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September 1987

To the Editor.—

Arch Intern Med. 1987;147(9):1683-1684. doi:10.1001/archinte.1987.00370090158031

In response to the article by Wachter in the March issue of the Archives,1 "Symptomatic Hypotension Induced by Nifedipine in the Acute Treatment of Severe Hypertension," the adverse effects noted are at variance with the results of studies conducted by Pfizer Pharmaceuticals, New York. To investigate the action of nifedipine capsules in the treatment of severe hypertension, we carefully monitored over 250 patients for at least four hours and showed no hypotensive "overshoot" (data on file, Pfizer Pharmaceuticals). Furthermore, as stated by the author, no significant hypotension has been noted in the over 400 patients with severe hypertension treated with nifedipine (some of whom comprise our patient population) described in the literature. Although this is not a US Food and Drug Administration—approved indication for nifedipine, the prior excellent results in this situation reflect careful titration with consideration to pharmacokinetics.

As has been well documented and noted by the

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