Nicorandil

Brand Piq-Pharma

In stock 510 Items

Available since: 2019-09-19

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Clinical Pharmacology

Nicorandil has an antianginal effect, which is based on a combination of nitrate-like properties and the ability to open potassium channels. Due to the opening of potassium channels, nicorandil causes hyperpolarization of the cell membrane, and the nitrate-like effect is to increase the intracellular content of cyclic guanyl monophosphate. These pharmacological effects lead to relaxation of smooth muscle cells and cell protection of the myocardium during ischemia. Hemodynamic effects are expressed in a balanced decrease in pre- and afterload (as opposed to nitrates and “slow” calcium channel blockers (BCCA), which act mainly on pre- or afterload, respectively). Taking into account the selective vasodilation of the coronary arteries, as a result, the load on the ischemic myocardium is minimal. Nicorandil does not affect myocardial contractility, practically does not change the heart rate (HR). Reduces systemic blood pressure (BP) by less than 10%, has a beneficial positive effect on cerebral circulation in patients with ischemic stroke. Nicorandil does not affect lipid metabolism and glucose metabolism. Nicorandil relieves an attack of angina with a decrease in pain within 4-7 minutes after taking under the tongue and its complete relief in 12-17 minutes.

Indications

relief of angina attacks;
prevention of attacks of stable angina pectoris (in combination with other antianginal drugs) and in monotherapy for intolerance to beta-blockers and BMCC.

Composition

1 tablet contains nicorandil 10 mg.

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Dosage and Administration

For oral use. Squeezed with water, take, regardless of the meal.
The dose of the drug is selected individually depending on the severity and duration of the disease.
Relief of angina.
Cordinik should be taken immediately at the first signs of an angina attack: 1 tablet of Kordinik® 20 mg is placed under the tongue and held until completely dissolved, without swallowing.
Prevention of attacks of stable angina (long-term therapy of stable angina).
Cordic is usually prescribed in a dose of 10 to 20 mg 3 times a day.
The maximum daily dose of 80 mg.
If a headache occurs, the initial dose may be reduced.

Adverse reactions

The cardiovascular system: heartbeat, tachycardia, lowering blood pressure, "flushing" of blood to the skin of the face, peripheral edema.
Central nervous system: weakness, headache (does not require discontinuation of the drug, can be alleviated by reducing the initial dose of the drug), dizziness, tinnitus, insomnia.
Digestive tract: nausea, vomiting, discomfort in the stomach, feeling of fullness in the stomach, stomatitis (extremely rare); in some cases, it is possible to increase the activity of liver transaminases (alanine aminotransferase and aspartate aminotransferase), alkaline phosphatase.
Hypersensitivity Reactions: possible development of allergic reactions.

Contraindications

With care: cardiac arrhythmias, atrioventricular block I degree, Prinzmetal angina, hypotension, renal and / or liver dysfunction, hypovolemia, pulmonary edema, angle-closure glaucoma, hyperkalemia, anemia.

Drug interactions

When taken simultaneously with antidepressants, phosphodiesterase-5 inhibitors (sildenafil, vardenafil, tadalafil), vasodilators, antihypertensive drugs, tricyclic antidepressants, diuretics, beta-adrenergic blockers, monoamine oxidase oxidative inhibitors (artimics), anti-depressants.

Special instructions

Drug needs to be canceled gradually.
During the period of therapy with Cordinik, it is necessary to control blood pressure, ECG indicators, the content of potassium ions and sodium ions in the blood; possible enhancement of existing cardiac arrhythmias. Care must be taken when driving and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Overdosage

Symptoms: pronounced decrease in blood pressure, tachycardia.
Treatment: gastric lavage, the appointment of Activated charcoal (especially in the first 2 h after overdose), maintaining the function of the cardiovascular system, the elevated position of the limbs, symptomatic and supportive therapy, IV the introduction of calcium gluconate and dopamine. Perhaps the use of hemodialysis.