Niferin SR Special Precautions

Care must be exercised in patients with very low blood pressure (severe hypotension with systolic pressure less than 90 mm Hg), in cases of manifest heart failure and in case of severe aortic stenosis.
As with other non-deformable material care should be used when administering Niferin SR 30 mg Tablets in patients with pre-existing severe gastrointestinal narrowing because obstructive symptoms may occur. In single cases obstructive symptoms have been described without known history of gastrointestinal disorders.
Niferin SR 30 mg Tablets must not be used in patients with Kock pouch (ileostomy after proctocolectomy).
When dosing barium contrast X-ray Niferin SR 30 mg Tablets may cause false positive effects (e.g. filling defects interpreted as polyp).
Care must be exercised in pregnant women, when administering nifedipine in combination with i.v. magnesium sulfate.
In patients with impaired liver function careful monitoring and, in severe cases, a dose reduction may be necessary.
Fertility: In single cases of in-vitro fertilization calcium antagonists like nifedipine have been associated with reversible biochemical changes in the spermatozoa's head section that may result in impaired sperm function. In those men who are repeatedly unsuccessful in fathering a child by in-vitro fertilization, and where no other explanation can be found, calcium antagonists like nifedipine should be considered as possible causes.
Effect on ability to drive and operate machines: Reactions to the drug, which vary in intensity from individual to individual, can impair the ability to drive or to operate machinery. This applies particularly at the start of the treatment, on changing the medication and in combination with alcohol.