Ventricular arrhythmia following short-acting nifedipine administration

M. Patricia Castaneda, Christine A. Walsh, Robert P. Woroniecki, Marcela Del Rio, Joseph T. Flynn

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Short-acting nifedipine is still advocated for use in children with severe hypertension, but is no longer recommended for use in adults because of adverse effects from rapid blood pressure reduction. A 19 year-old adolescent with symptomatic, severe hypertension (blood pressure 180/120) received 10 mg of short-acting nifedipine sublingually for blood pressure reduction. Within minutes after the dose, the patient complained of palpitations. Tachycardia (heart rate 100 beats per minute) and bigeminy were noted on the cardiac monitor. The bigeminy resolved but premature ventricular contractions were noted for the duration of her hospital stay. We hypothesize that reflex sympathetic activation following an abrupt drop in blood pressure may cause arrhythmias because of elevated catecholamine levels. Given this, it may be more appropriate to treat severe hypertension in children with intravenous antihypertensive agents that can be titrated to produce controlled reductions in blood pressure.

Original languageEnglish (US)
Pages (from-to)1000-1002
Number of pages3
JournalPediatric Nephrology
Issue number7
StatePublished - Jul 2005


  • Adolescents
  • Arrhythmia
  • Bigeminy
  • Calcium channel blockers
  • Children
  • Drug safety
  • Hypertension
  • Nifedipine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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