Nifedipine has been used with some success but must be used with caution when combined with volatile anesthetics (potentiates myocardial depression) and magnesium (cardiovascular collapse may occur). Women with singleton pregnancies admitted in preterm labor (24 to 34 weeks) were randomized to high-dose (HD) nifedipine ( N = 49; 20 mg loading dose, repeated in 30 minutes, daily 120 to 160 mg slow-release nifedipine for 48 hours followed by 80 to 120 mg daily until 36 weeks) or low-dose (LD) nifedipine ( N = 53; 10 mg, up to four doses every 15 minutes, daily 60 to 80 mg slow-release nifedipine … Hypertension in pregnancy is defined as systolic blood pressure (SBP) above 140 mmHg and/or diastolic blood pressure (DBP) above 90 mmHg; severe hypertension as SBP ≥ 160 mmHg with or without DBP ≥ 110 mmHg 1.Hypertension in pregnancy can be categorized as: chronic hypertension (before 20 weeks of gestation), gestational hypertension (later than 20 weeks) or pre … The study compared 116,000 pregnancy women from all 50 states. Nifedipine should be used with caution in people with: Nifedipine is a calcium channel blocker of dihydropyridine type. O. She'll spend the next few weeks putting on weight. My doctors tried stopping labor every time I had preterm labor until I hit 36 weeks, but I would have liked to have gone to at least 38 if I could have. 2008;100(1):65-68. I started having PTL issues with my daughter at 27 weeks, and was on procardia from 27 weeks until I was 37 weeks. With pre-eclampsia and pregnancy-induced hypertension, the blood pressure usually settles within three days. They have little teratogenic or fetotoxic potential. I've been on nifedepine with both my pregnancies now, and stopped taking it at 37 weeks with my son, and had him at 38 weeks...no complications, but did receive the steroid shots at 34 weeks… Feb 23rd '10. If you are or will be breast-feeding while you use Nifedipine CF, check with your doctor. Magnesium sulfate, or mag for short, is used in pregnancy to prevent seizures due to worsening preeclampsia, to slow or stop preterm labor, and to prevent injuries to a preterm baby's brain. Continue nifedipine 20 mg orally every 4 hours after the first dose for 48 hours. advertisement | page continues below. Nifedipine 10 mg PO 10 mg PO in 30 minutes if needed Supply contents 3 ml, 10 ml, and 20 ml syringes, appropriate needles and appropriate tubing sets EVIDENCE GRADING Level of Evidence: III-C REFERENCES 1. I take guanfacine. Nifedipine will only stave off contractions for 24 hours until about two weeks. Nifedipine prolonged pregnancy and caused a reduction in neonatal survival (rats). Also, two clients withdrew consent to continue the study after receiving intervention. Lisinopril is highly fetotoxic especially in second and third trimesters. She had a history of chronic essential hypertension and recent hypertension in pregnancy. Other antihypertensive agents commonly used in pregnancy include nifedipine (calcium-channel blocker) and methyldopa (centrally acting agent). The described side effects of nifedipine to the pregnant woman and her infant appear minimal. Nifedipine has a similar mechanism of action on the uterus. Betamimetics in pregnancy related to autism: Really? It has a molecular weight of 346.3. Time of tocoloysis in the terbutaline group (2.45 ± 1.67) was not different from the nifedipine group (2.78 ± 2.1); mean difference – 0.35 (95% CI −1.21 to 0.52, p = 0.2). Adverse maternal and fetal effects are shown in table 3. A typical pregnancy lasts about 40 weeks. Tell your doctor if you are breast-feeding a baby. Delivery gestational age (mean ± SD) was 35.4 ± 3.2 weeks for patients randomly assigned to receive nifedipine and 35.3 ± 3.2 weeks for patients who received no treatment ( P = .9). Mawaldi L, Duminy P, Tamim H. Terbutaline versus nifedipine for prolongation of pregnancy in patients with preterm labor. If you're diagnosed with preeclampsia late in your pregnancy, you may be surprised and scared to know that you'll be induced right away. Outside pregnancy, short acting nifedipine has been associated with increased risk of myocardial infarction and mortality when used to treat hypertension. Nifedipine group. The shots will stop at 36 weeks and 4 days and the Procardia will stop somewhere around there too. Nifedipine in the management of preterm labor: A systematic review and meta-analysis. Recent history (within 4 weeks) of myocardial infarction. Methodology: Eligible women are randomly assigned and treated with tablet Nimodipine 30mg 8th hourly (Group A) and Nifedipine 10mg 8th hourly (Group B). It has also been used for Gilles de la Tourette’s syndrome and opioid withdrawal. Women with chronic hypertension require careful monitoring during pregnancy as they have an … Additionally, some studies have used maintenance dosing with slow-release nifedipine (doses of 60 to 160 mg/day PO). Place and Duration of Study: Conducted at department of Obstetrics & Gynaecology, Combined Military Hospital Lahore, from Jan 2014 to Jun 2014. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1471-0528.2000.tb13222.x Some brand names for guanfacine are Intuniv® and Tenex®. Preterm labor is premature contractions of the uterus that can lead to premature delivery. Indications: High blood pressure, migraine, premature labor. venetoclax dose by at least 50%; resume previous venetoclax dose 2-3 days after nifedipine D/C: combo may incr. Independent data abstraction by two reviewers. Both nifedipine and labetalol have been used for treatment of pregnancy‐induced severe pre‐eclampsia. Introduction. Am J Obstet Gynecol2011;204:134.e1-20. 18 women (30%) in Nifedipine group had side effects compared to 48 women (80%) in Ritodrine group (P value < 0.001). Nifedipine CF is found in breast milk. Usual evaluation, monitoring and care for women with preterm labor. Nifedipine extended release tablets contain either: 30, 60, or 90 mg of nifedipine for once-a-day oral administration. Only 1 mother developed side effects from nifedipine. Preterm birth is the most common cause of neonatal morbidity and mortality. Introduction. The advantages of nifedipine use are rapid onset of action and lack of central nervous system depression. Your baby at 35 weeks Tap the plus for more details. Fetal malformations and adverse effects on pregnancy have been reported in animals; ... (35.6%). nifedipine, prostacyclin, or both. Because it is given in a tablet or capsule by mouth, it is easier to use than intravenous drugs. Your little one may be starting to make an exit plan by shifting to the heads-down position, all while working on important preparations such as building body fat and brain matter. Chronic hypertension is defined as blood pressure exceeding 140/90 mm Hg before pregnancy or before 20 weeks' gestation. Summary Recommendations: Nifedipine can be prescribed for high blood pressure, migraine headaches and premature labor. Nifedipine Mechanism : Nifedipine is a calcium channel blocker and inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle. We compared two dose regimens of tocolytic oral nifedipine. Women with singleton pregnancies admitted in preterm labor (24 to 34 weeks) were randomized to high-dose (HD) nifedipine ( N = 49; 20 mg loading dose, repeated in 30 minutes, daily 120 to 160 mg slow-release nifedipine for 48 hours followed … Definitions. Adalat CC tablets consist of an external coat and an internal core. It is not known whether nifedipine will harm an unborn baby. All oral antihypertensives reduced blood pressure to the reference range in most women. 11 However, the main benefit of a tocolytic drug is the prolongation of pregnancy for a 48-hour period to allow the steroid effect to enhance fetal lung maturity. (+50%) so fall in haematocrit.2. Extended-release nifedipine is … Shekhar S, Sharma C, Thakur S, et al. Nifedipine is an effective drug to treat severe hypertension in pregnancy and preterm labour. OR. INTRODUCTION. Nifedipine belong to a group of medications called calcium channel blockers. It is used to treat high blood pressure (hypertension) and chest pain (angina). Sometimes it is used to stop labor before 37 weeks of pregnancy (preterm delivery). Some brand names for nifedipine are Procardia®, Adalat CC®, and Afeditab CR®. (Table -I). Conde-Agudelo A, et al. Most of her basic physical development is now complete. Amlodipine (dihydropyridine) exhibited no signs of teratogenicity or embryo/fetal toxicity when administered orally to pregnant rats and rabbits during the period of organogenesis. ... Is procardia (nifedipine) xl in early pregnancy safe? What are the benefits of Primacare and Duet DHA (prenatal vitamins with essential fatty acids and precursors)? The meds I … For Adult. Less doses were needed to achieve the desired BP in the hydralazine group 2.74+-1.35 as compared to nifedipine group 3.86+-1.45 with a significant 'p' value of 0.000 as shown in table 2. You will need to discuss the benefits and risks of using Nifedipine CF while you are pregnant. Introduction. Nifedipine Labetalol Gestational weeks Frequency Percent Frequency Percent 20-25 1 2.0 0 0 25-30 5 10.0 4 8.0 30-35 10 20.0 6 12.0 35-40 31 62.0 38 76.0 >40 3 6.0 2 4.0 Total 50 100.0 50 100.0 Table 3: … When hypertension is first identified during a woman's pregnancy and she is at less than 20 weeks' gestation, blood pressure elevations usually represent chronic hypertension. It has a molecular weight of 346.3. Of 71 women who were enrolled and randomized, 2 patients were excluded after randomization and 1 was lost to follow-up; of the remainder, 35 patients received placebo and 33 received nifedipine. Pre‐eclampsia is one of the most challenging diseases of pregnancy. Usually, it is believed to inflict no damage or side effects on the mother … 1 doctor answer • … By rectum using ointment. Nifedipine treatment was associated with significantly more increase in urinary output in 1, 2, 6, 12, 18 and 24 hours after treatment (Figure 1 and Table 2). Seven women in the nifedipine group (1 5.2%) and another seven in the methyldopa group (26.9%) had chronic hypertension, defined as a diastolic blood pressure of 1 90 mmHg more than once either in the first half of pregnancy or six weeks after delivery. In two women, pulmonary hypertension was diagnosed dur-ing pregnancy, and in two, a year or more before conception. Nifedipine( Adalat®, Procardia®) Calcium channel blocker . Preterm labor is defined as the presence of uterine contractions of sufficient frequency and intensity to effect progressive effacement and dilation of the cervix prior to term gestation. Pregnancy is a bittersweet journey for any woman, for the end result might be the best thing ever, but there are still few bumps on this journey in the form of the ups and downs in the mother’s health. ... 19 weeks pregnant no fetal movement? The reason I ask, is because in a pregnancy where I delivered at 27 weeks (also due to PROM - complete rupture), I was put on mag sulfate as a first line of treatment for two days in order to receive betamethasone shots, and then put on Nifedipine. What do most prenatal vitamins consist of? A 35-year-old member asked: how long is it supposed to it take for procardia (nifedipine) to work on a pregnant woman? Both contain nifedipine, the coat as a slow release formulation and the … Nifedipine's mechanism of action is through smooth-muscle relaxation secondary to blockage of the slow calcium channels into the cells. Calcium Channel Blockers. Even at 35 weeks, every week counts. See NICE's information on prescribing medicines. May repeat in 30 minutes if contractions persist. BEFORE pregnancy. The definition of hypertension in pregnancy has not always been standardized, but following the “National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy” recommendation is currently a systolic blood pressure (SBP) ⩾ 140 mmHg and/or a diastolic blood pressure (DBP) ⩾ 90 mmHg (). Doctor said since I got the betamethasone shots at 34 weeks he was okay stopping the nifedipine and not adding another tocolytic medication. However, nifedipine obstructs the pathways, preventing calcium to reach to the uterus. Nifedipine is the most extensively studied agent for rapid control of BP, and until 1996 was used for acute BP lowering in hospitalized patients. Do Nifedipine, Atorvastatin, Ranitidine and Valsartan act as blood thinners? There were no differences in delivery within 48 hours (7.6% magnesium sulfate compared with 8.0% nifedipine, P =.92), gestational age at delivery (35.8 compared with 36.0 weeks, P =.61), birth before 37 and 32 weeks (57% compared with 57%, P =.97, and 11% compared with 8%, P =.39), and episodes of recurrent preterm labor. The mean duration of prolongation of pregnancy was 39.4 days. Sometimes it is used to stop labor before 37 weeks of pregnancy (preterm delivery). Some brand names for nifedipine are Procardia®, Adalat CC®, and Afeditab CR®. I take nifedipine. Can it make it harder for me to get pregnant? Studies on women have not been done to see if nifedipine could make it harder for a woman to get pregnant. Introduction. Bortolus R, Ricci E, Chatenoud L, Parazzini F. Nifedipine administered in pregnancy: effect on the development of children at 18 months. Preterm birth (PTB), also known as premature birth, is the birth of a baby at fewer than 37 weeks' gestational age, as opposed to full-term delivery at approximately 40 weeks. Pregnancy outcomes varied depending on response to therapy and interval between diagnosis and treatment, and on the pregnancy itself. Background The pressor response to laryngoscopy and tracheal intubation is a very important issue in hypertensive pregnant patients, involving an increase in systemic and pulmonary arterial pressures and pulmonary capillary wedge pressure (1-4).In addition, the stress of laryngoscopy can be associated with an … It is one of the treatments of choice for Prinzmetal angina. 2 The majority of neonatal deaths and over one third of infant deaths are linked to preterm birth. Increase in plasma volume (preload), starts to increase by 6th wk, & plateaus at 30wks. I'm having surgery in a few weeks and was notified that I had to stop taking any medications that contained blood thinners 10 days before. Preterm birth continues to be a problem for obstetricians. Nifedipine falls into category C. There are no well-controlled studies in pregnant women. Preliminary findings also indicate that these formulations are effective in the treatment of Ray naud’s phenomenon … Unstable or acute angina. In the present study, the efficacy and safety of oral nifedipine and intravenous labetalol for severe pre‐eclampsia therapy were compared. Premium Questions. Because it is given in a tablet or capsule by mouth, it is easier to use than intravenous drugs. Nifedipine should not be prescribed to people with: Cardiogenic shock. Nifedipine was administered orally to rats for two years and was not shown to be carcinogenic. Hydralazine may fall out of favor, as two meta-analyses, one including 35 studies (3573 women) and another with 21 trials (893 women), have demonstrated that pregnant women taking calcium channel blockers were less likely to have persistent high blood pressure when compared to those treated with hydralazine. Nifedipine antagonises influx of calcium through cell membrane slow channels, and sustained release formulations of the calcium channel blocker have been shown to be effective in the treatment of mild to moderate hypertension and both stable and variant angina pectoris. Relation to parity shows that maximum numbers of patient (Total 35, 58.3%) were primigravidas in both groups (P value .432). Introduction. BJOG. consider alternative, hold venetoclax or decr. Conclusions: The dihydropyridine group of calcium channel blockers (type II calcium blockers) and, specifically, nifedipine are safe for use in pregnancy. 11 The diagnosis generally requires two separate … Taking the medication as prescribed is important. I take guanfacine. Tocolytics are considered a standard treatment for women with threatened preterm delivery to allow time for maternal steroid administration and transfer to referral centers with neonatal intensive care units. The described side effects of nifedipine to the pregnant woman and her infant appear minimal. Pregnancy outcomes varied depending on response to therapy and interval between diagnosis and treatment, and on the pregnancy itself. Learn how steroids and antibiotics can treat preterm labor. Re: Anyone took / take Procardia/Nifedipine for contractions. Nifedipine 10 mg pregnancy . Discuss any possible risks to your baby. If you're diagnosed earlier in your pregnancy, you may have many weeks to worry about your baby's health. Base the choice on any pre-existing treatment, side-effect … Preterm birth is the most common cause of neonatal morbidity and mortality. Oral nifedipine versus intravenous labetalol for severe hypertension during pregnancy: a systematic review and meta-analysis Shekhar, S , Gupta, N , Kirubakaran, R , … These drugs can be given through an IV or by mouth between 24 and 34 weeks of pregnancy. The prolongation of pregnancy up to 37 weeks was observed in 28 women (46.6%) in Nifedipine group compared to 16 women (26.6%) in Ritodrine group (P value = 0.033). H. 18. Nifedipine helps in short-term prolongation of pregnancy by relaxing the smooth muscles and inhibiting contraction of the uterine wall. Nifedipine is a calcium channel blocker which has been commonly used in the treatment of preterm labor with dilation of the cervix, with good results. 1 Drugs to treat spiking high blood pressure in pregnancy include: Labetalol: a beta-blocker, which helps to slow your heart rate. DrugCentral is online drug information resource created and maintained by Division of Translational Informatics at University of New Mexico. After contractions have been controlled give nifedipine 20 mg every 3 to 8 hours. MD. Getting a RhoGAM shot is the best way to prevent any possible complications from Rh incompatibility. Obstet Gynecol . This signifies that disease with its associated morbidity is more common in first pregnancy. Although maintenance use of tocolytics after acute suppression of contractions has not been shown to prolong pregnancy, doses of 10 to 20 mg PO every 4 to 6 hours have been used. Clinical presentations are given in Table 1. Methods PPADAL was a randomized, double-blind, placebo-controlled trial conducted between 05/2008 and 05/2012 in five French hospitals. Some women have to be on nifedipine for three or four months, along with bed rest. Vitamins A, B6, B12, C,D, E, thiamine, riboflavin, niacinamide, iron, folic acid. This is believed to be due to the hypotension and reflex tachycardia that can predispose to an arrhythmia [ 35 ]. Side Effects of Nifedipine During Pregnancy. Nifedipine belong to a group of medications called calcium channel blockers. CAS PubMed Google Scholar In two women, pulmonary hypertension was diagnosed dur-ing pregnancy, and in two, a year or more before conception. Nifedipine is an effective drug to treat severe hypertension in pregnancy and preterm labour. I was able to carry about 3 weeks on the Nifedipine before delivering in this situation. Efficacy and safety of the combination of magnesium sulfate, phentolamine and nifedipine in the treatment of patients with hypertensive disorder complicating pregnancy (HDCP) and its effect on hemodynamics and urinary protein level were investigated. To assess the maternal and fetal outcomes of pregnancies affected by hypertensive disorders treated with nifedipine versus labetalol. I took Procardia with baby #2 and am taking it again now with baby #3. Consider nifedipine [] for women in whom labetalol is not suitable, or methyldopa if both labetalol and nifedipine [] are not suitable. Talk to your midwife about group B strep. Cornette J, et al. nifedipine, prostacyclin, or both. Multiple pregnancy Polyhydramnios Bleeding/thrombosis Early stress Low body mass index (BMI) Short conception cycle <1 yr Age <17 yr or >35 yr Diagnosis Diagnosis is difficult and is often wrong (50% of cases) For a reliable diagnosis of preterm labour, there should be painful uterine contractions >1 Study Design: Randomized controlled trial. As single drugs, nifedipine retard use resulted in a greater frequency of primary outcome attainment than labetalol or methyldopa use. Results: In oral Nifedipine group 64% patients were between 18-30 years while 36% were between 31-35 years of age. Just try to get every day you can out of it. We detected hypertensive crisis within the first 24 hours after achieving desired blood pressure in 20% of nifedipine treated group and 44% of … Unfortunately, many antihypertensives aren't suitable for pregnancy. 35. I have (had) the same type of circumstance that you're going through - contractions that may or may not be regular. Oral nifedipine or intravenous labetalol for hypertensive emergency in pregnancy: a randomized controlled trial. Almost one in eight babies in the USA is born before 37 weeks’ gestational age. Nifedipine is a vasodilator, and the shorter acting preparations are more likely to be associated with more rapid acute decreases in BP and reflex activation of the sympathetic nervous system, causing increases in heart rate and headaches, especially when used at higher doses (>60 mg/d). duration of use 8 weeks. Mean presenting BP was 169/113mmhg in hydralazine group and 171/113 mmHg in nifedipine group. 3 doctor answers • 4 doctors weighed in. Achaia Taltoan, Mercer University College of Pharmacy Preeclampsia is a syndrome characterized by a persistent blood pressure ≥ 140/90 mmHg and urine protein ≥ 300 mg/24 hours after 20 weeks of gestation. Most pregnancies last about 40 weeks, but about one in eight births in the U.S. occur before the 37th week, when the fetus is not fully developed. Maternal and fetal hemodynamic effects of nifedipine in normotensive pregnant women. 6, and has the structural formula: Nifedipine is a yellow crystalline substance, practically insoluble in water but soluble in ethanol. [2015] The use of Nifedipine in pregnancy is not recommended. Study design Meta-analysis of randomised controlled trials (published between 1966 and September 2002) of short acting antihypertensives for severe hypertension in pregnancy. Nifedipine 10 mg orally can be given and maintenance therapy with an ACE inhibitor could be started. Therefore, 34 participants were included data analysis. BJOG 2011;118:510-515. How Does Nifedipine Work during Pregnancy Basically, nifedipine slows down the contractions in the uterus since its a calcium channel blocker and the uterus requires calcium to contract. Nifedipine is the oral calcium channel blocker that is used in the management of hypertension in pregnancy. The dosage of nifedipine is 10 mg PO every 15-30 minutes, with a maximum of 3 doses. The side effects of calcium channel blockers include tachycardia, palpitations, and headaches. The American College of Obstetrics and Gynecology guidelines on pregnancy induced hypertension recommend immediate release nifedipine as one of the first line agents… Nifedipine During Pregnancy and Breastfeeding. It may be used to treat severe high blood pressure in pregnancy. Common name: Nifedipine; Calcium channel blockers ease muscle contractions in … A retrospective study in hypertensive patients treated during pregnancy with nifedipine or labetalol was conducted. Exp 35 years. Therefore, it is extremely important to take care, especially of … The European Association of Urology (EAU) Urolithiasis Guidelines Panel has prepared these guidelines to help urologists assess evidence-based management of stones/calculi in the urinary tract and incorporate recommendations into clinical practice. 2013;122(5):1057–1063. Nifedipine does carry risks and can cause side effects, so it's usually reserved for pregnant women who cannot carry to full term. Neonatal outcome was similar in both the groups. With baby #2, I started contracting at 33 weeks and delivered at 35w6d. Nifedipine is a yellow crystalline substance, practically insoluble in water but soluble in ethanol. Results: In oral Nifedipine group 64% patients were between 18-30 years while 36% were between 31-35 years of age. By mouth using modified-release medicines. For Adult. Outside pregnancy, short acting nifedipine has been associated with increased risk of myocardial infarction and mortality when used to treat hypertension. The dihydropyridine group of calcium channel blockers (type II calcium blockers) and, specifically, nifedipine are safe for use in pregnancy. BJOG . The remaining three women in the nifedipine group (6.5%) developed postpartum new hypertension. Nifedipine extended-release tablets contain 90 mg of nifedipine for once-a-day oral administration. Acute Treatment of Preterm Labor . [2019] 1.3.10 Consider labetalol to treat chronic hypertension in pregnant women. Beside above, why is nifedipine contraindicated in pregnancy? Preeclampsia (PE) is a severe disease that manifests in multiple systems, and uniquely occurs during pregnancy, usually after 20 weeks of gestation ().PE remains the leading cause of mortality and morbidity during pregnancy for women worldwide, and its most detrimental symptoms are severe elevated blood pressure and proteinuria. Magee LA, Abalos E, von Dadelszen P, Sibai B, Easterling T, Walkinshaw S. How to manage hypertension in pregnancy effectively. Objective To assess the impact of maintenance nifedipine therapy on pregnancy duration in women with preterm placenta previa bleeding. Guanfacine is a medication that has been approved to treat high blood pressure and attention deficit hyperactivity disorder (ADHD). Maintain haemoglobin at 10–11 g/dL, haematocrit at 30–35% and serum ferritin of 200–300 µg/mL Nutrition Provide protein intake of 1.2–1.4 g/kg pre-pregnancy weight/day + 20 g/day Provide calories intake of 25–35 kcal/kg/pregnant weight/day … Guanfacine is a medication that has been approved to treat high blood pressure and attention deficit hyperactivity disorder (ADHD). Group B strep is a common bacteria – up to 2 in 5 people … Some brand names for guanfacine are Intuniv® and Tenex®. The dosage of nifedipine is 10 mg PO every 15 … Clinical presentations are given in Table 1. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Nifedipine Market size is forecast to reach $1.37 billion by 2025, growing at a CAGR of 4.07% during the forecast period 2020-2025. Some brand names for nifedipine are Procardia®, Adalat CC®, and Afeditab CR®. Nifedipine should be used during pregnancy only if the possible … There are no controlled data in human pregnancy. Do Nifedipine, Atorvastatin, Ranitidine and Valsartan act as blood thinners? I personally think that in this kind of a situation, this medication is a life-saver. Zhonghua Fu Chan Ke Za Zhi 2000; 35 : 151–152. 1 Although the causes of preterm labor are not well understood, the burden of preterm birth is clear. Nifedipine is used alone or in combination with other drugs to treat high blood pressure (hypertension).Lowering high blood pressure helps prevent strokes, heart attacks, and … Nifedipine 10 mg PO 10 mg PO in 30 minutes if needed Supply contents 3 ml, 10 ml, and 20 ml syringes, appropriate needles and appropriate tubing sets EVIDENCE GRADING Level of Evidence: III-C REFERENCES 1.