Critical nitrendipine shortage leaves blood pressure patients scrambling for alternatives

Patients relying on the blood pressure medication nitrendipine are facing ongoing shortages. The problem affects all manufacturers of both the 10 mg and 20 mg doses. Doctors have begun switching prescriptions to alternative treatments as a result.

The shortages began last summer, with multiple companies struggling to meet demand. Aristo, Ratiopharm, Aliud Pharma, and AbZ have all reported production issues. Aristo's 20 mg formulation was initially expected to return by the end of 2023, but delays now push its availability to late 2026.

Ratiopharm and Aliud Pharma plan to resume 20 mg supplies by the end of March. AbZ expects to restart deliveries by the end of May. Meanwhile, the 10 mg version remains unavailable from all producers. Nitrendipine belongs to a class of drugs called calcium channel blockers. These medications work by blocking calcium from entering cells, which helps keep arteries relaxed and blood pressure stable. They fall into three main types: nifedipine, verapamil, and diltiazem. However, they are not suitable for patients with heart failure or those recovering from a heart attack. Common side effects include low blood pressure, headaches, flushing, and irregular heartbeats. As nitrendipine prescriptions drop, doctors are increasingly prescribing alternatives like amlodipine and lercanidipine. Germany's Federal Institute for Drugs and Medical Devices (BfArM) has listed nitrendipine among its reported shortages, highlighting broader supply issues for older medications.

The shortage has forced many patients to switch to different calcium channel blockers. While some manufacturers expect to restore supplies in the coming months, others face much longer delays. The situation reflects wider challenges in securing consistent drug production for long-established treatments.