Nisoldipine Explained

Nisoldipine is a pharmaceutical drug used for the treatment of chronic angina pectoris and hypertension. It is a calcium channel blocker of the dihydropyridine class. It is sold in the United States under the proprietary name Sular. Nisoldipine has tropism for cardiac blood vessels.^[1]

It was patented in 1975 and approved for medical use in 1990.^[2]

Contraindications

Nisoldipine is contraindicated in people with cardiogenic shock, unstable angina, myocardial infarction, and during pregnancy and lactation.^[3]

Adverse effects

Common side effects are headache, confusion, fast heartbeat, and edema. Hypersensitivity reactions are rare and include angioedema.

Interactions

The substance is metabolized by the liver enzyme CYP3A4. Consequently, CYP3A4 inducers such as rifampicin or carbamazepine could reduce the effectiveness of nisoldipine, while CYP3A4 inhibitors such as ketoconazole increase the amount of nisoldipine in the body more than 20-fold. Grapefruit juice also increases nisoldipine concentrations by inhibiting CYP3A4.

Pharmacology

Mechanism of action

Nisoldipine is a calcium channel blocker that selectively inhibits L-type calcium channels.

Further reading

• Mielcarek J, Grobelny P, Szamburska O . The effect of beta-carotene on the photostability of nisoldipine . Methods and Findings in Experimental and Clinical Pharmacology . 27 . 3 . 167–171 . April 2005 . 15834448 . 10.1358/mf.2005.27.3.890873 .
• Missan S, Zhabyeyev P, Dyachok O, Jones SE, McDonald TF . Block of cardiac delayed-rectifier and inward-rectifier K+ currents by nisoldipine . British Journal of Pharmacology . 140 . 5 . 863–870 . November 2003 . 14530219 . 1574108 . 10.1038/sj.bjp.0705518 .
• Hamilton SF, Houle LM, Thadani U . Rapid-release and coat-core formulations of nisoldipine in treatment of hypertension, angina, and heart failure . Heart Disease . 1 . 5 . 279–288 . 1999 . 11720635 .

Notes and References

1. Knorr AM . Why is nisoldipine a specific agent in ischemic left ventricular dysfunction? . The American Journal of Cardiology . 75 . 13 . 36E–40E . April 1995 . 7726122 . 10.1016/S0002-9149(99)80446-9 .
2. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 464 . en.
3. Book: Austria-Codex. Syscor 5 mg-Filmtabletten. Haberfeld H . Österreichischer Apothekerverlag . Vienna . 2019 . de.