Posted by Jedi on June 9, 2007, at 14:26:52
In reply to NIfedipine for BP crisis, posted by stargazer2 on June 9, 2007, at 8:10:17
Hi,
Many MDs will no longer write nifedipine scripts. The sublingual nifedipine can cause your BP to drop too far. The affect also lasts for four to six hours, so when the tyramine reaction is wearing off, your BP can drop to dangerously low levels. If you do take nifedipine, I would suggest starting at 5mg not 10mg. The one time I took the medication, 10mg put me in the hospital overnight on IV fluids. It caused my BP to drop but then it kept dropping long after the tyramine reaction had stopped. Extremely low BP can be fatal.
Be careful,
JediReference:
http://www.tu.edu/user_files/10/19.html
Monoamine Oxidase Inhibitors: Adverse Effects
Original Author: Paul Perry, Ph.D, BCPP
...
The antihypertensive effect lasts 4-6 hours. While the use of sublingual nifedipine in this setting has been reported to be reasonably safe, the general practice of sublingual nifedipine for hypertensive emergencies has been strongly challenged (Grossman et al 1996). The authors of this review/editorial site numerous reported cases of serious, even fatal complications of sublingual nifedipine use. Coupled with the lack of any clinical documentation attesting to a benefit, the authors argue that the use of sublingual nifedipine be abandoned. Therefore, when patients taking an MAOI experience a severe headache, especially when they've recently been non-compliant with their diet, they should report to the emergency room to receive appropriate hypertensive crisis management.
...> My pdoc has always given me a script for a small number of Nifedipine pills used in the event of a hypertensive crisis which you can verify with your BP monitor. A throbbing headache is usually an early sign of a escalating BP. If you suspect that you are having a BP crisis, you can bite on the pill which releases a liquid under your tongue (the fastest way to get the BP to come down)and then using your monitor you can follow the BP as it should decline. Obviously, if the BP stays high or your symptoms persist, a trip to the ER is warranted. You should taken your medication and tell them what your BP is and that you took Nifedipine at a certain time and give them any BP readings since you took the Nifedepine.
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> A prudent pdoc will prescibe Nifedepine or a similar medication to anyone taking a MAO as a first line defense with reducing the BP reaction associated with a food or medication reaction. My doctor is adamant about doing this and telling me exactly when and how to use it.
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> I have only had to take Nifedepine once but it makes sense if you are having concerns about the dietary restrictions that you carry a pill with you until you have more confdence in whatyou are eating.
>
> Stargazer
poster:Jedi
thread:761571
URL: http://www.dr-bob.org/babble/20070604/msgs/762005.html