Case report: nifedipine-rifampicin interaction attenuates the effect on blood pressure in a patient with essential hypertension

Am J Med Sci. 1992 Jan;303(1):25-7. doi: 10.1097/00000441-199201000-00006.


A 72-year-old woman with 5-year history of essential hypertension developed peritoneal tuberculosis. The patient's hypertension, which had been well-controlled by long-acting nifedipine, deteriorated after the administration of rifampicin, an antitubercular agent. During use of nifedipine and rifampicin, both the peak plasma concentration and the area under the curve of nifedipine decreased markedly to about 40% of those without rifampicin. The findings suggest that rifampicin may increase the elimination of nifedipine, presumably by induction of its hepatic metabolism. Nisoldipine, another calcium antagonist, also failed to lower the patient's blood pressure, when given in combination with rifampicin. Taken together, these findings indicate that more caution should be urged when calcium antagonist is prescribed along with rifampicin.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use
  • Aged
  • Blood Pressure / drug effects*
  • Drug Interactions
  • Ethambutol / therapeutic use
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Isoniazid / therapeutic use
  • Nicardipine / therapeutic use
  • Nifedipine / blood
  • Nifedipine / therapeutic use*
  • Propranolol / therapeutic use
  • Quinazolines / therapeutic use
  • Rifampin / therapeutic use*


  • Adrenergic alpha-Antagonists
  • Quinazolines
  • Ethambutol
  • bunazosin
  • Propranolol
  • Nicardipine
  • Nifedipine
  • Isoniazid
  • Rifampin