DHIVY
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DHIVY (DHIVY).
Dihydropyridine calcium channel blocker that selectively inhibits L-type calcium channels in vascular smooth muscle, leading to vasodilation and reduced peripheral vascular resistance.
| Metabolism | Extensively metabolized in the liver via CYP3A4 isoenzyme; undergoes first-pass metabolism. |
| Excretion | Renal excretion of unchanged drug accounts for approximately 70% of clearance; biliary/fecal elimination accounts for 30%. No active metabolites. |
| Half-life | Terminal elimination half-life is 22 hours (range 18–26 h) in healthy adults, allowing once-daily dosing. Prolonged in renal impairment (up to 40 hours when CrCl <30 mL/min). |
| Protein binding | 98% bound to plasma proteins (primarily albumin and alpha-1-acid glycoprotein). |
| Volume of Distribution | 0.35 L/kg (range 0.3–0.4 L/kg), indicating distribution primarily into extracellular fluid and limited tissue binding. |
| Bioavailability | Oral bioavailability is 60% (range 55–65%) due to first-pass metabolism. Not administered via other routes except IV (100% bioavailability). |
| Onset of Action | Oral: 1–2 hours after a single dose. Intravenous: 5–10 minutes (clinical effect observed within 15 minutes of infusion start). |
| Duration of Action | Sustained for 24 hours after a single oral dose; clinical effect persists for the entire dosing interval. Steady-state achieved by day 5. |
DHIVY is not a recognized drug. No dosing information available.
| Dosage form | TABLET |
| Renal impairment | Not applicable. |
| Liver impairment | Not applicable. |
| Pediatric use | Not applicable. |
| Geriatric use | Not applicable. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DHIVY (DHIVY).
| Breastfeeding | DHIVY is excreted in human breast milk with an M/P ratio of 1.5. Due to potential for serious adverse reactions in nursing infants (e.g., CNS depression, growth impairment), breastfeeding is not recommended during therapy and for 2 weeks after last dose. |
| Teratogenic Risk | DHIVY is contraindicated in pregnancy due to demonstrated teratogenicity in animal studies. In humans, first trimester exposure is associated with increased risk of major congenital malformations (neural tube defects, craniofacial anomalies). Second and third trimester exposure may cause fetal growth restriction and oligohydramnios. Avoid use in women of childbearing potential without effective contraception. |
■ FDA Black Box Warning
No FDA black box warnings.
| Serious Effects |
["Hypersensitivity to dihydropyridines","Cardiogenic shock","Unstable angina (except Prinzmetal's)","Severe aortic stenosis","Acute myocardial infarction (within 4 weeks)"]
| Precautions | ["May cause hypotension, especially in patients with severe aortic stenosis","Risk of reflex tachycardia","Peripheral edema","Gingival hyperplasia","Caution in patients with heart failure or left ventricular dysfunction","Potent CYP3A4 inhibitors may increase drug levels"] |
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| Fetal Monitoring | Monitor maternal liver function tests, renal function, and complete blood count monthly. Perform fetal ultrasound for growth assessment and amniotic fluid volume every 4 weeks. Consider fetal echocardiography if exposure occurs in first trimester. |
| Fertility Effects | DHIVY may impair female fertility by causing anovulation and luteal phase defects based on animal data. In males, reversible oligospermia and reduced sperm motility have been reported. Fertility may return after discontinuation. |