Drug interactions
Nisoldipine + Zafirlukast
Severity: Moderate
Nisoldipine and Zafirlukast: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nisoldipine has low bioavailability because of extensive first-pass CYP3A4 metabolism and is sensitive to inhibitors. Even a weak inhibitor such as zafirlukast could raise its levels, causing hypotension, flushing, headache or peripheral edema.
What this interaction means in plain words
Nisoldipine and Zafirlukast can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Nisoldipine belongs to Cardiovascular; Zafirlukast belongs to Respiratory.
Why it happens
Zafirlukast inhibits intestinal and hepatic CYP3A4, reducing first-pass metabolism of nisoldipine.
What to do
Monitor blood pressure and heart rate when starting zafirlukast. Reduce the nisoldipine dose if hypotension or edema develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Zafirlukast
- Pimozide + Zafirlukast Contraindicated
- Lomitapide + Zafirlukast Major
- Nilotinib + Zafirlukast Major
- Warfarin + Zafirlukast Major
- Apalutamide + Zafirlukast Moderate
- Carbamazepine + Zafirlukast Moderate
Other interactions of Nisoldipine
- Itraconazole + Nisoldipine Contraindicated
- Ketoconazole + Nisoldipine Contraindicated
- Apalutamide + Nisoldipine Major
- Carbamazepine + Nisoldipine Major
- Chloramphenicol + Nisoldipine Major
- Clarithromycin + Nisoldipine Major
Frequently asked questions
Can I take Nisoldipine with Zafirlukast?
MediHelp rates the interaction as moderate. Nisoldipine and Zafirlukast can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nisoldipine has low bioavailability because of extensive first-pass CYP3A4 metabolism and is sensitive to inhibitors. Even a weak inhibitor such as zafirlukast could raise its levels, causing hypotension, flushing, headache or peripheral edema.
How serious is the interaction between Nisoldipine and Zafirlukast?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate when starting zafirlukast. Reduce the nisoldipine dose if hypotension or edema develops.
What other medicines interact with Zafirlukast?
MediHelp also lists interactions of Zafirlukast with, for example, Pimozide, Lomitapide, Nilotinib. The full list is on the Zafirlukast page.
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