Nisoldipine

SULAR

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Pronunciation: NYE-soel-di-peen

Nisoldipine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Nisoldipine ballicule

What it isVascular L-type calcium-channel blocker; hypertension.

Why this oneIts pronounced food effect makes administration less forgiving than amlodipine and helps explain its marginal role.

What limits itPeripheral edema and reflex tachycardia limit use; grapefruit can further raise exposure.

Nisoldipine molecular structure (skeletal formula) — Molecular structure: Nisoldipine

FDA-approved for

hypertension (1995)

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Hypertension	Adults	17 mg QD	17-34 mg QD	34 mg QD
Hypertension	Age >65 or hepatic impairment	≤8.5 mg QD	titrate to BP	34 mg QD

Titration ≥1 week between dose increases (increase by 8.5 mg)

Renal Undefined

Hepatic Impaired hepatic function: start ≤8.5 mg QD; monitor BP closely during titration

Instructions

Take on an empty stomach (1 h before or 2 h after a meal)
Swallow whole; do not bite, divide, or crush
Avoid grapefruit products before and after dosing

Available strengths

ER tab 8.5, 17 mg

Cautions

Symptomatic hypotension, especially in elderly or hepatic impairment — monitor BP
Dose-related peripheral edema

Adverse reactions

Peripheral edema
Headache
Dizziness
Pharyngitis
Vasodilation
Palpitation

Pregnancy Category C; fetotoxic (not teratogenic) in animals at maternally toxic doses; use only if benefit justifies fetal risk

Lactation Undefined

Cost

Nisoldipine (SULAR)

Strength		#/mo	generic $/mo	CostPlus
8.5 mg	ER tab	30 qd		not offered
17 mg	ER tab	30 qd		out of stock

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Nisoldipine is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2008

NO BOXED WARNINGS

Principal riskPeripheral edema; food raises exposure

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger3 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilityHypotension and edema therapeutically; overdose can cause prolonged vasodilatory or cardiogenic shock.

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