Adalat is a nifedipine tablet for adults with high blood pressure or angina prevention. It helps relax arterial blood vessels, reducing resistance to blood flow and easing the heart’s workload.
Adalat contains nifedipine, a dihydropyridine calcium-channel blocker. It is used in hypertension and in the prevention of chronic stable angina, where narrowed coronary arteries can limit oxygen delivery to heart muscle.
Adalat is supplied as tablets for oral use. Nifedipine tablets may be designed to release the medicine gradually, keeping blood levels steadier across the day and avoiding the sharp concentration peaks associated with immediate-release nifedipine.
Modified-release tablets have a specific delivery structure. Breaking, crushing, or chewing them can disrupt that structure, releasing more medicine at once than intended. This can increase the chance of dizziness, flushing, palpitations, or an excessive fall in blood pressure.
A tablet shell may occasionally be seen in a bowel movement with some prolonged-release systems. The active medicine has already been released, so this does not automatically mean the dose failed.
The prescribed schedule depends on the condition being treated, blood-pressure response, other cardiovascular medicines, kidney and liver function, and side effects. Take Adalat by mouth at the same time each day if it has been prescribed as a regular treatment.
A practical routine includes:
If a dose is missed, take it when remembered unless the next scheduled dose is close. Do not take two doses together to compensate. Taking an extra tablet can produce marked low blood pressure, faintness, a fast heartbeat, or severe headache.
Blood-pressure treatment is measured over days and weeks, not by how a person feels after one tablet. Hypertension often causes no noticeable symptoms even when readings remain above target.
Calcium is needed for arterial muscle to contract. Nifedipine blocks L-type calcium channels in these muscles, so less calcium enters the cells. The arterial wall relaxes. Blood pressure can then decrease. The heart pumps against less resistance.
This action differs from medicines that lower blood pressure by slowing the heartbeat, removing salt and water, or reducing hormonal signals from the kidneys. Nifedipine mainly widens arteries and has less direct slowing effect on cardiac conduction than verapamil or diltiazem.
For angina, reduced arterial resistance lowers the work the heart must perform. Improved coronary artery relaxation can also support blood and oxygen supply to the heart. The British National Formulary lists nifedipine among calcium-channel blockers used for hypertension and angina prevention. [1]
It is used in hypertension and in the prevention of chronic stable angina, where narrowed coronary arteries can limit oxygen delivery to heart muscle.
The medicine controls symptoms and blood pressure; it does not provide immediate treatment for sudden chest pain.
Adalat and a generic nifedipine tablet share the same active substance when they contain nifedipine in an equivalent release design. The release mechanism matters as much as the ingredient name: a prolonged-release tablet should only be replaced by another clinically equivalent prolonged-release preparation.
| Feature | Adalat | Generic nifedipine |
|---|---|---|
| Active substance | Nifedipine | Nifedipine |
| Main purpose | Blood-pressure control and angina prevention | Blood-pressure control and angina prevention |
| Key consideration | Prescribed release profile | Equivalent release profile must match the prescription |
A switch between nifedipine preparations can change the timing of drug release, even when the total amount of nifedipine is similar. People who are stable on treatment should report new headaches, flushing, dizziness, worsening angina, or ankle swelling after any change in formulation.
The main benefit of nifedipine is its artery-relaxing action.
Its limitation is that this same action can cause oedema, headache, and postural dizziness.
Adalat is not for you if you have had an allergic reaction to nifedipine or another ingredient in the tablet. It should not be used in cardiogenic shock, where the heart cannot pump enough blood to support the body.
Extra care is required with very low blood pressure, severe narrowing of the aortic valve, unstable angina, recent heart attack, significant liver impairment, or heart failure with reduced blood pressure. These circumstances can alter how nifedipine affects circulation.
Nifedipine is metabolised by the CYP3A4 enzyme system. Strong CYP3A4 inhibitors can raise nifedipine levels and increase dizziness, flushing, swelling, or low blood pressure. Relevant examples include clarithromycin, erythromycin, ketoconazole, itraconazole, ritonavir, and grapefruit products. CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin, and St John’s wort can reduce nifedipine exposure.
Blood-pressure lowering can be stronger when Adalat is combined with other antihypertensives, nitrates, or medicines used for erectile dysfunction. Ciclosporin, tacrolimus, digoxin, and quinidine may also require closer clinical monitoring because nifedipine can affect their concentrations or effects. The 2025 MHRA Summary of Product Characteristics for nifedipine describes CYP3A4-mediated interactions as clinically relevant for nifedipine therapy.
Talk to the prescriber before using Adalat if you have very low blood pressure, heart problems, severe liver impairment, or a recent heart attack. Also check before treatment if you take other blood-pressure medicines, nitrates, erectile-dysfunction medicines, certain antibiotics or antifungals, seizure medicines, St John’s wort, or grapefruit products.
Most people tolerate nifedipine without serious difficulty, though side effects can occur. The effects most closely linked to arterial widening are headache, facial flushing, dizziness, awareness of heartbeat, tiredness, and ankle or lower-leg swelling.
Ankle swelling deserves a practical explanation. Nifedipine widens small arteries more than veins, which can increase pressure in capillaries and move fluid into surrounding tissue. This is not always caused by excess body water, so adding a diuretic does not consistently solve it.
Possible effects include:
Seek urgent medical help for fainting, severe breathlessness, swelling of the face or throat, a severe skin reaction, or chest pain that is new, worsening, or occurs at rest. Nifedipine can occasionally worsen angina at treatment initiation or after dose changes, especially in people with severe coronary artery disease. The MHRA product information for nifedipine identifies hypotension, oedema, headache, and flushing among recognised adverse effects. [2]
Common mistakes include:
A recurring problem is symptom-based dosing. High blood pressure may remain silent, while nifedipine side effects may be felt even when the blood-pressure benefit is substantial. Both the readings and the symptoms matter.
In clinical practice, prescribers usually assess Adalat through two measures: blood-pressure readings and tolerability. A reading may improve before a person notices any physical change. Angina prevention also takes consistency; missing doses can allow symptoms to return.
NICE hypertension guidance places calcium-channel blockers among established treatment options, with selection guided by age, ethnicity, co-existing illness, blood-pressure response, and other medicines. [3] Nifedipine can be a good fit when artery relaxation is the desired effect, though ankle swelling may limit long-term tolerability for some people.
Nifedipine begins relaxing blood vessels after it is absorbed, but blood-pressure management is assessed through repeated readings rather than a single dose response. The 2025 British National Formulary advises titration of antihypertensive therapy according to response and tolerability. A stable routine gives a more meaningful picture than irregular dosing. Home readings should be recorded at similar times when monitoring is requested.
Adalat can generally be taken with or without food, provided the routine stays consistent. The key dietary restriction is grapefruit, which can increase nifedipine exposure through CYP3A4 inhibition. The 2025 MHRA Summary of Product Characteristics for nifedipine describes food and interaction considerations for this medicine. Grapefruit juice should be avoided for the duration of treatment.
Nifedipine widens small arteries, increasing capillary pressure and allowing fluid to move into ankle tissues. This is called peripheral oedema and is a recognised calcium-channel blocker effect. The 2025 MHRA Summary of Product Characteristics for nifedipine lists oedema among recognised adverse effects. Swelling that is sudden, one-sided, painful, or associated with breathlessness needs urgent assessment.
Adalat is used to prevent angina rather than provide rapid relief of an acute chest-pain episode. The WHO’s 2023 cardiovascular disease guidance treats new or persistent chest pain as a symptom requiring prompt evaluation, especially when associated with breathlessness, sweating, nausea, or collapse. People with an angina action plan should follow the medicine instructions provided for acute symptoms. New pain at rest is an emergency warning sign.
Alcohol can contribute to dizziness, light-headedness, and low blood pressure, especially early in treatment or after a dose adjustment. The 2025 NHS patient guidance on nifedipine advises awareness of dizziness and reduced alertness during treatment. Avoid driving or hazardous tasks if dizziness, visual disturbance, or marked tiredness occurs. Large alcohol intake can also make blood-pressure readings less predictable.
Yes. St John’s wort can induce CYP3A4 and may reduce nifedipine concentrations, making blood-pressure or angina control less reliable. The 2018 EMA European Union herbal monograph on Hypericum perforatum identifies clinically relevant enzyme-inducing interactions with St John’s wort. This interaction can persist after the herbal product is stopped because enzyme activity takes time to return to baseline. Do not start or stop it while taking Adalat without prescriber review.
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Modified-release nifedipine preparations are intended to deliver medication more gradually than immediate-release forms. This allows steady treatment for chronic hypertension or angina prevention and may reduce abrupt blood-pressure changes.
The wording used for extended delivery can vary between prescribed preparations. What matters clinically is whether the tablet is intended for gradual release, how often it is prescribed, and whether it must remain intact when swallowed.
Do not assume that all nifedipine tablets can be substituted tablet-for-tablet. A modified-release formulation and an immediate-release formulation may act over very different time periods.
