Extended-release nifedipine bezoar identified one year after discontinuation

OBJECTIVE: To report a case of table impaction of nifedipine extended-relea se tablets (Procardia XL) discovered one year after discontinuation of the drug in a patient with peptic stricture. DATA SOURCES: English-language references identified via a MEDLINE search f rom 1966 through September 1998 and bibliographic review of pertinent artic les. DATA SYNTHESIS: Extended-release nifedipine has been associated wit the for mation of medication bezoars in cae reports. Bezoars are concretions of und igested material within the gastrointestinal (GI) tract. Although they can occur throughout the GI tract, bezoars are most frequently located in the s tomach and, rarely, in the duodenum. We report an unusual case of tablet im paction with a gastric outlet obstruction in the duodenal area discovered o ne year after the patient stopped takin extended-release nifedipine. CONCLUSIONS: Extended-release nifedipine is associated with tablet impactio n, even long after discontinuing administration. Although rare, clinicians should be aware of this potential problem when prescribing extended-release medications to patients at risk, and should consider this possible etiolog y when refractory epigastric pain and weight loss occur.