Ke Di

Nisoldipine

Treatment option: Hypertension

Medically reviewed

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ke Di

Property	Description
Active ingredient	Nisoldipine
Form	Extended-release tablet (Long-acting oral formulation)
Pharmacological class	Calcium channel blocker (Dihydropyridine derivative)
General purpose	Management of elevated arterial pressure
Origin	Synthetic derivative

What Type of Medicine is Ke Di (Nisoldipine)?

Ke Di is a prescription-only pharmaceutical preparation whose active component is Nisoldipine, a compound clinically recognized as a highly selective calcium channel blocker and a calcium ion antagonist. Nisoldipine belongs to the dihydropyridine derivative subclass, meaning it is a synthetic entity that selectively targets the vascular system. This classification reflects its role in managing cardiovascular function. This vascular selectivity is a distinguishing feature of the Nisoldipine compound, defined by its primary action on the peripheral arteries.

Composition and Formulation: The Extended-Release Tablet

The active ingredient, Nisoldipine, is formulated as an extended-release tablet intended for oral administration, designed to provide a sustained, long-acting effect. This physical form is a single-ingredient product utilizing specialized coating and matrix systems to manage drug delivery. The design of the extended-release tablet is essential because it is engineered to ensure a continuous and steady concentration of the active component over a full dosing interval. Nisoldipine exhibits a long half-life, which supports its utility for once-daily dosing regimens.

What is the General Purpose of This Medication?

The general purpose of the Ke Di medication is to manage conditions associated with excessive arterial constriction by inducing vasodilation. Nisoldipine achieves this by inhibiting the influx of calcium ions into the vascular smooth muscle cells, causing the arteries to widen and relax. The resulting physiological action is a fundamental decrease in peripheral vascular resistance. This core benefit is utilized to manage elevated arterial pressure and to provide relief from discomfort linked to poor arterial flow. A typical use scenario involves the sustained, routine management of high blood pressure in adult patients.

Regulatory References

What side effects are possible with Ke Di?

Possible Side Effects and Safety Information

The safety profile of Ke Di, which contains Nisoldipine, is organized according to official regulatory documentation, classifying documented adverse effects by frequency and the body system affected.

Adverse Reaction Classifications

Classification	Examples of Reactions
Very Common (ge 10%)	Peripheral edema (swelling of the extremities), Headache
Common (1% to 10%)	Dizziness, Palpitation, Vasodilation/Flushing, Pharyngitis, Sinusitis, Nausea, Rash
System-Organ Classes	Cardiovascular System, Nervous System, Respiratory System, Gastrointestinal System, Dermatological System

Serious Adverse Reactions and Constraints

Official labeling documents the potential for serious adverse reactions, including a rare but critical risk of worsening angina (chest pain) or acute Myocardial Infarction, particularly when treatment is initiated or the dose is adjusted. Other serious effects include pronounced hypotension (low blood pressure) and Systemic Hypersensitivity Reactions such as angioedema (swelling of the face, lips, or throat).

Time- and Exposure-Related Patterns: Adverse effects like peripheral edema are often observed within the first two to three weeks of therapy initiation. Pronounced hypotension and fainting are most likely to occur during the initial dosage titration or subsequent upward dose adjustments.

Population-Specific Safety: Dosage modification is explicitly required for patients with hepatic impairment (liver conditions) due to the reduced clearance of the medicine. Older adults may also require lower starting doses, as they may experience higher plasma concentrations. The safety and effectiveness have not been established for pediatric use, and use during pregnancy and lactation should be avoided.

Safety Restrictions: The medicine is contraindicated in individuals with a known allergy to Nisoldipine or other related calcium channel blockers. Official documents also restrict the consumption of grapefruit products and high-fat meals, as these significantly increase the drug's concentration, which raises the risk of adverse effects.

Overdose and Emergency Response

The regulatory information for an overdose of Nisoldipine (Ke Di) is defined by severe cardiovascular instability and the risk of delayed toxicity due to its extended-release formulation.

Documented Manifestations and Serious Outcomes

An overdose may result in a state of profound hypotension (extremely low blood pressure) and the rapid development of shock. Documented cardiac disturbances include severe changes in heart rate, such as a very slow heartbeat (bradycardia) or a potentially compensatory rapid heartbeat (tachycardia). Central nervous system signs, including confusion and the potential for seizures, are also documented manifestations. In severe cases, the potential for multiple organ failure and death is noted in regulatory materials. The risk is considered heightened for individuals with preexisting heart conditions or those who have co-ingested other cardioactive substances.

Emergency Actions and Monitoring Requirements

Regulators state that an individual must seek immediate medical help right away upon any suspicion of an overdose. This involves calling emergency services or the Poison Help hotline if the person is collapsed, seizing, or cannot be awakened. Due to the nature of the extended-release tablet, which risks delayed toxicity, an overnight hospital stay for continuous observation of vital signs and cardiac function (e.g., ECG) is typically required, even if initial symptoms appear mild. Management is supportive; documented measures include the administration of activated charcoal and intravenous fluids. Instructions caution specifically against attempting to induce vomiting without medical direction.

Therapeutic Uses of Ke Di

What Ke Di Treats: Main Uses and Benefits

Ke Di is primarily utilized for the routine, long-term management of essential arterial hypertension, a chronic condition defined by a persistent elevation in systemic blood pressure. It is applied in addressing conditions marked by increased physiological stress, such as sustained, elevated systemic pressure, and supports symptomatic relief in contexts of coronary circulation.

Controlling high blood pressure is intended to reduce the excessive strain on the heart and arteries. The key therapeutic benefit may assist with the management of pressure over the full daily period, which is commonly used to help with the reduction of long-term cardiovascular strain and supports the maintenance of functional stability. The medication may also assist with managing symptoms related to stable coronary artery disease, such as pressure-related chest discomfort.

The medication is relevant in contexts involving heightened systemic burden where continuous management of high blood pressure is appropriate. Indications include essential arterial hypertension and providing relief for pressure-related chest discomfort associated with stable coronary circulation.

“The action of managing systemic pressure contributes to easing the overall symptom load on the cardiovascular system.”

Quick Fact: Relevant for Managing Sustained Systemic Pressure and Coronary Circulation Discomfort

Regulatory References

NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Who Can and Cannot Use Ke Di (Nisoldipine)?

Official regulatory information defines specific populations that are eligible, restricted, or prohibited from using Ke Di, which contains the active ingredient Nisoldipine.

Populations Who Must Not Use Ke Di (Contraindications)

Classification	Exclusion Criteria
Hypersensitivity	Known allergy to Nisoldipine or any other dihydropyridine calcium channel blocker.
Dietary Restriction	Concomitant consumption of Grapefruit or Grapefruit Juice is strictly prohibited.
Dietary Restriction	Must not be taken with a high-fat meal as this impairs proper absorption.

Populations with Conditional or Restricted Use

Pediatric Patients (Children): Safety and effectiveness of Ke Di have not been established in this age group.
Geriatric Patients (Older Adults): Use requires cautious dose selection, generally starting at the lowest available dose, due to expected higher drug concentrations.
Hepatic Impairment: Patients with conditions like liver cirrhosis must use the medication with caution and require a lower initial dose.
Cardiovascular Conditions: Use should be cautious in patients with a history of severe obstructive coronary artery disease or compromised ventricular function (heart failure), as safety in these specific groups is not established.
Pregnancy and Lactation: Use during pregnancy is only recommended if the potential benefit justifies the risk, as adequate, well-controlled human studies are not available. Nursing mothers are generally advised to discontinue nursing or discontinue the drug.

What should I know about interactions with other medicines?

Interactions with other medicines and products

This section details the officially documented interaction patterns for Ke Di (Nisoldipine) based on regulatory information.

Documented Interaction Classifications

The most clinically relevant interactions are classified by regulatory authorities as either pharmacokinetic modification via the CYP3A4 enzyme system or additive pharmacodynamic effects.

Contraindicated Combinations: Co-administration with strong CYP3A4 enzyme inhibitors (e.g., Itraconazole) is formally prohibited due to the risk of extreme exposure increases. Grapefruit and Grapefruit Juice are also strictly contraindicated, as they significantly increase Nisoldipine plasma concentrations (Cmax and AUC).
Pharmacokinetic Modification: Nisoldipine is a CYP3A4 substrate. Strong CYP3A4 inducers (e.g., Phenytoin, Rifamycins) are restricted from co-administration as they can severely decrease plasma levels, while agents like Quinidine have also been shown to decrease Nisoldipine bioavailability.
Pharmacodynamic Interactions: Co-administration with other antihypertensive agents such as Beta-Blockers results in a documented additive hypotensive effect.

Administration and Population Notes

The extended-release formulation must be taken on an empty stomach, requiring a strict separation from a meal (1 hour before or 2 hours after) due to a major food effect. Furthermore, patients with hepatic impairment and elderly patients demonstrate documented decreased clearance, resulting in 2- to 3-fold higher plasma concentrations, which is an important consideration for interaction severity.

Mechanism of Action

Ion Channel Blockade and Vascular Relaxation

Nisoldipine, the active component of Ke Di, functions as a highly selective calcium ion antagonist, directly blocking the L-type voltage-gated calcium channels located on the membranes of vascular smooth muscle cells. This molecular interference prevents the influx of extracellular calcium ions (Ca^2+), which are essential for activating the contractile machinery of the smooth muscle tissue. This mechanism results in muscle relaxation and subsequent peripheral vasodilation.

Reducing Systemic Resistance (Afterload)

The consequence of arteriolar vasodilation is a reduction in Systemic Vascular Resistance (SVR), often termed afterload. The mechanism exhibits vascular selectivity, concentrating its action on the blood vessels rather than the myocardium. By lowering this resistance, the drug adjusts the mechanical conditions against which the heart pumps blood. The mechanical consequence is the primary physiological mechanism for the resulting reduction in systemic arterial pressure.

Sustained Mechanism via Extended Release

The utilization of an extended-release formulation provides a gradual and continuous rate of calcium channel blockade over a prolonged period. This sustained mechanism modulates the rate of resistance reduction, which limits the acute activation of the baroreceptor reflex—the physiological counter-response that can cause a temporary, compensatory increase in heart rate.

Dosage and Administration Information

Ke Di is an oral medication administered as an extended-release tablet and is generally prescribed for long-term, routine daily use. The extended-release formulation is designed to be taken once daily to maintain sustained drug levels.

The typical adult starting dose is 17 mg taken once per day. Dosage adjustments, if required, are made gradually in 8.5 mg increments at intervals of at least one week to allow for assessment of response. The maximum recommended daily dose for this formulation in adult patients is 34 mg.

Proper administration is essential for the extended-release function. The tablet must be swallowed whole and must never be crushed, divided, or chewed, as this compromises the intended delivery system. The medicine must be taken on an empty stomach, which is defined as one hour before or two hours after consuming a meal. Furthermore, strict avoidance of grapefruit and grapefruit juice is indicated throughout the treatment period.

Specific populations require modified regimens. For older adults and patients with hepatic impairment, the starting dose is reduced and should not exceed 8.5 mg once daily, due to increased systemic exposure. If a dose is missed, the dose should not be doubled; the patient should simply resume the usual regimen at the next scheduled time.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Ke Di (Nisoldipine)

This overview describes the official research evidence that exists for Ke Di (Nisoldipine extended-release), detailing the types of studies conducted and what their findings indicate, without providing medical advice or recommendations.

Evidence for Use in Essential Arterial Hypertension

Research explored the use of Ke Di in Randomized Controlled Trials (RCTs), many of which were double-blind, comparing the long-acting formulation to a placebo and other active medications. The studies monitored biomarker shifts such as blood pressure, specifically measuring changes in systolic and diastolic readings over the study period. Research examined the medication’s role in meeting pre-defined blood pressure thresholds. However, long-term effects are not fully established regarding certain cardiovascular outcomes. Studies involving comparison to other medications data show patterns related to certain major cardiovascular events in specific study settings. Evidence quality varies across studies and the results apply only to the populations studied.

Evidence for Use in Pressure-Related Chest Discomfort

Ke Di was studied for its role in addressing conditions associated with pressure-related chest discomfort. These trials primarily examined outcomes related to physical discomfort and functional measures. Researchers monitored changes in patient-reported outcomes describing perceived discomfort. Research explored long-term findings related to major cardiovascular events over a defined time interval. This research data show patterns related to a difference in the need for revascularization procedures compared to the group receiving placebo. However, the same study reported that the research did not find a difference in the underlying progression of the coronary artery disease when compared to placebo.

What is Still Uncertain About Ke Di Research

Key limitations include that long-term effects are not fully established for all high-risk populations, particularly for outcomes monitoring physiological strain or stress when compared to other drug classes. Comparative evidence against some newer drug classes for both indications is lacking. The available research provides insight into short-term changes, but the findings describe group patterns, not personal outcomes.

Key Studies & References

Nisoldipine: MedlinePlus Drug Information

Frequently Asked Questions (FAQ)

Common questions about Ke Di (FAQ)

Q: Does Ke Di interact with common over-the-counter pain relievers like Tylenol (Acetaminophen) or Advil (Ibuprofen)?

A: Regulatory documents mention that taking certain Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, may reduce the blood pressure-lowering effects of calcium channel blockers. Official information also indicates that Acetaminophen may potentially lead to a higher serum level of Ke Di (Nisoldipine) in the body. Information about potential interactions should be reviewed with a healthcare professional.

Q: What should I do if I accidentally take two Ke Di tablets at the same time?

A: The official product information does not provide direct guidance for patients who accidentally take two tablets. However, regulatory documents indicate that an overdose would likely cause an exaggeration of the drug's primary action, which may include pronounced hypotension (very low blood pressure) or fainting. Any time an overdose is suspected, contacting emergency medical services or a poison control center is advised.

Q: How long will it take for Ke Di to start lowering my blood pressure after I start taking it?

A: According to official product information, the extended-release formulation is designed to provide sustained reductions in blood pressure over the entire 24-hour dosing period. While regulatory text does not give an exact timeline for when the initial effect begins, the goal of the long-acting formulation is to provide a consistent effect through gradual release.

Q: If I have kidney disease, do I need a lower dose of Ke Di?

A: Official regulatory documents state that dose adjustments are typically not necessary for patients who have mild to moderate renal impairment (kidney disease). This is because the body's primary way of clearing Ke Di (Nisoldipine) does not heavily rely on the kidneys.

Q: Can I take Ke Di if I am planning to become pregnant?

A: Official information states that adequate, well-controlled human studies are not available. Regulatory information states that use during pregnancy is considered only when the potential benefit is believed to justify the potential risk to the fetus. It is also noted that the drug should be avoided in non-pregnant, non-lactating females in certain clinical trial settings.

How should Ke Di be stored and disposed of?

How to Store and Dispose of Ke Di (Nisoldipine Extended-Release)

Official regulatory labeling dictates strict conditions for the storage and disposal of Ke Di tablets.

Storage Requirements

Ke Di must be stored at Controlled Room Temperature, defined as 20 C to 25 C (68 F to 77 F). The medication must be actively protected from environmental factors that cause degradation: protect from light and moisture, and keep the container tightly closed.

Prohibited Conditions: Do not store near excess heat, and the medication must not be frozen.
Child Safety: All product must be stored securely out of the sight and reach of children and pets.

Disposal Instructions

Unused or expired Ke Di should be disposed of primarily through an official drug take-back program. Regulatory guidance prohibits flushing the tablets down the toilet or sink. If a take-back program is unavailable, the product may be mixed with an unpalatable substance (such as used coffee grounds) and sealed in a container before disposal in the household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.