Document Detail


Nifedipine for severe hypertension in pregnancy: emotion or evidence?
MedLine Citation:
PMID:  15937600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A meta-analysis of randomized controlled trials suggests that nifedipine appears to be a reasonable agent for treatment of acute severe hypertension in pregnancy. However, in a 1999 survey of Canadian practitioners, most stated that they rarely or never use nifedipine capsules for treatment of acute severe pregnancy hypertension. Also, there are case reports of adverse outcomes following use of nifedipine capsules in pregnancy, although the risks appear to have been overplayed. We suggest that a reasonable approach is ongoing use of nifedipine capsules, with perhaps an initial dosage of 5 mg rather than 10 mg. Having women swallow the capsule without first biting it may also be a prudent approach, because there is insufficient information from most of the published clinical trials to say exactly how the nifedipine capsules were administered. Further, use of the 10 mg nifedipine prolonged action tablet may also be a reasonable approach for treatment of severe hypertension in pregnancy, although more data are needed. Such research would be particularly relevant given that nifedipine appears to be a promising treatment for spontaneous preterm labour. We must resist the temptation to throw out of our limited therapeutic armamentarium an effective oral preparation before adequately considering the evidence.
Authors:
Laura A Magee; Anne-Marie Côté; Peter von Dadelszen
Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC     Volume:  27     ISSN:  1701-2163     ISO Abbreviation:  J Obstet Gynaecol Can     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-06-06     Completed Date:  2005-07-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101126664     Medline TA:  J Obstet Gynaecol Can     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  260-2     Citation Subset:  IM    
Affiliation:
Department of Specialized Women's Health, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Canada
Capsules
Female
Humans
Hypertension, Pregnancy-Induced / drug therapy*,  psychology*
Nifedipine / administration & dosage,  adverse effects,  therapeutic use*
Pregnancy
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Capsules; 21829-25-4/Nifedipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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