Talk:Nifedipine

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Male Contraceptive Effects

Nifedipine and other calcium-channel blockers may interfere with the normal development of sperm, potentially reducing the fertility of men who take it. It has been studied by at least one researcher as a potential reversible male contraceptive, [1] however, it is not being actively pursued as a contraceptive by any major pharmaceutical companies, possibly because of perceptions that publicizing its contraceptive effects would negatively impact sales as a blood-pressure medication, or because an expired patent and the availability of inexpensive generics makes research into new uses an unappealing financial prospect.[2]

At least one case of possible Nifedipine-induced infertility has been reported in the literature. [3].

Couples who are having difficulty conceiving should consult their doctor if the man is taking nifedipine.

The apparent contraceptive mechanism is an inhibition of the normal mannose lectin coating of the spermatozoa's outer membrane; this coating is necessary for correct binding with the egg. This may be caused when a greater-than-normal amount of cholesterol is integrated into the membrane, stiffening the membrane and preventing normal outward migration of mannose from the interior.^[1]^[2]

This is completely disproportionate to the rest of the article. One researcher pushing it and one case report on infertility make this too obscure for a general encyclopedia. JFW | T@lk 22:54, 10 October 2006 (UTC)[reply]

I don't think it was right to remove this. Safety warnings are of the utmost importance. --IO Device (talk) 22:10, 22 March 2009 (UTC)[reply]

Well, i came here looked specifically for this information... and despite a passing familiarity with mediawiki, i am not a wikipedian. To me, at least, this is a highly relevant section. 66.173.237.26 (talk) 03:26, 17 July 2011 (UTC)[reply]

References

^ Goodwin, LO, NB Leeds, I Hurley, FS Mandel, RG Pergolissi and S Benoff (1997) “Isolation and characterization of the primary structure of testis-specific L-type calcium channel: implications for contraception.” Molecular Human Reproduction 3(3): 255-68.
^ Benoff, S (1998) “Voltage dependent calcium channels in mammalian spermatozoa.” Frontiers in Bioscience 3: D1220-40.

[Dosing/off-label]

Tocolysis for pregnancy is an off-label use, not a dosage.—Preceding unsigned comment added by 63.165.50.227 (talk) 20:47, 20 January 2009 (UTC)[reply]

This medication is deadly if taken in overdose. It should be kept out of the reach of children and anyone suspested of being depressed or suicidal. —Preceding unsigned comment added by 108.3.64.13 (talk) 16:13, 10 January 2010 (UTC)[reply]

procardia xl

Could someone mention Procardia XL dosage form release mechanism. Specifically that it is a plastic shell with a small opening that lets the drug out slowly. This is important since the nifedipine is released later and over a different kinetic time period. Also the shell can form a pseudobezoar within the patient. --74.179.121.14 (talk) 16:15, 10 April 2011 (UTC) Procardia XL is an osmotic push-pull system. See Wikipedia "Osmotic controlled-release oral delivery system" or abbreviated OROS for an explanation. Because the shell of the system cannot be digested and is emptying within about 24h, it can in rare cases be collected in the stomach. The stomach has an sphincter muscle that is controlling the food and liquid transport to the small intestine. Larger bodies like the empty OROS shell may not pass this sphincter. This empty shell is called a bezoar. dieter.e.becker@gmail.com[reply]

cyp3a4 inhibitor???

Is this drug a cyp3a4 inhibitor? I know it is a substrate, but data on whether or not is inhibits said enzyme is contradictory at best. I know it could THEROTICALLY produce inhibition via competing with other drugs for the limited enzyme, but does this translate to having any useful inhibtion activity, and if so would it be worth taking as a inhibitor??? — Preceding unsigned comment added by 24.98.250.155 (talk) 23:18, 14 September 2011 (UTC)[reply]

Mechanism of action

The following was added by Herizora‎:

“

As a calcium channel blocker, nifedipine is expected to inhibit the currents of L-type Cav1.3 channels in the zona glomerulosa of the adrenal, reducing aldosterone production and corroborating to lower blood pressure.^[1]^[2]

”

It contains only primary sources, and the titles of the journal articles don't give the impression that they are primarily about the mechanism of nifedipine. I would recommend WP:MEDRS-compatible secondary sources in the first instance. JFW | T@lk 22:11, 26 October 2014 (UTC)[reply]

Seriously? You base your judgement on the TITLES of research articles?

The TITLES of the journal articles? Seriously? This Jfdwolff guy didn't even read the actual research. Anyone can write a book (your secondary resources) and write whatever they like in it. Now talk about peer reviewed scientific articles. Take the time to read these references, if reading will actually make you understand what is written in them. If you can actually understand something that is not the instructions manual of Wikipedia, which I do believe you can't. Herizora (talk) 22:45, 26 October 2014 (UTC)[reply]

Herizora Please don't attack the messenger. Have you read WP:MEDRS? It is quite specific about the importance of using secondary sources. Many primary research studies cannot be replicated (even those published in Nature cannot always be replicated, see doi:10.1038/496398a). JFW | T@lk 08:46, 28 October 2014 (UTC)[reply]

Jfdwolff I do understand your point. However it doesn't change the fact that you based your judgement on the titles of the research papers alone. Sorry, but I am afraid that's rather obtuse. Regards. Herizora (talk) 10:24, 28 October 2014 (UTC)[reply]

Herizora I agree in principle that it is much better to review the entire article. However, I don't always have access to the full text and it is generally not difficult to distinguish on the basis of more limited information alone.

I see that most of the additions are based on your PhD work. I really do hope that I can convince you to stick around and contribute further within the constraints of our policies. JFW | T@lk 11:51, 28 October 2014 (UTC)[reply]

Jfdwolff Thanks for your response. I would like to share the information for the general public. That's it. But I believe it's not possible with the current policy of Wikipedia. Herizora (talk) 12:40, 28 October 2014 (UTC)[reply]

Herizora No, it is generally not possible to use Wikipedia to share recent research findings with the general public. JFW | T@lk 13:07, 28 October 2014 (UTC)[reply]

Jfdwolff Although I did not take the trouble of adding the reference, the suggestions that nifedipine and other calcium channel blockers can reduce aldosterone levels in human subjects has been published by several groups as far as 1998 (16 years). It is possible to google it up, but then the title of the research papers may not give you the right clue about the contents. Herizora (talk) 13:14, 28 October 2014 (UTC)[reply]

Herizora I accept that I might have been able to find a suitable secondary source in the fulltext of the papers cited. Could I suggest that you identify the best source (per WP:MEDRS) and add it to the article? JFW | T@lk 13:23, 28 October 2014 (UTC)[reply]

Jfdwolff I will try to find a suitable reference, or an acceptable collection of references including review articles, and then try to add the relevant information to the article. Please make sure to watch it. Herizora (talk) 13:39, 28 October 2014 (UTC)[reply]

References

^ Azizan EA, Poulsen H, Tuluc P, Zhou J, Clausen MV, Lieb A, Maniero C, Garg S, Bochukova EG, Zhao W, Shaikh LH, Brighton CA, Teo AE, Davenport AP, Dekkers T, Tops B, Küsters B, Ceral J, Yeo GS, Neogi SG, McFarlane I, Rosenfeld N, Marass F, Hadfield J, Margas W, Chaggar K, Solar M, Deinum J, Dolphin AC, Farooqi IS, Striessnig J, Nissen P, Brown MJ. (2013). "Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension". Nature Genetics. 45 (9): 1055–1060. doi:10.1038/ng.2716. PMID 23913004.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Felizola SJA, Maekawa T, Nakamura Y, Satoh F, Ono Y, Kikuchi K, Aritomi S, Ikeda K, Yoshimura M, Tojo K, Sasano H. (2014). "Voltage-gated calcium channels in the human adrenal and primary aldosteronism". J Steroid Biochem Mol Biol. 144 (part B): 410–416. doi:10.1016/j.jsbmb.2014.08.012. PMID 25151951.{{cite journal}}: CS1 maint: multiple names: authors list (link)

GITS

PMID 19475779 is a review of the GITS system. 2009. A secondary source. JFW | T@lk 23:51, 17 November 2014 (UTC)[reply]

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Hypertensive emergencies

Citing "Medical uses" > "High blood pressure" > 2nd paragraph:

Sublingual administration of nifedipine promotes a hypotensive effect via peripheral vasodilation. It can cause an uncontrollable decrease in blood pressure, reflex tachycardia, and a steal phenomenon in certain vascular beds. There have been multiple reports in the medical literature of serious adverse effects with sublingual nifedipine, including cerebral ischemia/infarction, myocardial infarction, complete heart block, and death.

Citing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552217/ > heading "Discussion" > 2nd paragraph:

Sublingual nifedipine causes blood-pressure lowering through a peripheral vasodilation. It can cause an uncontrollable decrease in the blood pressure, reflex tachycardia, and a steal phenomenon in certain vascular beds. There have been multiple reports in the medical literature of serious adverse effects with sublingual nifedipine, which include cerebral ischaemia/infarction, myocardial infarction, complete heart block and death.

These passages are virtually identical. So, who copied who?

I found this post to dr-bob.org from June 14, 2008. It cites an article from Medscape.com dated December 02, 2002. -- Mentropane (talk) 06:42, 28 November 2019 (UTC)[reply]

Moreover, this "steal phenomenon" requires further explanation.

Furthermore, there are sources suggesting that nifedipine is a suitable choice of drug for treating hypertensive emergencies: <https://www.bmj.com/content/286/6358/19>. According to this article, nifedipine typically improves cerebral blood flow.

-- Mentropane (talk) 03:04, 28 November 2019 (UTC)[reply]

[1] Goodwin, LO, NB Leeds, I Hurley, FS Mandel, RG Pergolissi and S Benoff (1997) “Isolation and characterization of the primary structure of testis-specific L-type calcium channel: implications for contraception.” Molecular Human Reproduction 3(3): 255-68.

[2] Benoff, S (1998) “Voltage dependent calcium channels in mammalian spermatozoa.” Frontiers in Bioscience 3: D1220-40.

[Azizan-3] Azizan EA, Poulsen H, Tuluc P, Zhou J, Clausen MV, Lieb A, Maniero C, Garg S, Bochukova EG, Zhao W, Shaikh LH, Brighton CA, Teo AE, Davenport AP, Dekkers T, Tops B, Küsters B, Ceral J, Yeo GS, Neogi SG, McFarlane I, Rosenfeld N, Marass F, Hadfield J, Margas W, Chaggar K, Solar M, Deinum J, Dolphin AC, Farooqi IS, Striessnig J, Nissen P, Brown MJ. (2013). "Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension". Nature Genetics. 45 (9): 1055–1060. doi:10.1038/ng.2716. PMID 23913004.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[Felizola-4] Felizola SJA, Maekawa T, Nakamura Y, Satoh F, Ono Y, Kikuchi K, Aritomi S, Ikeda K, Yoshimura M, Tojo K, Sasano H. (2014). "Voltage-gated calcium channels in the human adrenal and primary aldosteronism". J Steroid Biochem Mol Biol. 144 (part B): 410–416. doi:10.1016/j.jsbmb.2014.08.012. PMID 25151951.{{cite journal}}: CS1 maint: multiple names: authors list (link)

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