Hello.

Thank you for your query at DoctorSpring.com.

I understand your concern. Rarely, Nifedipine can cause nasal congestion and also of the adjacent areas. 

Your symptoms of blocked ear and associated ringing are mainly due to congestion of a tube which connects the middle ear to the back of your nose, called the Eustachian tube. Congestion of the sinuses and the throat have brought about the other symptoms.

You can take a combination of an anti-histamine and decongestant and can continue Nifedipine.

I have the following suggestions.

1. Please take an OTC Pseudoepherine 120 mg + Loratidine 10 mg (e.g.: Claritin D 24-hour) once in the night for a week. This decongestant plus antihistamine combination will relieve and prevent congestion and help resolve your symptoms.

2. You should carry out steam inhalation at least 3 times daily. This will clear your sinuses and relieve congestion, as well as help clear the Eustachian tube block.

3. You can chew a gum to or try the Valsalva maneuver (Try to blow out against a pinched nose and pursed lips) to relieve the blocked ear. Chewing gum works by the repeated swallowing of saliva which in turn helps to clear the accumulated secretions within the eustachean tube. Valsalva maneuver also helps to clear the tube by forcing its contents out into the back of the nose.

4. Please carry out warm saline gargling 3-4 times daily.

This should relieve all your symptoms.

Feel free to ask queries.

Thank you. 

Hello.

You can take the two drugs separately instead of the combination. You can use any brand available as OTC containing OTC Pseudoephedrine such as Sudafed®/ Sudo-Tab®/ SudoGest/ Nexafed®/ Oranyl. Depending on the strength you find, please adjust the dosing interval as follows:

-Pseudoephedrine 60 mg, then take it 3 times daily.

-Pseudoephedrine 120 mg, then take it 2 times daily, 12 hours apart.

-Pseudoephedrine 240 mg, then take it once daily.

In addition to the Pseudoephedrine, you should take OTC Loratadine 10 mg (Claritin/ Alavert/ Loradamed), once in the night. If that is not available, alternatively you can use OTC Cetirizine 10 mg, once in the night.

Let me know if you have any queries.

Thank you.

Hello. Thank you for your appreciation. Nifedipine should be tapered and then stopped in patients with coronary artery disease in order to avoid worsening of chest pain. Since you are on Nifedipine for Raynaud's, it is safe to just stop it without tapering the dose. Calcium channel blockers are very much different from beta blockers. The dose of beta blockers needs to be gradually tapered before stopping them in order to avoid rapid heart beat, increase in blood pressure etc. These effects are usually not seen on stopping calcium channel blockers. Sudafed has the potential to raise blood pressure but practically this is not seen commonly. It can still be used in hypertensives but should be used cautiously. In non-hypertensive subjects, this is not a concern. So you need not worry. Good luck in finding a new doctor. Thank you.