Nifedipine/Procardia - your experiences?
: niana January 29, 2013 at 11:27 PM
The nifedipine seemed to do the "trick" at the time while I was taking it because contractions were not an issue afterwards during my daily monitoring.  However, the dose i was on caused me to have extremely lowered blood pressure which caused me to pass out a few times.
: Re: Nifedipine/Procardia - your experiences?
: ann003 January 31, 2013 at 11:57 AM
I'm still on Procardia (31w1d), but here is my input:

1. How many weeks pregnant were you when you were first prescribed it, and how long did you take it?  28w, told to take it as needed since my contractions come and go (but can be rather strong).  I'm still taking it. 

2. When did you end up delivering your baby?  n/a

3.  Why were you prescribed it?  Were you already having lots of contractions, or was it a preventative measure because you had previous preterm births?  I have an irritable uterus and my cervix has shortened to 2.8 cm.  I kept going in to L&D, but for the most part my contractions weren't productive.  However, my contractions were strong and consistent.   

4.  What dose were you given?  20 mg/4 hours or as needed

5.  Any other thoughts?  Because I only take it when I have contractions, I'm usually always laying down when I'm on it.  I'm definitely more cautious about getting up fast, etc.  I find that it gives me nausea, so I take it in conjunction with my Zofran.  Also, it causes constipation, so I've had to increase my dosage of stool softener.  But the Procardia works and it works fast, so it's worth it.