Do not take Adalat Retard 20mg:

• If you have had a heart attack within the last month.
• If you get a sudden angina attack. Adalat Retard will not help relieve symptoms of angina quickly.
• If you have unstable angina.
• If you are allergic to nifedipine, any other similar medicines (known as dihydropyridines) or any of the other ingredients of this medicine (listed in section 6).
• If you are taking rifampicin, an antibiotic.
• If you have a liver disease that prevents your liver from working properly.
• If you have inflammation of the bowel or intestines, such as Crohn’s disease.
• If you have an obstruction or narrowing in your intestines, or have had this in the past.
• If you have ever had an obstruction in the gullet (the oesophagus – the tube connecting the throat to the stomach).
• If you have been told that you have a narrowing of the aortic heart valve (stenosis).
• If you have ever had a collapse caused by a heart problem (cardiogenic shock), during which you became breathless, pale and had a cold sweat and dry mouth.
• If you have a “Kock pouch” (a surgically constructed intestinal reservoir with an opening through the abdominal wall) in your gut.
• If your blood pressure continues to rise despite treatment (malignant hypertension).

• Tell your doctor and do not take Adalat Retard if any of these apply to you.

Warnings and precautions

Talk to your doctor before taking Adalat Retard

• If you have low blood pressure and you were prescribed Adalat Retard for your angina. Your blood pressure may be decreased further by this treatment.
• If you have a heart condition where your heart cannot cope with increased strain (poor cardiac reserve).
• If you are pregnant.
• If you are breast-feeding. If you need to take Adalat LA, you should stop breast-feeding before you start to take this medicine.
• If you are a diabetic. The treatment for your diabetes may need to be adjusted. If you have any questions about this, ask your doctor.
• If you are on kidney dialysis. If you have a very high blood pressure and a low blood volume, you might experience a sudden drop in blood pressure when you take Adalat LA.
• If your liver is not working properly. Your doctor may need to do some blood tests. You may also be given a lower dose of Adalat LA.

• Talk to your doctor before you take Adalat Retard if any of these apply to you.

Tell your doctor:

• If your chest pain (angina) gets worse (comes on more often or more severely) over a matter of hours or days. You may be advised not to take Adalat LA.
• If you have chest pains after taking your first dose of Adalat LA. Your doctor may wish to change your treatment.
• If you notice increased breathlessness.
• If you notice swelling of the ankles.

• Tell your doctor before you take the next dose if any of these apply to you.

Also tell your doctor:

• If you are giving a urine sample. Adalat Retard may interfere with the results of certain urine tests.
• If you are to have a barium contrast x-ray (barium meal). These tablets may affect the results of the test.
• If you are a man who has been unable to father a child by in vitro fertilisation. Drugs like Adalat Retard have been shown to impair sperm function.

Other medicines and Adalat Retard

Tell your doctor if you are taking, have recently taken or might take any other medicines.

Some medicines may affect the way Adalat Retard works. Tell your doctor if you are taking:

• Other medicines to treat high blood pressure.
• Rifampicin (an antibiotic).
• Cimetidine (to treat stomach ulcers).
• Digoxin, diltiazem, quinidine or beta-blockers (to treat heart conditions).
• Quinupristin/dalfopristin (a combination antibiotic).
• Phenytoin, carbamazepine or valproic acid (to treat epilepsy).
• Cisapride (to treat reduced movements of the gullet and stomach).
• Magnesium sulphate injections during pregnancy (may cause a severe fall in blood pressure).
• Erythromycin (an antibiotic).
• Ketoconazole, itraconazole or fluconazole (anti-fungal medicines).
• Indinavir, nelfinavir, ritonavir, saquinavir or amprenavir (to treat HIV).
• Fluoxetine or nefazodone (to treat depression).
• Tacrolimus (to prevent the rejection of transplanted organs).
• Phenobarbital (usually used to treat insomnia or anxiety).

Adalat LA with food and drink

You can take Adalat Retard with or without food.

Do not drink grapefruit juice or eat grapefruit while taking Adalat Retard.

Do not start taking Adalat LA within 3 days of drinking grapefruit juice or eating grapefruit. Tell your doctor if you have had grapefruit or grapefruit juice in this time. Also, do not drink grapefruit juice or eat grapefruit whilst taking Adalat Retard. Grapefruit juice is known to increase the blood levels of the active ingredient, nifedipine. This effect can last for at least 3 days.

Adalat Retard contains 9.4 mg of sodium (main component of cooking/table salt). This is less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’. Increasing the daily dose to 90 mg nifedipine results in an intake of 28.2 mg sodium. This is equivalent to 1.41 % of the recommended maximum daily dietary intake of sodium for an adult. Tell your doctor if you are on a low-salt diet.

Pregnancy and breast-feeding

If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

You may be able to use Adalat Retard but only after special consideration and agreement by your doctor.

Do not take Adalat Retard if you are breast-feeding. If you need to take Adalat LA, you should stop breast-feeding before you start taking this medicine.

Driving and using machines

Adalat Retard may make you feel dizzy, faint, extremely tired or have visual disturbances. Do not drive or operate machinery if you are affected in this way.

This may be more likely when you first start treatment, if you change tablets, or if you have drunk alcohol.

 How to store Adalat Retard

Keep this medicine out of the sight and reach of children.

Do not store above 30°C.

Store your medicine in its original container. Protect from strong light and only remove the tablet from the blister strip when you are about to take it.

Do not use this medicine after the expiry date which is stated on both the outer carton and on each blister strip of tablets after EXP. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.