nisoldipine

CLINICAL USE

Calcium-channel blocker:Hypertension Angina

DOSE IN NORMAL RENAL FUNCTION

10–40 mg daily (varies, depending on indication)

PHARMACOKINETICS

Molecular weight :388.4

%Protein binding :>99

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :2.3–7.1

half-life – normal/ESRD (hrs) :7–12/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Not dialysed. Dose as in normal renal function

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anaesthetics: enhanced hypotensive effect

Antibacterials: metabolism accelerated by rifampicin

Anti-epileptics: concentration reduced by phenytoin and possibly carbamazepine, barbiturates and primidone

Antifungals: metabolism possibly inhibited by itraconazole and ketoconazole avoid; avoid with fluconazoleAntihypertensives: enhanced hypotensive effect, increased risk of first-dose hypotensive effect of post-synaptic alpha-blockers; occasionally severe hypotension and heart failure with beta-blockers

Antivirals: concentration possibly increased by ritonavir

Grapefruit juice: concentration increased – avoid concomitant useTheophylline: possibly increased theophylline concentration

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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