Do not take Nifedin 20mg Retard if:

• you have had a heart attack within the last month
• you get a sudden angina attack. Nifedin 20mg Retard will not help relieve symptoms of angina quickly.
• you have unstable angina
• you are allergic to the active ingredient (nifedipine), to any other similar medicines known as dihydropyridines (e.g. amlodipine, felodipine and nimodipine) or to any of the other ingredients of this medicine (See section 6).
• you are taking rifampicin, an antibiotic
• you have been told that you have a narrowing of the aortic heart valve (stenosis)
• 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
• your blood pressure continues to rise despite treatment (malignant hypertension)
• you have been told to avoid lactose, that you have a hereditary condition called Lapp lactase deficiency or glucose-galactose malabsorption.

Tell your doctor and do not take Nifedin 20mg Retard if any of these apply to you. If you are unsure whether you might have any of these conditions, please ask your doctor.

Warnings and precautions

Take special care with Nifedin 20mg Retard and check with your doctor or pharmacist before taking your medicine if:

• you have low blood pressure (may cause dizziness or fainting on standing up) and your doctor prescribed Nifedipress MR for your angina. Your blood pressure may be decreased further by this treatment
• you have a heart condition where your heart cannot cope with increased stress such as exercise (poor cardiac reserve)
• you are pregnant
• you are breastfeeding. If you need to take Nifedin 20mg Retard, you should stop breastfeeding before you start to take this medicine.
• you are a diabetic. The treatment for your diabetes may need to be adjusted. If you have any questions about this, ask your doctor
• 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 your blood pressure when you take Nifedin 20mg Retard
• your liver is not working properly. Your doctor may need to do some blood tests. You may also be given a lower dose of the medicine

Talk to your doctor before you take Nifedin 20mg 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 Nifedin 20mg Retard
• If you have chest pains after taking your first dose of Nifedin 20mg Retard. 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. Nifedin 20mg Retard may interfere with the results of certain urine tests.
• If you are a man who has been unable to father a child by in vitro fertilisation. Drugs like Nifedipress MR have been shown to impair sperm function.

Other medicines and Nifedin 20mg Retard:

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

Some medicines may affect the way Nifedin 20mg Retard works. Tell your doctor if you are taking:

• other medicines to treat high blood pressure
• Rifampicin (an antiobiotic)
• 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 sulfate 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 to treat insomnia or anxiety).

Nifedin 20mg Retard with food and drink:

You can take Nifedin 20mg Retard either with or without food.

Do not drink grapefruit juice or eat grapefruit while taking Nifedin 20mg Retard

Do not start taking Nifedin 20mg Retard 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 Nifedin 20mg Retard. Grapefruit juice is known to increase the blood levels of the active ingredient, nifedipine. This effect can last for at least 3 days.

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 Nifedin 20mg Retard but only after special consideration and agreement by your doctor.

Do not take Nifedin 20mg Retard if you are breast-feeding. If you need to take Nifedin 20mg Retard, you should stop breast-feeding before you start taking this medicine.

Driving and using machines:

Nifedin 20mg 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 applies particularly at the start of treatment, on changing the medication and in combination with alcohol.

Important information about some of the ingredients of Nifedin 20mg Retard

This medicine contains lactose (a sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking the medicine.

How to store Nifedin 20mg Retard Tablets

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

Do not store above 25°C.

Store your medicine in the original package in order to 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 the outer carton and on each blister strip 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 to protect the environment.