Nifedipine gastrointestinal therapeutic system (GITS) in the treatment of coronary heart disease and hypertension

Abstract

Since the 1960s, calcium antagonists have been available for the treatment of angina pectoris and hypertension. The first of this class, nifedipine, was introduced and readily accepted as the third treatment option for angina, alongside β-blockers and nitrates. However, the short-acting formulations of nifedipine had pharmacokinetic properties that were far from ideal and in 1995, several studies involving various dosing regimens reported possible dangerous effects in secondary prevention. Since then, large-scale, randomized controlled trials with new controlled-released formulations of nifedipine have demonstrated the effectiveness and safety of this drug. As a consequence of these results, guidelines for both hypertension and angina pectoris have been recently reconsidered, and have put the modern formulations of calcium channel blockers in a pole position. Within this group of therapeutics, nifedipine gastrointestinal therapeutic system has a unique position and it cannot be replaced by other controlled-release formulations of nifedipine, the pharmaceutical properties of which have yet to be tested in large-scale outcome trials.

Keywords::

• atherosclerotic disease
• calcium channel blockers
• coronary heart disease
• GITS
• hypertension
• nifedipine
• treatment guidelines

Acknowledgements

During the preparation of this article, the help of R Agrawal in revising the manuscript and giving valuable advice on the subject was very much appreciated. J Bergmans supervised the final version of the manuscript in taking care of the correct documentation and the many references needed.