Procardia (Nifedipine) for Angina

Procardia (nifedipine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with certain types of angina, which is chest pain caused by reduced blood flow to the heart.

How Procardia Works and How It’s Taken

Procardia and Procardia XL contain nifedipine, a calcium channel blocker. Nifedipine reduces the movement of calcium into heart muscle and blood vessel muscle cells. This relaxes blood vessels, lowers blood pressure, and reduces the heart’s workload, although the exact way it relieves chronic stable angina is not fully known.

Doctors prescribe Procardia or Procardia XL when adults have chronic stable angina or vasospastic angina. Vasospastic angina happens when a heart artery suddenly tightens or spasms. For chronic stable angina, these medicines may be used when beta-blockers or nitrates do not control symptoms or cannot be tolerated.

Procardia comes as an immediate-release soft gelatin capsule that is usually taken 3 times daily. The capsule should be swallowed whole.

Procardia XL comes as an extended-release tablet. Swallow the tablet whole, and do not chew, crush, bite, or divide it. The empty tablet shell may appear in the stool after the medicine has been released, which is expected.

Typical Dosing for Angina

Procardia immediate-release capsules

The recommended starting dose is one 10-milligram capsule by mouth 3 times daily.

The usual effective dose is 10 milligrams to 20 milligrams 3 times daily. Some people may need 20 milligrams to 30 milligrams 3 or 4 times daily.

Doses above 120 milligrams per day are rarely needed. More than 180 milligrams per day is not recommended. A single dose should rarely be more than 30 milligrams.

Procardia XL extended-release tablets

Treatment for angina usually starts with 30 milligrams or 60 milligrams once daily.

The dose is generally adjusted over 7 to 14 days so the doctor can check symptoms and blood pressure. Doses above 120 milligrams daily are not recommended. Experience with doses above 90 milligrams in people with angina is limited, so higher doses should be used carefully and only when medically needed.

When either medicine is stopped, the dose should generally be lowered gradually under a doctor’s supervision.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Procardia Side Effects

In controlled clinical studies of Procardia, the following side effects occurred in about 6 percent to 27 percent of people:

Dizziness or lightheadedness
Flushing or feeling warm
Headache
Weakness
Nausea or heartburn
Muscle cramps or tremor
Peripheral edema (swelling in the legs, ankles, or feet)
Nervousness or mood changes
Palpitations (feeling like your heart is racing or pounding)
Dyspnea (shortness of breath), cough, or wheezing
Nasal congestion or sore throat

In clinical studies of Procardia XL, peripheral edema occurred in about 10 percent to 30 percent of people, depending on the dose. Other common side effects included:

Headache
Fatigue
Dizziness
Constipation
Nausea

Serious Side Effects and Warnings

Procardia can cause serious side effects that may require immediate medical attention. These include:

Severe hypotension (low blood pressure) — Blood pressure can drop too much, especially when starting Procardia or after a dose increase.
Worsening angina or myocardial infarction (heart attack) — Chest pain can increase, or a heart attack can occur when starting Procardia or after a dose increase.
Congestive heart failure or pulmonary edema (fluid in the lungs) — These problems can cause worsening shortness of breath.
Syncope (fainting) — This most often occurs when first starting Procardia or after a dose increase.
Severe allergic reaction — Angioedema can cause swelling of the face, mouth, or throat and may make it hard to breathe.
Blood cell problems — Low platelets, anemia, or low white blood cells can increase the risk of bleeding or infection.
Allergic hepatitis — An allergic reaction can cause liver injury.
Serious heart rhythm or conduction problems — Ventricular arrhythmias or conduction disturbances can occur.
Vision loss — Temporary loss of vision has been reported.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Procardia

Procardia and Procardia XL do not require routine laboratory testing before starting treatment. Your doctor will check your blood pressure and may order blood, liver, kidney, digoxin, or clotting tests based on your health conditions and other medicines.

Tell your doctor if you have any allergies to nifedipine or any ingredients in Procardia or Procardia XL.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Avoid grapefruit and grapefruit juice while taking Procardia or Procardia XL. Grapefruit can raise the amount of nifedipine in your body.

Procardia can cause a serious drop in blood pressure, especially when treatment starts or the dose is increased. Immediate-release Procardia capsules should not be used within the first one to two weeks after a heart attack or during acute coronary syndrome.

Do not take Procardia or Procardia XL if you have had a serious allergic reaction to nifedipine or any of their ingredients.

Procardia XL is also FDA-approved to treat hypertension in adults.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Procardia, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective are Procardia and Procardia XL for angina?

In controlled studies lasting up to eight weeks, Procardia and Procardia XL reduced how often chronic stable angina occurred and helped people exercise longer.

They are also used for vasospastic angina, which happens when a coronary artery tightens or spasms. Procardia helps relax these arteries and prevent the spasm.

The prescribing information says that long-term safety and continued effectiveness for chronic stable angina have not been fully confirmed.

Can Procardia and Procardia XL be used with other medicines for heart disease?

Procardia and Procardia XL may be used with some other medicines for angina, but certain combinations need close monitoring.

They may be taken with long-acting nitrates. However, controlled studies have not confirmed how well this combination works for angina.

Sublingual nitroglycerin may be used as needed for sudden angina symptoms, especially while the Procardia dose is being adjusted.

When Procardia is used with a beta-blocker, some people may experience severe low blood pressure, worsening angina, or heart failure. A doctor should monitor blood pressure closely.

Procardia may also affect digoxin levels. Digoxin levels should be checked when Procardia is started, changed, or stopped.

How long do Procardia and Procardia XL take to work for heart disease?

Procardia can be detected in the blood about 10 minutes after a dose. Blood levels peak in about 30 minutes.

Procardia XL releases the medicine slowly. Blood levels rise over several hours and reach a plateau about six hours after the first dose. Steady-state levels are reached by the second day of daily dosing.

The prescribing information does not state exactly how soon angina symptoms will improve.

Doctors usually adjust the dose over 7 to 14 days while checking symptoms and blood pressure. In hospitalized people who are monitored closely, immediate-release Procardia may be increased more quickly.