Nifedipine for preterm labour

Examples

Generic Name	Brand Name
nifedipine	Adalat XL, APO-Nifed

Nifedipine is a tocolytic medication sometimes used during preterm labour to slow uterine contractions. Nifedipine is taken only by mouth (orally) as a tablet or capsule.

Use of nifedipine for the treatment of preterm labour is an unlabelled use of the drug. Nifedipine, a calcium channel blocker, is more commonly used to treat high blood pressure and heart disease.

How It Works

Smooth muscle tissue, like the uterus, needs calcium to contract. Nifedipine blocks the passage of calcium into certain tissues, relaxing the uterine muscles and smooth muscles of blood vessels throughout the body.

Why It Is Used

Nifedipine is used for the treatment of preterm labour when:

• Regular contractions of the uterus have thinned (effaced) the cervix and opened (dilated) it less than 4 cm, and the mother's amniotic sac has not broken.
• The mother is healthy.
• The fetus is alive and not in distress.
• Labour needs to be delayed for 24 to 48 hours. This is typically necessary with corticosteroid treatment to help fetal lungs mature. Sometimes labour is delayed so the mother can be moved to a hospital with special facilities for treating premature infants.
• Treatment with other tocolytic medications was stopped because of side effects.

How Well It Works

Small studies so far show that nifedipine may work better than other drugs to slow or stop preterm labour, with fewer problems for newborns.¹

Side Effects

Side effects of nifedipine can include:

• Dizziness, light-headedness, and nervousness.
• Skin flushing or redness.
• Headache.
• Nausea.
• Muscle cramps or tremors.
• Low blood pressure in the mother and a possible decrease in the blood supply to the fetus.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

• A mother's blood pressure is checked frequently while she takes this medication.
• Pregnant women with liver disease should not take nifedipine.
• Nifedipine should not be used together with magnesium sulfate.

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Author:	Kathe Gallagher, MSW Carrie Henley	Last Updated: April 10, 2007
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Anne C. Poinier, MD - Internal Medicine Gregory A L Davies, MD, FRCSC, FACOG - Maternal-Fetal Medicine William Gilbert, MD - Perinatology
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