Different dosage regimens of nifedipine, labetalol, and hydralazine for the treatment of severe hypertension during pregnancy: a network meta-analysis of randomized controlled trials

Pharmaceutical administration for severe hypertension during pregnancy: Network meta-analysis

“…We found that labetalol took less time than nifedipine and hydralazine to obtain the maximum effect. However, another study ( Wu et al, 2022 ) showed that among the three pharmaceuticals hydralazine, nifedipine, and labetalol, hydralazine required a shorter time to reach the target blood pressure; this differed from the results of the current study. Another study ( Adebayo et al, 2020 ) showed that nifedipine and hydralazine showed no difference in the time taken to achieve the target blood pressure.…”

“…A larger area indicates a better effect of medical treatment on this outcome, the higher the effective rate of blood pressure reduction after medication. The analysis results of several previous studies were consistent with our results, for example, two previous studies ( Alavifard et al, 2019 ; Wu et al, 2022 ) showed that nifedipine compared with labetalol and hydralazine in the treatment of severe hypertension during pregnancy had a higher rate of achieving the target blood pressure. Duley et al ( Duley et al, 2013 ) conducted a related study that included 35 trials and 3,573 women, and found that nifedipine was more effective than hydralazine in reducing persistent hypertension during pregnancy.…”

Mechanistic Framework to Predict Maternal‐Placental‐Fetal Pharmacokinetics of Nifedipine Employing Physiologically Based Pharmacokinetic Modeling Approach

“…Generating such information for clinicians can help to address the current gap between nifedipine maternal and fetal exposure and neonatal outcomes. 2,4,51 In conclusion, a detailed mechanistic PBPK model has been developed in this work to predict the maternalplacental-fetal PK of nifedipine. The model can provide insight into the nifedipine placental and fetal exposure helping to better understand the mechanisms of nifedipine distribution and elimination within the fetalplacental unit.…”

“…Nifedipine has been extensively used in the treatment of mild to severe hypertension for pregnant women and as a tocolytic agent to prevent preterm labor. [2][3][4] Twenty-seven years have passed since then and there are still many questions to be answered on this topic. Administering nifedipine during pregnancy is believed to carry varying levels of teratogenic risks.…”

“…In 1996, the following question was published in a specialized journal: Is the use of nifedipine during pregnancy safe for the fetus (adapted from Tadio et al 1 )? Nifedipine has been extensively used in the treatment of mild to severe hypertension for pregnant women and as a tocolytic agent to prevent preterm labor 2–4 . Twenty‐seven years have passed since then and there are still many questions to be answered on this topic.…”