Nifedipine

Brand Krka dd Novo mesto AO

In stock 1053 Items

Available since: 2019-09-19

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Clinical Pharmacology

Cordipin® retard belongs to the group of calcium channel blockers, which is dihydropyridine. It has antianginal and antihypertensive activity. Expands coronary and peripheral arterial vessels, reduces the myocardial oxygen demand by reducing the afterload on the heart and oxygen delivery.

Indications

- stable angina, Prinzmetal angina
- arterial hypertension (in combination therapy)
- Raynaud's disease

Composition

1 tab .:
- nifedipine 20 mg,
excipients: microcrystalline cellulose, glyceryl palmitostearate, talc, anhydrous colloidal silicon dioxide, sodium lauryl sulfate, magnesium stearate, povidone.
film coating composition: methacrylate copolymer, talc, titanium dioxide, macrogol 4000, quinoline yellow dye.

Nifedipine is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Cordipin retard	Krka dd Novo mesto AO	Slovenia	pills
Calcigard retard	Torrent	India	pills
Nifedipine	Obolensky OP	Russia	pills
Nifecard hl	Sandoz	Switzerland	pills
Corinfar Retard	Teva	Israel	pills
Corinfar	Teva	Israel	pills
Cordaflex®	Egis	Hungary	pills
Fenigidin	Zdorovye	Russia	pills

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Dosage and Administration

Dose cordipina retard is selected individually.
The recommended dose is 1-2 pills 2 times a day.
The maximum daily dose is 60 mg.
For patients with Prinzmetal angina, the daily dose may be increased to 80–120 mg.

Adverse reactions

- headache, dizziness, orthostatic hypotension
- hyperemia of the skin, peripheral edema
- skin rash, urticaria, itching
- heart rhythm disorders (tachycardia, bradycardia, asystole), chest pain
- increased fatigue, muscle weakness, muscle cramps, tremor
- sleep disturbance
- nausea, heartburn, constipation, diarrhea, increased activity of hepatic transaminases, intrahepatic cholestasis
- impaired renal function
- agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia

Contraindications

- hypersensitivity to nifedipine or other dihydropyridines, other components of the preparation cordipin retard
- cardiogenic shock
- porphyria
- Aortic stenosis
- unstable angina
- sick sinus syndrome
- severe heart failure
- arterial hypotension
- acute myocardial infarction (1st week of acute period)
- lactose deficiency, galactosemia, glucose / galactose impaired absorption syndrome
- pregnancy, lactation
- children's and teenage age up to 18 years

Drug interactions

With the simultaneous appointment of nifedipine and other antihypertensive drugs, beta blockers, diuretics, nitroglycerin and isosorbid with a prolonged action should be taken into account the synergistic effect of these drugs (possibly a significant reduction in blood pressure).
The simultaneous appointment of fentanyl may further reduce blood pressure. Nifedipine treatment should be stopped 36 hours prior to anesthesia using fentanyl.
Simultaneous use with cimetidine, tricyclic antidepressants, ranitidine can potentiate the antihypertensive effect of nifedipine. Rifampicin induces the activity of liver enzymes, accelerating the metabolism of nifedipine, which leads to a decrease in the effectiveness of the latter. The joint appointment of nifedipine can increase the serum concentration of digoxin, carbamazepine, phenytoin, theophylline and reduce the concentration of quinidine.
With the simultaneous use of nifedipine and calcium preparations, the effect of nifedipine is reduced.
It is not recommended to use grapefruit juice during Cordipin therapy, due to the possible enhancement of the effects of the drug.

Special instructions

At the beginning of treatment with nifedipine, especially if it is combined with beta-blockers, hypotension may occur.
At the beginning of treatment with nifedipine, it is necessary to carefully monitor patients with hypertrophic cardiomyopathy, unstable angina, diabetes mellitus, severe liver dysfunction, pulmonary hypertension and elderly patients.
In patients with impaired renal function, dose change is usually not required.
As a result of reflex tachycardia in patients with severe coronary insufficiency, myocardial ischemia (an increase in painful seizures) can become heavier.
Special care is needed when using immediate-release nephedipine dosage forms in patients with angina pectoris or after acute myocardial infarction.
Nifedipine may affect some laboratory parameters (alkaline phosphatase, ALT, AST, LDH). These changes are not always associated with clinical manifestations, however, in some cases, symptoms of cholestasis or jaundice were observed.
Cordipin should be discontinued before an inhalation test with methacholine to evaluate bronchial hyperreactivity.
Cancel nifedipine should be gradual, since the sudden cessation of reception (especially after long-term treatment) may develop "withdrawal syndrome".
Influence on ability to drive a car and other mechanisms:
In some patients, especially at the beginning of treatment, the drug may cause dizziness and reduce the ability to drive a car or other mechanisms. Further, the degree of restriction is determined depending on the individual tolerance of nifedipine.

Overdosage

Symptoms: marked reduction in blood pressure, acceleration or slowing of heart rate, irregular heart rhythm, nausea, vomiting, weakness, redness of the skin, dizziness, increased sleepiness, lethargy, convulsions, loss of consciousness.
Treatment: induce vomiting and give activated charcoal. Symptomatic treatment.