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Nifedipine therapy administered sublingually or swallowed during treatment of hypertensive emergencies and pseudoemergencies has been widely used in the last decade. Severe adverse effects including symptomatic hypotension,¹ stroke,² ST-segment depression, ventricular fibrillation,³ and myocardial infarction have been reported.⁴ We describe herein a patient who developed anaphylaxis after receiving sublingual nifedipine for pseudoemergency hypertensive treatment.

A 71-year-old man with a history of prostatic adenocarcinoma that had been treated with hormonal blockade for the previous 3 months visited our accident and emergency department because of a pathologic L1 vertebral fracture. His blood pressure was reported at 210/120 mm Hg during a rheumatologic workup. He had no history of drug allergy, atopy, or hypertension. There was no evidence of target organ damage on examination of fundus oculi, heart, lungs, and central nervous system. The patient received 10 mg of sublingual nifedipine. Fifteen minutes later, he became stuporous (Glasgow coma scale score, 11) and . . . [Full Text of this Article]

RELATED ARTICLE

Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies?
E. Grossman, F. H. Messerli, T. Grodzicki, and P. Kowey
JAMA. 1996;276(16):1328-1331.
ABSTRACT