Nifedipine pharmacokinetics during preterm labor tocolysis

Ferguson, Jane F.; E, Ii; Schutz, Thomas; Pershe, Robert A.; Stevenson, DK; Blaschke, Terrence F.

doi:10.1016/0020-7292(90)90023-e

Cited by 14 publications

(22 citation statements)

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“…A limitation to address is the potential influence of tocolysis on our study results, considering that we wanted to predict the risks of PTD in untreated women. In general, tocolysis is only given for the first 48 h after admission and these drugs have a short half‐life . Thus, we think that it is unlikely that tocolysis could have influenced the results of this study.…”

Section: Discussionmentioning

confidence: 95%

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Hermans

Bruijn

Vis

et al. 2015

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 95%

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Hermans

Bruijn

Vis

et al. 2015

Acta Obstet Gynecol Scand

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“…The reported data are related to the use of nifedipine as a tocolytic agent with different doses. Studies have reported a 77% transfer rate of gastrointestinally released nifedipine (30–150 mg day –1 ), a 76% transfer rate in normotensive women prepared for Caesarean delivery (a single sublingual 20 mg tablet) and a 72% transfer rate for nifedipine capsules (20 mg 6/6 h) .…”

Section: Discussionmentioning

confidence: 99%

Effect of type 2 diabetes mellitus on the pharmacokinetics and transplacental transfer of nifedipine in hypertensive pregnant women

Filgueira

Carvalho

et al. 2017

Brit J Clinical Pharma

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“…Nifedipine reduces the basal tone and the amplitude and frequency of spontaneous‐ and oxytocin‐ or prostaglandin‐induced contractions 11,12 . Nifedipine easily crosses the placenta with a ratio of 0.93 between umbilical cord blood and maternal serum concentrations 13,14 …”

Section: The Interest In Nifedipine For Tocolysismentioning

confidence: 99%

Nifedipine trials: effectiveness and safety aspects

Geijn¹,

Lenglet²,

Bolte³

2005

BJOG

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Nifedipine (Adalat) is marketed as an anti-hypertensive agent. Nifedipine inhibits voltage-dependent L-type calcium channels, which leads to vascular (and other) smooth muscle relaxation and negative inotropic and chronotropic effects on the heart. Vasodilation, followed by a baroreceptor-mediated increase in sympathetic tone then results in indirect cardiostimulation. Nifedipine was introduced as a tocolytic agent at a time when h-agonists and magnesium sulphate dominated the arena for the prevention of preterm birth. The oral administration route, the availability of immediate and slow-release preparations, the low incidence of (mild) side effects, and its limited costs explain the attraction to this medication from the obstetric field and its rapid and widespread distribution. Currently, over 40 studies have been published on nifedipine's tocolytic effectiveness, including seven meta-analyses. The quality of the studies suffers particularly from performance bias because the majority of them failed to ensure adequate blinding to treatment both for providers and patients. Concerns about other methodological flaws include measurements, outcome assessment and attrition bias. In particular, the safety aspects of nifedipine for tocolysis have been underassessed. Conclusions from the metaanalyses, favouring the use of nifedipine as a tocolytic agent, are not supported by close examination of the data. The tocolytic effectiveness and 'safety' of nifedipine has been studied primarily in normal pregnancies. Based on its pharmacological properties, one should be cautious to administer nifedipine when the maternal cardiovascular condition is compromised, such as with intrauterine infection, twin pregnancy, maternal hypertension, cardiac disease, etc. Life-threatening pulmonary oedema and/or cardiac failure are definite risks and have been reported. Under such circumstances, the baroreceptor-mediated increase in sympathetic tone may not balance the cardiac-depressant activity of nifedipine.

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Nifedipine pharmacokinetics during preterm labor tocolysis

Cited by 14 publications

References 0 publications

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Effect of type 2 diabetes mellitus on the pharmacokinetics and transplacental transfer of nifedipine in hypertensive pregnant women

Nifedipine trials: effectiveness and safety aspects

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