Nifedipine pharmacokinetics and pharmacodynamics during the immediate postpartum period in patients with preeclampsia.

Abstract

Pharmacokinetic and pharmacodynamic parameters of oral nifedipine were studied in the immediate postpartum period in eight women with preeclampsia. Peak serum concentrations of 18 +/- 2.1 micrograms/L occurred 40 minutes after ingestion of nifedipine (10 mg). The terminal elimination half-life (mean = 1.35 +/- 0.3 hours) was found to be shorter than that reported for normotensive volunteers or nonpregnant hypertensive women (mean, 3.4 +/- 0.4 hours). A mean apparent oral elimination clearance of 3.3 +/- 1.3 L/hr/kg was more rapid than that found in normal volunteers (mean, 0.49 +/- 0.09 L/hr/kg) or in women with pregnancy-induced hypertension in the third trimester (mean, 2.0 +/- 0.8 L/hr/kg). Initial nadirs in mean arterial pressure were noted at 50 minutes after ingestion of nifedipine, with an average reduction in mean arterial pressure of 13.8 mm Hg. A dosing interval of every 3 to 4 hours is suggested when rapid-release nifedipine is used in the postpartum patient with preeclampsia.