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The following safety information outlines potential risks and precautions related to the use of nifedipine ER (Procardia XL). It is important to review these details and consult with your healthcare provider if you have any questions or concerns.

• Low Blood Pressure: This medication may cause a decrease in blood pressure, which can lead to dizziness and other side effects, particularly when starting the treatment or increasing the dosage. If you are sensitive to low blood pressure, avoid rapid changes in position, such as standing up quickly. Those taking beta-blockers should be particularly cautious.

• Worsening Chest Pain or Heart Attack: In rare cases, individuals with severe coronary artery disease may experience aggravated chest pain or even a heart attack, especially when beginning treatment or increasing the dose. Seek immediate medical attention if you experience severe chest pain, jaw pain, or a racing heartbeat. This risk is heightened for those who suddenly stop taking beta-blockers before starting nifedipine ER.

• Heart Failure: Nifedipine ER may rarely lead to heart failure, particularly in patients taking beta-blockers or those with aortic stenosis. Be alert to symptoms such as unexpected weight gain, difficulty breathing when lying down, or leg and foot swelling. These may also indicate heart failure, so regular monitoring by your provider is advised.

• Leg and Foot Swelling: Swelling is a common side effect, typically at higher doses. While often harmless, inform your healthcare provider if it becomes troublesome. Also, as swelling can signal heart failure, regular follow-ups are recommended.

• Stomach or Intestinal Injury: Rarely, nifedipine ER can cause blockages or ulcers in the digestive tract, possibly necessitating surgery. Individuals with a history of intestinal problems should discuss this with their provider prior to starting the medication. Contact your provider if you experience persistent stomach pain, bloating, or difficulty with bowel movements.

Please ensure regular consultations with your healthcare provider to manage these risks and to maintain overall health.

When taking this medication, some individuals may experience common side effects, such as headaches, dizziness, nausea, flushing, and fatigue. These effects are generally mild and often improve over time. Swelling, or edema, in the legs, feet, or hands is relatively common and may occur in some users. Constipation and leg or muscle cramps have also been reported. If any of these effects persist or worsen, it's important to consult your healthcare provider for guidance.

There are also some less common but potentially severe side effects to be aware of. These include swelling of the ankles or feet, shortness of breath, unusual weakness or tiredness, irregular or racing heartbeat, and fainting. Some individuals may experience mental or mood changes, swollen or tender gums, vision changes, or severe constipation and abdominal pain. In rare cases, symptoms of a heart attack, such as chest pain, shortness of breath, or unusual sweating, may occur, particularly in those with pre-existing severe heart disease. Immediate medical attention is necessary if these symptoms arise.

Although rare, serious allergic reactions can occur. Symptoms include rash, itching or swelling, particularly of the face, tongue, or throat, severe dizziness, and trouble breathing. Should you experience any signs of an allergic reaction, seek medical help immediately. If you notice any other unusual effects, reach out to your healthcare provider. Remember, while side effects are possible, they are not experienced by everyone and are often manageable with proper medical advice.

Nifedipine, a medication used for heart conditions, can interact with various drugs, which might impact its effectiveness. Certain medicines, such as apalutamide, enzalutamide, mitotane, St. John's wort, and rifamycins (like rifabutin and rifampin), may alter how nifedipine is eliminated from your body. Additionally, drugs used to manage seizures, including carbamazepine, phenobarbital, and phenytoin, can also affect nifedipine's performance.

It is crucial to inform your healthcare provider about all other medications and supplements you are taking, including over-the-counter products, vitamins, and herbal supplements. Some medications may not be recommended for use with nifedipine unless necessary. These include abametapir, amobarbital, atazanavir, and many others. If both nifedipine and any of these drugs are necessary, your doctor might adjust the dosage or frequency of use.

Furthermore, combining nifedipine with certain medications like cimetidine, ginkgo, or magnesium may heighten the risk of side effects. Your healthcare provider will decide if the benefits outweigh the risks and may modify your treatment plan accordingly. Always discuss with your pharmacist or doctor how to use all your medications safely, especially if you're using cough-and-cold products, diet aids, or NSAIDs like ibuprofen or naproxen.