Procardia XL (nifedipine xl) is a calcium-channel blocker used to lower blood pressure and prevent angina. The medication works by disrupting the flow of calcium, blocking it from being absorbed into cells. This in turn causes blood vessels to relax, improving blood flow and oxygen delivery while reducing the heart's overall workload.

Though less common, Procardia XL is also used in treating Raynaud's phenomenon, a condition in which arterial spasms severely restrict blood flow to the fingers and sometimes other extremities, causing pain and numbness.

The XL in this product stands for extended-release, meaning this particular medication is usually taken just once per day. It is also sold as Adipine XL, Adalat XL, Nifedical XL, and other names.

This product comes in tablets; like most extended-release medications, tablets should not be crushed or chewed. Some versions will have a score line on each tablet; these may be split. If there's no score line it should be swallowed whole. Taking tablets with food is optional. Avoid grapefruit and grapefruit juice while taking Procardia XL; it may make the medication significantly more powerful.

Taking Control of Blood Pressure

Patients diagnosed with hypertension (high blood pressure) will likely be given a prescription for Procardia XL or similar medications. Along with treating the immediate hypertension, patients are also typically encouraged to make lifestyle changes; quitting smoking, losing weight, exercise and so forth will usually help with blood pressure and general heart health. Those unable to make sufficient lifestyle changes will likely take Procardia XL or other hypertension treatments for the remainder of life.

Procardia XL may be sufficient on its own, or it may be given with other anti-hypertensive treatments if a single medication isn't sufficient to control blood pressure. Treatment with Procardia XL is usually similar regardless of other medications:

• Most patients start on 30 to 60 mg, taken once per day.
• After one or two weeks, dosage may be increased, if needed, up to 120 mg taken once per day.
• Do not exceed 120 mg per day without doctor approval. Rarely dosage may be increased to 240 mg per day, but adding other anti-hypertensive treatments will provide more benefit than higher doses of Procardia XL.

Procardia XL works fairly quickly, with substantial results being seen just a few days after starting treatment, and dosage adjustments may be made sooner than the 7 to 14 days recommended. If time permits, however, most doctors prefer to wait a week or two to be sure maximum benefit is reached before modifying dosage.

Hypertension rarely produces noticeable side effects until a major medical event, such as stroke, heart attack, or kidney failure. Be sure to take blood pressure medication as directed, even if otherwise feeling fine.

Managing Angina

Procardia XL may be given to help reduce the occurrence of angina and, when it does happen, to make it less severe. A doctor will need to determine if the type of angina being experienced will respond to Procardia XL.

Angina is usually the result of insufficient oxygen reaching the heart. Procardia XL's action of relaxing and widening blood vessels, therefore improving blood flow and oxygen delivery, provides obvious benefit. The medication will lower blood pressure, however, so is not suitable for those with normal or low blood pressure.

Treatment is similar to use for hypertension:

• Most patients start on 30 to 60 mg, taken once per day.
• After one or two weeks, dosage may be increased, if needed, up to 120 mg taken once per day.
• Do not exceed 120 mg per day without explicit doctor approval.

Note that Procardia XL is not a "rescue" treatment; it will do nothing for an angina attack in progress. Rescue treatments, like nitroglycerin, should continue to be used as-needed.

Most patients taking Procardia XL for angina find that, after a few weeks of treatment, angina attacks become considerably less frequent or are eliminated entirely, even if doing relatively strenuous activity.

Treating Raynaud's Phenomenon

Procardia XL can provide benefit in treating Raynaud's phenomenon provided the Raynaud's phenomenon is not secondary to erythromelalgia. Calcium channel blockers like this product can cause erythromelalgia to flare up.

For Raynaud's phenomenon extended-release vasodilators---particularly calcium channel blockers like Procardia XL---are often preferred treatments. Medications like this do reduce the frequency and severity of attacks but there seems to be a lot of variations between patients, with some saying the difference is only marginal while others find symptoms are completely gone.

Treatment is similar to other uses:

• Most patients start on 30 to 60 mg, taken once per day.
• After one or two weeks, dosage may be increased, if needed, up to 120 mg taken once per day.
• Do not exceed 120 mg per day without explicit doctor approval.

Again, regardless of what it's used for, Procardia XL will lower blood pressure. Patients with normal to low blood pressure are not good candidates for this medication.