Procardia XL (Nifedipine) Oral: Uses, Side Effects - Verywell Health

What Is Procardia XL?

Procardia XL (nifedipine) is a prescription medication for high blood pressure and angina (chest pain). Procardia XL belongs to a group of drugs called calcium channel blockers. These drugs work by relaxing and widening your blood vessels, which helps lower blood pressure. They also improve chest pain by allowing more oxygen and blood to be delivered to your heart.

Procardia is available as an extended-release tablet and capsule.

Drug Facts

Generic Name: Nifedipine

Brand Name(s): Procardia XL

Drug Availability: Prescription

Therapeutic Classification: Dihydropyridine calcium channel blocker

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Nifedipine

Dosage Form(s): Extended-release tablet, capsule

What Is Procardia XL Used For?

The FDA has approved Procardia XL to treat high blood pressure (hypertension) and certain forms of chest pain (angina).

Your healthcare provider may prescribe Procardia XL alone or in combination with other medicines to help lower your blood pressure. Keeping your blood pressure in a healthy range can decrease your risk of a stroke or heart attack.

How to Take Procardia XL

Procardia XL is typically taken once per day. It is important to swallow the tablet whole without chewing, crushing, or cutting. Doing so could affect how fast Procardia XL is absorbed into your body and increase your risk of side effects.

Grapefruit juice can cause Procardia XL levels to become too high. Avoid eating grapefruits or drinking grapefruit juice while taking Procardia XL.

Storage

Store Procardia XL at room temperature, away from moisture and humidity.

Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the FDA's website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you travel with Procardia XL, get familiar with your final destination's regulations. Make sure to make a copy of your Procardia XL prescription. Keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

How Long Does Procardia XL Take to Work?

Procardia XL will begin to work the first day you start taking it. Your healthcare provider may slowly increase your dose over several weeks to find the best dose for you.

Off-Label Uses

Healthcare providers may prescribe medicines for conditions other than those approved by the FDA. This is called "off-label" use. Procardia XL may be used off-label to treat:

What Are the Side Effects of Procardia XL?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

You may experience side effects while taking Procardia XL. Let your healthcare provider know if you develop any side effects that bother you or don't go away. Common side effects include:

You may notice something that looks like a tablet in your stool. Don't worry—it's just an empty shell. Procardia XL contains a special shell that helps slowly release the medication into your body. After the medicine gets absorbed, the shell will pass through your body and into your stool. This is normal.

Severe Side Effects

In rare cases, Procardia XL may cause serious side effects. Call your healthcare provider right away if you develop any severe reactions. Call 911 if your symptoms feel life-threatening or you think you are having a medical emergency.

Serious side effects include:

• A fast or abnormal heartbeat 
• Fainting, passing out, or very bad dizziness 
• New or worsening chest pain 
• Severe constipation or stomach pain—these could be signs of a serious intestinal problem 
• Shortness of breath, a large weight gain, or swelling in your arms or legs 
• Signs of an allergic reaction: rash; swelling of the face, lips, or throat, trouble breathing.
• Signs of bleeding in the stomach or intestines: black, tarry, or bloody stools; throwing up blood or vomit that looks like coffee grounds.

Report Side Effects

Procardia XL may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Procardia XL Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For treatment of chest pain or high blood pressure:
  • For oral dosage form (capsules):
    • Adults—At first, 10 milligrams (mg) three times a day. Your doctor may increase your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • Adults—At first, 30 or 60 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 90 mg once a day.
    • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Procardia XL:

Severe allergic reaction: Avoid using Procardia XL if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: There's not enough information about the safety and effectiveness of Procardia XL in those who are pregnant and their unborn fetuses. Discuss with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Procardia XL during your pregnancy.

Breastfeeding: There's not enough known about the safety of Procardia XL in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed and weigh the benefits and risks of taking Procardia XL while nursing and the different ways available to feed your baby.

Adults over 65: Older adults might also be more sensitive to Procardia XL side effects due to potential changes in kidney function and medication clearance.

Children: The safety and effectiveness of Procardia XL have not been established in children.

Kidney problems: Individuals with kidney problems may not be able to clear medication from their bodies as easily. This means the medicine stays in the body longer and can have increased side effects. For this reason, your healthcare provider will likely not prescribe Procardia XL beyond a certain dosage if you have severe kidney impairment.

Missed Dose

If you accidentally forgot your Procardia XL dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't double up to make up for the missed dose.

Try to find ways to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Procardia XL might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Procardia XL?

Taking too much Procardia XL may cause flushing, palpitations, dizziness, low blood pressure, nervousness, nausea, vomiting, and swelling.

If you've taken more than your prescribed dose, call your healthcare provider or the Poison Control Center. If your symptoms feel life-threatening, call 911.

What Happens If I Overdose on Procardia XL?

If you think you or someone else may have overdosed on Procardia XL, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Procardia XL, call 911 immediately.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

You should not use this medicine if you are also taking certain other medications such as carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), or St. John's Wort. Using these medicines together can cause serious problems. Make sure your doctor knows all of the medications you are taking.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. These symptoms are more likely to occur when you begin taking this medicine, or when the dose is increased.

This medicine may cause fluid retention (edema) in some patients. Tell your doctor right away if you have bloating or swelling of the face, arms, hands, lower legs, or feet; tingling of the hands or feet; or unusual weight gain or loss.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests. This medicine may affect the results of certain medical tests.

Grapefruits and grapefruit juice may increase the effects of nifedipine by increasing the amount of this medicine in your body. You should not eat grapefruit or drink grapefruit juice while you taking this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Procardia XL?

If you're allergic to Procardia XL or any of its ingredients, avoid using it. Ask your pharmacist or healthcare provider for a full list of the ingredients if you're unsure.

Certain conditions increase your risk of developing complications from Procardia XL. Let your healthcare provider know about all your medical conditions and allergies so they can determine if Procardia XL is the best treatment for you. 

What Other Medications Interact With Procardia XL?

Many medications may interact with Procardia XL. Let your healthcare provider know about all the medicines you take, including over-the-counter, nonprescription products. 

Beta-blockers are generally considered safe when taken with Procardia XL, but you may be at increased risk for side effects. Your healthcare provider may monitor you more closely if you take a beta-blocker, including:

• Betapace (sotalol)
• Zebeta (bisoprolol)
• Bystolic (nebivolol)
• Coreg (carvedilol)
• Corgard (nadolol)
• Inderal LA (propranolol)
• Normodyne or Trandate (labetalol)
• Lopressor (metoprolol)
• Tenormin (atenolol)

Some medicines can cause Procardia XL levels to become too high or too low. Let your healthcare provider know if you take:

• Certain HIV medications
• Tagamet (cimetidine)
• Biaxin (clarithromycin) 
• Dilantin (phenytoin)
• Nizoral (ketoconazole) 
• Mysoline (primidone) 
• Serzone (nefazodone) 
• Noxafil (posaconazole)
• Phenobarbital 
• Rifadin or Rimactan (rifampin) 
• Sporanox (itraconazole)
• Tegretol (carbamazepine)
• Vfend (voriconazole)

If you take digoxin (brand names such as Lanoxin and Cardoxin) your levels may need to be monitored more closely, especially when starting, stopping, or changing your dose of Procardia XL. 

This is not a list of all the drugs that may interact with Procardia XL. Always keep an up-to-date list of all your medicines, and let your healthcare provider and pharmacist know any time there are changes.

What Medications Are Similar?

Procardia XL belongs to a group of drugs called calcium channel blockers. Other calcium channel blockers that also treat high blood pressure or angina include:

• Conjupri (levamlodipine)
• Plendil (felodipine)
• DynaCirc (isradipine)
• Cardene (nicardipine) 
• Norvasc (amlodipine)
• Sular (nisoldipine)

Some calcium channel blockers are taken once daily, whereas others must be taken several times daily. You may tolerate one calcium channel blocker better than another, especially if you have other health conditions like heart failure. Cost is also a consideration. You and your healthcare provider will work together to select the best treatment for you.

This is a list of calcium channel blockers also prescribed to treat high blood pressure or angina. It is NOT a list of drugs recommended to take with Procardia XL. You should not take these drugs together. Ask your pharmacist or a healthcare practitioner if you have questions.

Frequently Asked Questions

• Procardia XL is a calcium channel blocker. These drugs help decrease blood pressure by relaxing blood vessels. Procardia XL also improves chest pain by allowing more blood and oxygen to get delivered to the heart.

• You will begin to notice improvements in your chest pain or blood pressure the first day you start taking Procardia XL. Your healthcare provider may increase your dose over several weeks to find the optimal dose for you.

How Can I Stay Healthy While Taking Procardia XL?

Your healthcare provider may prescribe Procardia XL to help keep your blood pressure healthy or improve angina symptoms (chest pain). But managing your blood pressure is just one part of keeping your heart healthy.

Consider the following:

• Take medications as recommended by your healthcare provider.
• Stay active.
• Follow a heart-healthy diet. Consider working with a team that includes a registered dietitian nutritionist (RD or RDN).
• Quit smoking tobacco if you do.
• Consider support groups or working with a mental health provider to help you find coping strategies to change the way you think, feel, react, or respond to living with your condition.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.