- With the simultaneous use of other antihypertensive drugs,as well as tricyclic antidepressants, nitrates, cimetidine inhalational anesthetics, diuretics, the hypotensive effect of nifedipine may be enhanced.
- The blockers of "slow" calcium channels can further increase the negative inotropic effect of antiarrhythmics such as amiodarone and quinidine.
- When combining nifedipine with nitrates, tachycardia increases.
- Diltiazem inhibits the metabolism of nifedipine in the body, which may require the simultaneous administration of these drugs to reduce the dose of nifedipine.
- Reduces the concentration of quinidine in the blood plasma.
- Increases the concentration of digoxin and theophylline in the blood plasma.
- Rifampicin accelerates the metabolism of nifedipine, joint use is not recommended.
- With concomitant administration with cephalosporins (eg, cefixime) can increase the bioavailability of cephalosporins by 70%.
- Sympathomimetics, non-steroidal anti-inflammatory drugs (suppression of prostaglandin synthesis in the kidneys and retention of sodium and liquid ions in the body), estrogens (fluid retention in the body) reduce the hypotensive effect.
- Nifedipine can displace from the bond with proteins preparations with a high degree of binding (including indirect anticoagulants - coumarin derivatives and. indandion, anticonvulsant, non-steroidal anti-inflammatory drugs, quinine, salicylates, sulfinpyrazone), so that their concentration in the blood plasma can increase.
- Nifedipine inhibits the metabolism of prazosin and other alpha-adrenoblockers, which can lead to an increase in the hypotensive effect.
- If necessary, the dose of vincristine is reduced, because nifedipine inhibits its removal from the body, which can cause increased side effects.
- Lithium preparations can enhance toxic effects (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).
- With the simultaneous administration of procainamide, quinidine and other drugs that cause lengthening of the interval QT, risk of significant lengthening of the interval QT increases.
- Grapefruit juice inhibits the metabolism of nifedipine in the body, so it is contraindicated during treatment with nifedipine.
- Nifedipine is metabolized by the cytochrome P450 3A system, so the simultaneous use of drugs that inhibit this system,may lead to the interaction of this drug and nifedipine: for example, macrolides, antiviral drugs (for example, amprenavir, indinavir, nelfinavir, ritonavir or saquinavir); antifungal agents of the azole group (ketoconazole, itraconazole or fluconazole) cause an increase in the concentration of nifedipine in the blood plasma.
- Taking into account the experience of using BIMC nimodipine, it is impossible to exclude similar interactions with nifedipine: carbamazepine, phenobarbital can cause a decrease in the concentration of nifedipine in blood plasma; a valproic acid - Increase in the concentration of nifedipine in blood plasma.