Nifedipine

Nifedipine is a calcium channel blocker, a type of pharmaceutical that relaxes blood vessels so the heart does not have to pump as hard and increasing the supply of blood and oxygen to the heart. It is sold under the brand names Adalat CC, Afeditab CR, Nifedical XL, Nifeditab CR, Procardia, and Procardia XL. Nifedipine's main metabolite, Dehydronifedipine, has been found in sewage sludge.

Why It's Prescribed
Nifedipine is prescribed for patients with high blood pressure or angina (chest pain).

Labeled uses include: Hypertension.

Additionally, unlabeled uses include: Chronic Angina Pectoris, Prinzmetal Angina, Raynaud's Phenomenon.

Form, Route, and Dosage
Nifedipine is available as a capsule and an extended-release (long-acting) tablet to take orally. Nifedipine is available as a capsule in the strengths 10mg and 20mg. Additionally, it is available in an extended-release tablet in the strengths 30mg, 60mg, and 90mg. Typically, patients are prescribed no more than 120mg of nifedipine per day.

Side Effects
Some patients taking this medication might experience side effects, including:
 * headache
 * nausea
 * dizziness or lightheadedness
 * flushing (feeling of warmth)
 * heartburn
 * fast heartbeat
 * muscle cramps
 * constipation
 * cough
 * decreased sexual ability
 * swelling of the face, eyes, lips, tongue, hands, arms, feet, ankles, or lower legs
 * difficulty breathing or swallowing
 * fainting
 * rash
 * yellowing of the skin or eyes
 * increase in frequency or severity of chest pain (angina)

Overdoses
Patients may overdose on this medication if they take too much of it. Some symptoms of overdose include:
 * dizziness
 * fast heartbeat
 * flushing (feeling of warmth)
 * nervousness
 * nausea
 * vomiting
 * swelling of the hands, feet, ankles, or lower legs
 * blurred vision
 * fainting

As a Pollutant
Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.

In Sewage Sludge
Nifedipine's main metabolite, dehydronifedipine, has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found dehydronifedipine in 19 samples (23%) in concentrations ranging from 3.48 to 24.6 parts per billion. There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

In Drinking Water
An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it. Of those tested, Northern New Jersey and Tucson, AZ both tested positive for dehydronifedipine, the main metabolite of nifedipine.

Related SourceWatch articles

 * Biosolids
 * Sewage sludge
 * Food Rights Network
 * Pharmaceuticals