Contents of a 10 mg nifedipine capsule (0.33 ml) were withdrawn by syringe and administered subcutaneously to a patient with hypertensive urgency due to misinterpretation of a physician's order. The drug apparently had its desired hypotensive effect and no adverse effects were noted. The literature on use of nifedipine in hypertensive urgency is reviewed. Subcutaneous administration is not recommended because of a lack of suitable controlled studies and the potential for adverse effects.
Get full access to this article
View all access options for this article.
References
1.
BertelOConenDRaduEW. Nifedipine in hypertensive emergencies. Br Med J1983; 286: 19–21.
2.
ErbelRMeyerJBrandE. Emergency treatment of hypertensive crisis with sublingual nifedipine. Postgrad Med J1983; 59 (suppl 3): 134–6.
3.
BeerNGallegrosICohenA. Efficacy of sublingual nifedipine in the acute treatment of systemic hypertension. Chest1981; 79: 571–4.
4.
LaccheABasagliaP. Hypertensive emergencies: Effects of therapy by nifedipine administered sublingually. Curr Ther Res1983; 34: 879–87.
EllrodtAGAultMJRiedingerMSMurataGH. Efficacy and safety of sublingual nifedipine in hypertensive emergencies. Am J Med1985; 79 (suppl 4A): 19–25.
7.
OpieLHJenningsA. Sublingual captopril versus nifedipine in hypertensive crises. Lancet1985; 2: 555.
8.
AdlerAGLeahyJJCressmanMD. Management of perioperative hypertension using sublingual nifedipine. Arch Intern Med1986; 146: 1927–30.
9.
HoustonMC. Treatment of hypertensive urgencies and emergencies with nifedipine. Am Heart J1986; 111: 963–9.
10.
WachterRM. Symptomatic hypotension induced by nifedipine in the acute treatment of severe hypertension. Arch Intern Med1987; 147: 556–8.
11.
McAllisterRGJr. Kinetics and dynamics of nifedipine after oral and sublingual doses. Am J Med1986; 81 (suppl 6A): 2–5.
12.
McRaeRPLiebsonPR. Hypertensive crisis. Med Clin North Am1986; 70: 749–67.
13.
VidtDG. Current concepts in treatment of hypertensive emergencies. Am Heart J1986; 111: 220–5.
14.
FergusonRKVlassesPH. Hypertensive emergencies and urgencies. JAMA1986; 255: 1607–13.
15.
AndersonRJReedWG. Current concepts in treatment of hypertensive urgencies. Am Heart J1986; 111: 211–9.
16.
SchillerEC. An easy way to administer sublingual nifedipine (letter). Anesthesiology1986; 65: 239.
17.
VanhartenJBurggraafKDanhofMVanbrummelenPBreimerDD. Negligible sublingual absorption of nifedipine. Lancet1987; 2: 1363–4.
18.
FosterTSHamannSRRichardsVR. Nifedipine kinetics and bioavailability after single intravenous and oral doses in normal subjects. J Clin Pharmacol1983; 23: 161–70.
19.
IshikawaMYokotaNSawazakiA. Rectal administration of perforated nifedipine capsules to maintain an effective level of longer duration. Am Heart J1986; 112: 1116–9.
