Depin
Depin is nifedipine 5 / 10 mg capsules from Cadila — first-generation dihydropyridine CCB. Lower doses used for Raynaud’s, chilblains, and vasospastic conditions. For chronic hypertension, use the extended-release formulations (Nicardia Retard, Cardipin Retard) rather than IR capsules. Pregnancy-safe; also used for tocolysis (preterm labour).
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Depin?
Depin is a 5 / 10 mg nifedipine tablet from Cadila Pharmaceuticals — a first-generation dihydropyridine calcium-channel blocker (CCB). Introduced 1981 (Bayer as Adalat / Procardia) — the original dihydropyridine CCB. Short-acting immediate-release nifedipine caused controversy in the 1990s after reports of MI and mortality increase with sublingual / rapid-onset formulations; modern practice uses extended-release (Retard, MR, CC, XL, OROS) formulations exclusively for chronic hypertension. Plasma half-life IR ~2-5 hours; Retard / MR / CC / XL ~20-24 hours. Use ONLY extended-release nifedipine (Retard, MR, CC, XL, OROS, GITS) for chronic hypertension. Sublingual or crushed immediate-release nifedipine is contraindicated for chronic BP control — it causes rapid BP drops with reflex sympathetic activation, tachycardia, and in some studies MI or mortality. The ER formulations avoid these problems by delivering a smooth 24-hour plasma profile. Typical hypertension dose: Retard 20 mg twice daily OR CC/XL 30 mg once daily; target Retard 20-30 mg twice daily OR CC/XL 30-60 mg once daily. Main side effects: ankle (peripheral) oedema, flushing, headache from vasodilation, reflex tachycardia (blunted by amlodipine’s long half-life; common with IR nifedipine). Safe to combine with beta-blockers, ACE inhibitors, ARBs, and thiazides (unlike non-DHP CCBs). Pregnancy: nifedipine MR is pregnancy-safe and often first-line; amlodipine is reasonable second option.
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What Is Depin?
Depin is an oral 5 / 10 mg nifedipine tablet from Cadila Pharmaceuticals, supplied in 30-180 capsules. Introduced 1981 (Bayer as Adalat / Procardia) — the original dihydropyridine CCB. Short-acting immediate-release nifedipine caused controversy in the 1990s after reports of MI and mortality increase with sublingual / rapid-onset formulations; modern practice uses extended-release (Retard, MR, CC, XL, OROS) formulations exclusively for chronic hypertension.
Nifedipine belongs to the dihydropyridine calcium-channel blocker subclass, distinguished from the non-dihydropyridines (diltiazem, verapamil) by its selective action on vascular smooth muscle with minimal direct cardiac effect. This selectivity profile is clinically important: DHPs can be combined safely with beta-blockers (the combination is standard in angina), while non-DHPs cannot (additive bradycardia/heart-block risk).
How Nifedipine Works
Calcium-channel blockers bind L-type voltage-gated calcium channels and reduce calcium influx into the cell during depolarisation. In arterial smooth muscle, reduced calcium entry means less actin-myosin interaction and direct arterial vasodilation — lowering systemic vascular resistance and blood pressure.
Dihydropyridines are ~10-fold more potent on vascular smooth muscle than on cardiac muscle — so the dominant clinical effect is vasodilation, with minimal direct suppression of cardiac contractility or conduction. The body’s baroreflex can trigger mild reflex tachycardia after fast-onset vasodilation; this is the problem with short-acting nifedipine that led to the 1990s controversy — modern ER formulations eliminate it via slow smooth onset.
Onset of clinical effect: Retard onset 1-4 hours; full BP effect at 1-2 weeks.
Approved and Evidence-Based Uses
- Hypertension — Retard / CC / XL formulation only
- Hypertension in pregnancy — Retard/MR is first- or second-line alongside labetalol and methyldopa
- Preterm labour tocolysis (off-label but widely used) — relaxes uterine smooth muscle
- Prinzmetal / vasospastic angina
- Raynaud’s phenomenon
- Chronic stable angina — often combined with a beta-blocker (the beta-blocker blunts the reflex tachycardia)
Pivotal trial evidence: INSIGHT (2000) — nifedipine GITS non-inferior to co-amilozide for CV events in HTN. ACTION (2004) — nifedipine GITS added to standard angina therapy reduced need for coronary procedures.
Depin Dosage
Hypertension:
- Starting dose: Retard 20 mg twice daily OR CC/XL 30 mg once daily
- Target dose: Retard 20-30 mg twice daily OR CC/XL 30-60 mg once daily
- Maximum: Retard 60 mg twice daily OR CC/XL 90 mg once daily
- Titrate every 1-2 weeks based on BP response and tolerability (particularly oedema)
Angina: Retard 20-40 mg twice daily
Administration: once daily (or twice daily for IR nifedipine formulations). Swallow whole — do NOT crush or split extended-release formulations (delivers an IR dose with risk of hypotension). Take with or without food.
Discontinuation: no specific withdrawal syndrome; can be stopped without taper. BP will return to pre-treatment levels within 1-2 weeks.
Side Effects
Common (>5%, mostly mild and transient):
- Peripheral (ankle) oedema — Peripheral (ankle) oedema — similar mechanism to amlodipine; more common with nifedipine at higher doses. Gum hyperplasia is a recognised long-term complication (10-15% after 2+ years); practice meticulous oral hygiene and schedule dental reviews.
- Flushing (warm face and upper body)
- Headache (particularly at start of therapy; usually adapts within 2-4 weeks)
- Reflex tachycardia (palpitations) — less common with long-acting formulations
- Dizziness, postural hypotension
- Fatigue
- Mild constipation (less than non-DHPs)
Uncommon:
- Gingival hyperplasia (gum overgrowth) — 10-15% of long-term users; practice meticulous oral hygiene and schedule dental reviews every 6 months
- Rash, pruritus
- Nausea, abdominal discomfort
- Erectile dysfunction (rare)
- Liver enzyme elevations (usually mild, reversible)
- Rare reports of photosensitivity
Historical warning: short-acting (immediate-release) nifedipine capsules, particularly when used sublingually for “hypertensive urgency”, were associated with myocardial infarction and mortality increase in the 1990s (Psaty 1995). Modern practice uses ER (Retard/MR/CC/XL/OROS) formulations exclusively for chronic HTN. Never crush or open an ER capsule to make an IR dose.
Contraindications & Cautions
- Known hypersensitivity to nifedipine or dihydropyridine class
- Cardiogenic shock
- Severe aortic stenosis (can cause critical hypotension)
- Unstable angina or MI within 1 month (DHPs other than amlodipine)
- Obstructive hypertrophic cardiomyopathy (reduces outflow gradient dynamically)
- Severe hepatic impairment (all DHPs are hepatically metabolised)
Pregnancy: nifedipine MR is pregnancy-safe and is first- or second-line for gestational hypertension and preeclampsia alongside labetalol and methyldopa. Also used off-label for preterm-labour tocolysis.
Breastfeeding: small amounts in breast milk; generally considered acceptable with infant monitoring.
Drug Interactions
- Grapefruit juice — inhibits CYP3A4 metabolism; can raise plasma levels of amlodipine and particularly nifedipine/nimodipine by 2-3×. Avoid on treatment days, or use consistently if at all.
- Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, cobicistat) — raise CCB plasma levels; reduce dose or avoid
- Strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John’s wort) — reduce CCB plasma levels; may need dose increase
- Simvastatin — amlodipine modestly increases simvastatin exposure; cap simvastatin at 20 mg/day when combined
- Beta-blockers — DHPs combine safely with beta-blockers (the combination is standard in angina — beta-blocker blunts reflex tachycardia, CCB provides vasodilation). Distinct from non-DHP CCBs (diltiazem, verapamil) which should NOT be combined with beta-blockers.
- Other antihypertensives — generally complementary; monitor BP
- Sildenafil / tadalafil (PDE5 inhibitors for erectile dysfunction) — additive hypotension; caution particularly at high CCB doses
Calcium-Channel Blocker Class at a Glance
| CCB | Class | Niche |
|---|---|---|
| Amlodipine (Amlode, Amlip) | DHP (3rd gen) | Reference DHP; once-daily HTN + angina; ASCOT evidence |
| Nifedipine (Depin, Nicardia Retard, Cardipin) | DHP (1st gen) | Pregnancy-safe MR; tocolysis; must use ER formulations for chronic HTN |
| Nimodipine (Nimodip) | DHP (cerebrovascular) | Subarachnoid haemorrhage vasospasm prevention — NOT for routine HTN |
| Diltiazem (Dilzem, Dilzem CD) | Non-DHP (benzothiazepine) | HTN + rate control + angina; moderate cardiac effect |
| Verapamil (Calaptin 40, Calaptin SR) | Non-DHP (phenylalkylamine) | Strongest cardiac effect; SVT, AF rate, cluster headache |
DHP vs non-DHP — why it matters: DHPs (amlodipine, nifedipine) act selectively on arterial smooth muscle with minimal cardiac effect — safe to combine with beta-blockers. Non-DHPs (diltiazem, verapamil) slow AV nodal conduction and reduce cardiac contractility — do NOT combine with beta-blockers (additive bradycardia, heart block, acute heart failure risk). If your patient is already on a beta-blocker, use a DHP.
Storage
Store Depin below 25°C. Protect from light. Keep out of reach of children.
Frequently Asked Questions
Why have my ankles started swelling after Depin?
Peripheral oedema is a class effect of dihydropyridines, caused by pre-capillary arteriolar dilation that raises hydrostatic pressure in the lower-leg venules. It is NOT fluid overload and does NOT respond to diuretics. Management options: (1) reduce the CCB dose; (2) add an ACE inhibitor or ARB which balances pre- and post-capillary vasodilation and eliminates the oedema mechanism (often the preferred solution); (3) switch to a non-DHP CCB (diltiazem, verapamil) if rate-related side effects are acceptable; (4) leg elevation and compression stockings as adjuncts.
How long does Depin take to lower blood pressure?
ER/Retard nifedipine: noticeable BP drop within 1-4 hours; full effect at 1-2 weeks.
Can I take Depin with a beta-blocker?
Yes — DHPs combine safely with beta-blockers. The combination is standard in angina: the DHP vasodilates and reduces myocardial oxygen demand; the beta-blocker blunts the reflex tachycardia. This is different from non-DHP CCBs (diltiazem, verapamil) which should NOT be combined with beta-blockers due to additive bradycardia and heart-block risk.
Can I eat grapefruit on Depin?
Grapefruit (juice and fresh fruit) inhibits CYP3A4 metabolism and can raise nifedipine plasma levels by 2-3×, increasing the risk of hypotension, dizziness, and oedema. Best practice: avoid grapefruit/juice while on CCBs, or consume consistently (your dose is titrated to BP response; sporadic grapefruit disrupts that).
Is Depin safe in pregnancy?
Nifedipine MR is pregnancy-safe and is first- or second-line antihypertensive in pregnancy alongside labetalol and methyldopa. Also used off-label to delay preterm labour (tocolysis).
Can I combine Depin with my other BP medications?
Yes — DHP CCBs combine well with ACE inhibitors (ramipril, lisinopril), ARBs (losartan, telmisartan, olmesartan), beta-blockers (bisoprolol, metoprolol), and thiazide diuretics (HCTZ). The ACEi/ARB + CCB combination is particularly useful because it eliminates the ankle oedema side effect.
Why should I not use immediate-release nifedipine for chronic HTN?
Short-acting (immediate-release) nifedipine causes rapid BP drops with reflex sympathetic activation — tachycardia and a surge in sympathetic tone that, in some observational studies from the 1990s, was associated with myocardial infarction and mortality increase. The extended-release formulations (Retard, MR, CC, XL, OROS) deliver the same total daily dose over 24 hours with a smooth plasma profile and do not have this problem. Always use extended-release nifedipine for chronic hypertension, never IR capsules.
Where can I buy Depin online?
You can buy Depin (nifedipine 5 / 10 mg, 30-180 capsules) from MedsBase with discreet packaging and worldwide shipping.
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| Strength | 5 mg, 10 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s |
| Pharma Form | Capsule/s |
| Manufacturer | Zydus Cadila Pharma |
| Treatment | High blood pressure, Chest pain (Angina) |
| Generic Brand | Nifedipine |
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