To the Editor.
—The conclusion of the article by Dr Grossman et al1 might be paraphrased as this: Although not approved for this purpose, nifedipine capsules have been used (orally and sublingually) for acute reduction of blood pressure. Several well-documented reports describe profound hypotension, MI, and death when immediate-release nifedipine capsules were used in this setting. The use of immediate-release nifedipine capsules for this purpose should be avoided.This is good advice. In fact, these recommendations and this wording have been part of the FDA-approved labeling (written communication, Raymond J. Lipicky, MD, Food and Drug Administration, August 25,1993) of immediate-release nifedipine capsules since 1993.
Fenichel RR. Nifedipine for Hypertensive Emergencies. JAMA. 1997;277(10):790. doi:10.1001/jama.1997.03540340024021