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Author Topic: Can anyone tell me about Nifedipine (Procardia)?  (Read 9605 times)

Alice

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Can anyone tell me about Nifedipine (Procardia)?
« on: May 31, 2011 at 07:54 PM »
Hi,

I'm in the UK and want to find out about nifedipine/Procardia for preventing preterm labour.  I get the impression it's used in the US and Canada but less so over here.  Can anyone tell me about their experiences?  Such as:

At what point were you prescribed it?

Did you have it in hospital or were you given tablets to take at home?

Did it stop your contractions?

Did it have any side effects?

All info much appreciated.
Lost beloved twin boys at 2 days, and one month, after preterm delivery at 27+4 in September 2010 and appalling medical care.

Healthy baby boy arrived at 33 weeks in July 2011 and is doing really well.

Angela

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #1 on: May 31, 2011 at 11:04 PM »
Hi, Alice!

Have you checked out our page about treatment options for preventing and treating preterm labor? It mentions Nifedipene/Procardia. http://www.keepemcookin.com/prevention.aspx

In the meantime, I'll share my experiences with it. I know we have other ladies here who are on it currently, and hopefully they can share their experiences too.

At what point were you prescribed it?
At 24 weeks, with increases in the dosage amount or the frequency every 3 to 4 weeks.

Did you have it in hospital or were you given tablets to take at home?
They monitored me on it at the hospital for two days, and then I went home with a prescription.

Did it stop your contractions?
Yes, it really did limit them. If my bladder was full or I got up too quickly I'd have a few contractions, but that is typical. It did seem though that my body would adjust to the dose, and then I'd have another episode of preterm labor, and we'd increased either the dose or the frequency.

Did it have any side effects?
I'd feel kind of zombie-like. Walking around but not totally with it. Not as alert, I guess is how I should describe it. It can make your blood pressure especially low, so it needs to be monitored regularly.

Ladies: Can you all offer your experiences?

mckoygirl

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #2 on: May 31, 2011 at 11:36 PM »
I've included a link to a resourceful website with multiple different preterm labor medications, procardia/nifidipine being one.

http://www.marchofdimes.com/pregnancy/pretermlabor_drugs.html

Initially I was in the hospital and was prescribed brethine/terbutaline (now not recommended long term for preterm labor due to complications to us mothers), and indocin (also only recommended for a short time). At a follow up appointment they switched me to procardia.
I was put on procardia around 19 weeks, 10mg every 8hours initially, they increased that to every 4-6 hours later. It did help my contractions considerably. The drug wasn't originally designed for preterm labor, it is a calcium channel blocker used to decrease blood pressure. Due to this, it has side effects that reflect low blood pressure and vasodilation such as: facial flushing, hot flashes, peripheral edema (swelling in your feet/hands), increased heart rate and strength (you may feel as if your heart is bounding/pounding and at a rapid rate). I already have low blood pressure so I had to be very careful because I would feel faint and nearly pass out if I was up for just a few minutes. I never felt "zombie-like" as Angela describes, but I assume that's from the low blood pressure. I just felt weak or faint. The facial flushing was pretty intense, my cheeks would burn and flare as if I was sunburned. Small price to pay for stopping the contractions though! I would notice when it was getting close to time for my next dose, I would start contracting more, so that's why they increased the dosage.

I just was going to add: occasionally if I had to take it more (4-6hrs), it would trigger a headache as well.
« Last Edit: May 31, 2011 at 11:39 PM by mckoygirl »
Due date: 7/7/2011
Twins (we're not finding out the sexes!)
5th pregnancy (5yrs old-put on bedrest with her @ 35wks for PIH)
3 previous losses
Put on bedrest this pregnancy @ 17weeks for Cervical shortening & preterm labor
Thanking God for each day I'm given with my twins!

HeatherGayle

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #3 on: May 31, 2011 at 11:37 PM »
I have been prescribed Nifedipine extended-release tablets Bayer Standard, which goes by Adalat XL. The box says it is an antihypertensive/anti-anginal agent. I take it to lower my chronic hypertension. I do not have contractions or pre-term labour issues. I was initially prescribed Labetalol, but those side effects were too much to bear.


At what point were you prescribed it? I was prescribed Labetalol at 11 weeks, and then switched to Adalat a few weeks later.

Did you have it in hospital or were you given tablets to take at home? I was prescribed it by my obgyn.

Did it stop your contractions? n/a

Did it have any side effects? I seem to get headaches, dizziness, nausea, but that may be from the hypertension itself. One thing this medicine helped with was angina. It isn't as troublesome now.

I hope that helps!


threacatcher

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #4 on: May 31, 2011 at 11:38 PM »
Hi Alice!

At what point were you prescribed it?
I was prescribed it at 28 weeks to stop contractions 2 minutes apart. And yesterday (30 weeks and 3 days) to once again stop contractions.

Did you have it in hospital or were you given tablets to take at home?
I was given it in the hospital. My doctor is really wary about giving me medication to stop contractions without doctoral supervision.
Did it stop your contractions?
It stopped my contractions for about 8 hours so I could get some sleep. I have been having contractions at 4 minutes apart for a few weeks now, so having a good solid chunk of contractionless sleep was a God send.
Did it have any side effects?
It makes me throw up and have diarrhea the day after. I also feel dizzy and sluggish. But a lot of medications do this to me. My body doesn't like foreign substances.  :P
On bedrest for 26 weeks, Linnea Rose Thyme Manchester born 08/05/11.

On bedrest with baby #2 due 10/6/12.

sarahker

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #5 on: June 01, 2011 at 08:18 AM »
Hi Alice,
I'm 27w5d pregnant with twin boys, and I've been on hospital bedrest for he past 3.5 weeks for shortened cervix and contractions. When I was first admitted to the hospital I was given a shot of terbutaline to stop the contractions, and I've been on a maintenance dose of nifedipene (20mg, every 6 hours) ever since then.  It seems to really work to stop the contractions, and I've noticed that if the nurses are very late in bringing it to me (which happens more than you'd think), I have "break through" contractions between doses.  I have talked to my physicians about the possibility of going home in a few weeks, and it sounds likely that I would be given a prescription for nifedipene to take at home as well. 

I'd be happy to answer any other questions you have. 

Best,

Sarahker

Angela

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #6 on: June 01, 2011 at 10:37 AM »
Hi, Alice. I posted your question on the KeepEmCookin Facebook page too, and here are the responses:

Ramina said:
I took nifidepine from 21 wks until my daughter was born at 32.5. I took it every 4 hrs and it seemed to work great for me. Didn't notice any side effects. Good luck! Oh and yes, I was in the hospital.

Kimberly said:
I took it through the end of my 2nd pregnancy and am still taking it now. 19 months post partum!

Clementine said:
They gave it to me when i was on hospital bedrest. however it did make my blood pressure drop so they had to keep a close eye on me and did not give it to me to take home. i do believe it helped keep anthony cooking longer as that was from 27 - 29 weeks pregnant and i am now 36 weeks and still cooking.

Alice

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #7 on: June 01, 2011 at 12:12 PM »
Thank you Angela, Mckoygirl, Sarahker, Threacatcher, and HeatherGayle.   It's so great to be able to get the benefit of people's experiences on this forum.

I spoke to my doctor about nifedipine today and the response was frustrating.  She said they don't use nifedipine and are extremely cautious in their use of tocolytics in general because it's not clear that they don't do more harm than good.  Her point was this: they had previously had some success in delaying labour by giving women antibiotics, only to find when they followed up the children at the age of 7 that they were doing worse than the ones who had not had labour delayed with antibiotics, with more instances of things like cerebral palsy.  They reasoned that even though they could control the inflammatory processes contributing to labour, it was more harmful to babies to be kept longer in a sub-optimal uterine environment than to be born prematurely.  This has made them wary of anything that delays premature labour, including progesterone (which I am now taking in pessary form having obtained it from another doctor despite the fact that my hospital, one of the top research hospitals in London, UCLH, is only using it in a trial in which you may end up in the placebo group).

I understand their caution to some extent, but it doesn't make sense to me that they are prioritising the unknown possible theoretical risks of these drugs above the known and serious risks of prematurity, which include death and disability.

However, I do not have the option to change hospital as I need to deliver in one with a level 3 neonatal ICU so it looks as though nifedipine will not be an option for me whatever happens. :(
Lost beloved twin boys at 2 days, and one month, after preterm delivery at 27+4 in September 2010 and appalling medical care.

Healthy baby boy arrived at 33 weeks in July 2011 and is doing really well.

mckoygirl

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Re: Can anyone tell me about Nifedipine (Procardia)?
« Reply #8 on: June 01, 2011 at 03:25 PM »
Alice- I am sorry they aren't more responsive to your concerns. Yes, it would make more sense to start with the known versus the unknown risks. I know our physicians here frequently prescribe procardia by mouth for women experiencing preterm labor, and any risk to the infant has yet to be proven long-term. Terbutaline was used also for a while as a labor suppressant, but was recently recommended by the FDA as short-term use only due to the possible maternal complications of long term use. Some would argue a drug is a drug, but antibiotics are totally different medications from Calcium-channel blockers. I wonder what part of the results from that study were from the antibiotic itself, or from the delay of labor?
 I guess they have a totally different attitude in the UK about healthcare than we do. Most physicians here are much more concerned with the patient's requests (often doing what the patients ask-such as prescribing procardia if they want it), and of course documenting if they counseled the patient against a treatment but the patient still insists. In other words- the patients have much more say in their care. Who knows... after socialized medicine hits us (as it will soon), we may be much worse off in the long run.  :-\

I'm sorry there aren't a lot of options hospital-wise, but it's good you are able to have a level 3 NICU available to you, regardless. I live in Georgia near Atlanta and we have North Side hospital which is the number 1 baby factory in the United States (more than 18,000 deliveries a year). The hospital I'm planning on delivering at is only a level 2 (also where I work), but since I've past the 34 week mark, hopefully we will be able to deliver there and keep the babies with us.

I visited London for the second time this past summer and fell completely in love with it! My husband travels with work and let me accompany him on a business trip. We stayed in the Marble Arch area (couldn't believe how heavily populated by Muslims it was! I was in the minority without a burka!) and I must have walked 8-10 miles a day, every day for a week. I finally conquered the Underground after blistering my feet beyond recognition. We've both discussed moving there if he ever gets a decent job offer.  :)
Due date: 7/7/2011
Twins (we're not finding out the sexes!)
5th pregnancy (5yrs old-put on bedrest with her @ 35wks for PIH)
3 previous losses
Put on bedrest this pregnancy @ 17weeks for Cervical shortening & preterm labor
Thanking God for each day I'm given with my twins!