Nifedipine drops instructions for use. Types of medicines, commercial names of analogues, release forms. Contraindications to the drug

Cardiology and antihypertensive drug Nifedipine is quite popular among patients with arterial hypertension. It is used as monotherapy and as part of complex treatment.

There are dozens of analogues and trade names, active substance which is nifedipine. Instructions for use provides information about the rules and methods of using the medication.

The therapeutic effect of this drug (LS) is provided by the composition of Nifedipine. Active ingredient is a derivative of 1,4-dihydropyridine - chemical compound nifedipine.

As part of auxiliary ingredients, except for calcium stearate, povidone, cellulose and potato starch contained milk sugar lactose. This should be taken into account for people suffering from intolerance to this carbohydrate or a deficiency of an enzyme that helps to absorb it (lactase).

Nifedipine release form - tablets.

Pharmacological group and mechanism of action

The instructions for use indicate which pharmacotherapeutic cluster Nifedipine belongs to. This is a selective (that is, selective) pharmacological group, which is usually denoted by the abbreviation BMKK.

Pharmacodynamics (mechanism of action) of Nifedipine and medications of this group is based on a decrease in leakage calcium ions in the cells of the myocardium and smooth muscle layer of the coronary and peripheral vessels.

Impacts on venous vessels, sinoatrial and atrioventricular nodes, the drug does not have an antiarrhythmic effect.

Helps reduce:

• total peripheral vascular resistance (OPSS);
• cardiac muscle tone and afterload;
• myocardial needs for oxygenation (oxygen saturation),

as well as an increase in the duration of left ventricular diastole.

In response to a negative inotropic effect (decrease in the strength of heart contractions), Nifedipine causes a reflex acceleration of the pulse.

What are these pills for?

The medication Nifedipine is prescribed for high blood pressure. Moreover, it is assigned medical specialist subject to prior diagnostic examination patient. Take Nifedipine, from what it will count right patient or his relatives on their own, it is impossible. For example, these pills should not be given to hypotensive patients during a single episode of physiological elevation. blood pressure(BP), say, if it jumped from the use of tonics.

Indications

Let us clarify what specific pathologies are indicated in the instructions for use for Nifedipine in the indications for use. Like many other antihypertensive drugs, this medication is indicated not only for the treatment of hypertension, but also for diseases that often accompany hypertension. Therefore, the annotation to Nifedipine indicates:

• , manifested by angina pectoris, including variant.

These are those pathological conditions, from which Nifedipine tablets are prescribed as a monotherapeutic agent or one of the medications of complex therapy.

Why is hypertension dangerous?

At what pressure and pulse is it used?

In the description of the drug Nifedipine, the instructions for use do not indicate at what pressure it is prescribed. Obviously - with such indicators of blood pressure, which give reason to the doctor to diagnose arterial hypertension (AH).

If the medication is prescribed for, then the value of blood pressure should also be taken into account here. According to the instructions for Nifedipine, it should not be< 90 мм рт.ст. по систолическому показателю.

Can it be used in hypertensive crisis?

AT official instructions to Nifedipine in indications for use is not indicated. Patients with hypertension should receive continuous antihypertensive therapy to prevent a rise in pressure, and not to use drugs occasionally in emergency cases.

However practical experience The use confirmed the ability of this medication to quickly and effectively reduce high blood pressure when taken sublingually (sublingually).

1. To reduce blood pressure with Nifedipine in a hypertensive crisis, you should put 1 tablet of Nifedipine 10 mg under the tongue and wait for its complete dissolution (usually the effect occurs within a few minutes).
2. At this time, it is desirable for the patient to be in a prone or reclining position (dizziness may occur).
3. If there is no effect, it is allowed to take the pill again no earlier than half an hour after the first dose.
4. The maximum dose for hypertensive crisis is 30 mg taken in 3 doses with an interval of 30 minutes.

Before everyone next trick it is necessary to measure blood pressure and, when it normalizes, stop taking Nifedipine tablets.

Instructions for use of the drug

Before using Nifedipine tablets, the instructions for use should be studied with particular care.

Perhaps, during a visit to the doctor, you forgot about some comorbidities in which the medication is contraindicated. Or you are simultaneously taking other medicines that can weaken or, conversely, enhance the effect of BMCC.

None of the information contained in the instructions for use for drugs should be neglected.

How to use?

The method of use for Nifedipine pressure is standard for tablets from the BMKK group. They are drunk during a meal or immediately after it, using for a drink. clean water. This is important because taking Nifedipine with certain liquids, in particular grapefruit juice, it is impossible - it completely suppresses the metabolism of BMCC.

Is it possible under the tongue?

For cases emergency assistance with a hypertensive crisis, you can put Nifedipine under the tongue - this will accelerate its action and lead to a decrease in blood pressure. But with prolonged therapy, Nifedipine tablets to lower blood pressure should be swallowed whole.

Dosage

With regard to the dosage, one should strictly adhere to the prescriptions of the doctor, who will select it on an individual basis.

The starting dose of Nifedipine is usually 5-10 mg (½-1 tablet), the number of doses per day is 2-3 times. A week later, you can bring the therapeutic dose to a value of 20 mg, taking Nifedipine 20 mg 1-2 times a day, or 2 tablets in the morning and evening of Nifedipine 10 mg. Instructions for use indicates the maximum daily dose - 40 mg.

Nifedipine dosage adjustment is required for patients:

• taking other antihypertensive and antianginal drugs;
• with severe disorders of cerebral perfusion;
• with impaired hepatic function;
• old age.

Any changes in doses and regimen should be agreed with the doctor.

How long does it take to start working?

When describing the pharmacodynamic properties of Nifedipine, the instructions for use provide the following information on the question of how long Nifedipine begins to act:

• at oral intake- 20 minutes;
• with sublingual - 5-10 minutes.

The duration of the effect is 4-6 hours for tablets short action and 12-24 hours - for prolonged.

special instructions

Instructions for use section about special instructions pressure tablets Nifedipine begins with a warning.

1. It is forbidden to drink alcohol during treatment with Nifedipine. The active substance of these tablets, belonging to the BMKK pharmaceutical group, is absolutely incompatible with ethanol.
2. Instructions for use warns that at the initial stage of administration, the development of angina pectoris is possible, and against the background of the simultaneous use of beta-blockers, an increase in signs of heart failure.
3. With caution, Nifedipine should be taken in patients on hemodialysis, with hypovolemia and irreversible renal failure.

As indicated in the instructions for use, if necessary surgical intervention the physician should be informed about nifedipine therapy.

A separate paragraph in the instructions for use provides information on the use of the medication in the perinatal and lactation periods. Until the 20th week of pregnancy, the medication is clearly contraindicated. If necessary (and only under the supervision of a doctor), this medicine is allowed to be taken by women in position in the minimum therapeutic doses. But the instructions for use warn that such drugs as Nifedipine should be used by pregnant women with caution and only in consultation with the doctor.

Contraindications

There is a medication Nifedipine and contraindications. This is a standard list of conditions for BMCC in which the use of drugs can provoke life-threatening and health-threatening effects. It is forbidden to be treated with Nifedipine when:

• (and within 4 weeks after it);
• pregnancy and lactation period;
• decompensated CHF;
• simultaneous treatment with Rifampicin;
• (GARDEN< 90 мм);
• cardiogenic shock, collapse;
• intolerance to any of the ingredients of the drug.

Due to the lack of clinical data on the safety and efficacy of use in people under 18 years of age, Nifedipine is contraindicated for them.

Possible overdose

As already mentioned, drugs should be taken strictly in the dosage that the attending physician will select for the Nifedipine medication. An overdose, the symptoms of which can occur even if the maximum dose is slightly exceeded, usually manifests itself:

• bradycardia (significant slowing of the pulse);
• function suppression sinus node, which is expressed by the inadequacy of the heart rate, the deterioration of the blood supply to the myocardium;
• a strong and prolonged decrease in blood pressure;
• redness of the face;
• headache.

With severe intoxication with Nifedipine, you need:

• gastric lavage;
• receiving activated charcoal;
• slow, within 5 minutes, the introduction of antidotes - 10% chloride or calcium gluconate under the control of its concentration in plasma.

With severe hypotension - the introduction of dobutamine or dopamine intravenously, with AHF - strophanthin. The hemodialysis procedure in such a situation is ineffective. Treatment of an overdose should be carried out in a hospital setting.

Side effects

The following table will tell you about the side effects of Nifedipine and the frequency of their manifestation.

Majority unwanted effects are transient (transient) in nature and are quickly eliminated when the medication is discontinued.

Can it be combined with Elevit?

The multivitamin and mineral-containing remedy Elevit is often prescribed to pregnant and lactating women for the treatment and prevention of micro- and macronutrient deficiencies, hypovitaminosis. Women who are forced to take BMCK even during this period are interested in whether Nifedipine can be taken with Elevit, and what the instructions for use say about the compatibility of these drugs.

An impressive list of restrictions on the compatibility of Nifedipine casts doubt on the possibility of its simultaneous administration with Elevit.

Elevit contains the trace element magnesium in the form of oxide, stearate and hydrophosphate trihydrate. And the instructions for use of Nifedipine indicate that simultaneous reception with preparations containing magnesium sulfate, it can provoke a blockade of neuromuscular synapses (points of contact between neurons and effector cells) in women in a position. Clinical Research on the safety of such a combination has not been carried out, and the lack of data can be considered a weighty argument against combining drugs, especially when we are talking about the treatment of pregnant women.

Which is better when compared with other drugs?

Let's try to compare Nifedipine with other antihypertensive or similar action. Long-term therapy sometimes requires the rotation of the drugs used, so familiarization with the most common drugs will not be superfluous.

The basis of white cylindrical tablets Amlodipine of prolonged action is amlodipine besilate - a substance related to the second generation BMCC.

This is also a derivative of dihydropyridine, the action of which is to block calcium channels, reducing the transmembrane penetration of Ca ions into the cell. According to the instructions for use, it has not only a hypotensive, but also an anti-ischemic effect. Available in dosages of 5 and 10 mg, contains lactose. Comparing which is better - Nifedipine or Amlodipine, it is necessary to remember the duration of action of both drugs.

Andipal

Instructions for use Andipal calls this drug a combined analgesic drug, the active core of which consists of non-narcotic analgesic(metamisole sodium), antispasmodic (papaverine), vasodilator (bendazole or dibazol) and barbiturate (phenobarbital). A slight vasodilating effect has an effect on the smooth muscle layer of the walls of blood vessels, indications for use include migraines, all kinds of colic and others. pain syndromes. The section of the instructions for use on interactions refers to the ability of Andipal tablets to enhance the hypotensive effect of BMCC, ACE inhibitors, nitrates and other antihypertensive drugs. Therefore, it is not correct to compare Nifedipine or Andipal, which is better.

Ginipral

Ginipral tablets are prescribed for the threat of premature termination of pregnancy (uterine tone), starting from the 20th week. Today, this medicine is difficult to find in pharmacies, and it is not uncommon to hear that Nifedipine is prescribed to women instead of Ginipral. Hence their question arises - which is better, Ginipral or Nifedipine. If we compare these medicines in terms of their effect on the tone of the uterus, then Ginipral is undoubtedly preferable. But some women (noted - if they have hypertension) tolerate Nifedipine well. Others, judging by the reviews, are advised to refrain from taking it, as they have encountered side effects. So, you need to select a medication individually. We should not forget that these medicines, according to their instructions for use, are completely different readings to use, so talking about their interchangeability is wrong.

The drug Kapoten belongs to the pharmacological group (ACE) of prolonged action. It is indicated for hypertension, dysfunction of the left ventricle in the post-infarction period, chronic heart failure, diabetic nephropathy accompanying type 1 diabetes mellitus.

It is the drug of choice for huge amount patients with arterial hypertension not aggravated by severe renal or hepatic insufficiency and other severe pathologies. The active substance is captopril. In patients with bronchial obstruction or a tendency to bronchospasm, taking an ACE inhibitor may cause a side effect in the form of a dry, hysterical cough. In this case, when choosing Kapoten or Nifedipine, which is better preferred BMCC Nifedipine.

The same active substance is the core of the medicine of the same name - Captopril. To compare Nifedipine or Captopril, which is better, you should focus on the lists of contraindications and side effects, as well as on the individual tolerance of the components, and select the medicine in accordance with these factors. Another factor worth paying attention to is the possibility of using Nifedipine in the treatment of pregnant women from the 20th week, which cannot be said about Captopril. ACE inhibitors for women in position are contraindicated at any time.

One thing can be said about the Cordaflex preparation - it is a direct, or structural, analogue of Nifedipine, and all indications for use, lists of side effects and warnings in the instructions for use of this medication are presented for the active substance nifedipine. True, in the indications, in addition to hypertension and coronary artery disease, Raynaud's syndrome is indicated, as well as the prevention of Prinzmetal's angina. Those who prefer European manufacturers can pay attention to Hungarian or Swiss-made Kordaflex.

Gross formula

Pharmacological group of the substance Nifedipine

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Nifedipine

Blocker calcium channels- a derivative of 1,4-dihydropyridine.

Yellow crystalline powder. Practically insoluble in water, hardly soluble in alcohol. Molecular mass 346,3.

Pharmacology

Blocks calcium channels, inhibits the transmembrane entry of calcium ions into cells smooth muscle arteries and cardiomyocytes. Expands peripheral, mainly arterial, vessels, incl. coronary, lowers blood pressure (possible slight reflex tachycardia and an increase cardiac output), reduces peripheral vascular resistance and afterload on the heart. Increases coronary blood flow, reduces the force of heart contractions, the work of the heart and myocardial oxygen demand. Improves myocardial function and helps to reduce the size of the heart in chronic heart failure. Reduces pressure in pulmonary artery, renders positive influence on cerebral hemodynamics. It inhibits platelet aggregation, has anti-atherogenic properties (especially with prolonged use), improves post-stenotic circulation in atherosclerosis. Increases the excretion of sodium and water, lowers the tone of the myometrium (tocolytic effect). Long-term use (2-3 months) is accompanied by the development of tolerance. For long-term therapy of arterial hypertension, it is advisable to use fast-acting dosage forms at a dose of up to 40 mg / day (with an increase in the dose, the development of concomitant reflex reactions is more likely). In patients with bronchial asthma can be used with other bronchodilators (sympathomimetics) for maintenance treatment.

When taken orally, it is rapidly and completely absorbed. Bioavailability of all dosage forms is 40-60% due to the effect of "first pass" through the liver. Approximately 90% binds to plasma proteins taken dose. With intravenous administration, T 1/2 is 3.6 hours, the volume of distribution is 3.9 l / kg, plasma Cl is 0.9 l / min, and the constant concentration is 17 ng / ml. After oral administration, C max in plasma is created after 30 minutes, T 1/2 - 2-4 hours. About 80% is excreted by the kidneys in the form of inactive metabolites and approximately 15% - with faeces. In small quantities passes through the BBB and the placental barrier, penetrates into breast milk. In patients with impaired liver function, the total Cl decreases and T 1/2 increases. When capsules are taken orally, the effect manifests itself after 30-60 minutes (chewing accelerates the development of the effect) and lasts 4-6 hours, with sublingual use, it occurs after 5-10 minutes and reaches a maximum within 15-45 minutes. The effect of tablets with a two-phase release develops in 10-15 minutes and lasts 21 hours. It does not have mutagenic and carcinogenic activity.

The use of the substance Nifedipine

Arterial hypertension, including hypertensive crisis, prevention of angina attacks (including Prinzmetal's angina), hypertrophic cardiomyopathy(obstructive, etc.), Raynaud's syndrome, pulmonary hypertension, broncho-obstructive syndrome.

Contraindications

hypersensitivity, acute period myocardial infarction (first 8 days), cardiogenic shock, severe aortic stenosis, chronic heart failure in the stage of decompensation, severe arterial hypotension, pregnancy, breastfeeding.

Application restrictions

Age up to 18 years (safety and effectiveness of use have not been determined).

Use during pregnancy and lactation

Contraindicated in pregnancy.

Stop during treatment breast-feeding.

Side effects of the substance Nifedipine

From the side of cardio-vascular system and blood (hematopoiesis, hemostasis: often (at the beginning of treatment) - flushing of the face with a feeling of heat, palpitations, tachycardia; rarely - hypotension (up to fainting), pain similar to angina pectoris, very rarely - anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura.

From the side nervous system and sense organs: at the beginning of treatment - dizziness, headache, rarely - stupor, very rarely - change visual perception, loss of sensation in the arms and legs.

From the digestive tract: often - constipation, rarely - nausea, diarrhea, very rarely - gingival hyperplasia (with long-term treatment), increased activity of hepatic transaminases.

From the respiratory system: very rarely - bronchospasm.

From the musculoskeletal system: very rarely - myalgia, tremor.

Allergic reactions: itching, urticaria, exanthema, rarely - exfoliative dermatitis.

Others: often (at the beginning of treatment) - swelling and redness of the hands and feet, very rarely - photodermatitis, hyperglycemia, gynecomastia (in elderly patients), burning sensation at the injection site (with intravenous administration).

Interaction

Nitrates, beta-blockers, diuretics, tricyclic antidepressants, fentanyl, alcohol increase the hypotensive effect. Increases theophylline activity, reduces the renal clearance of digoxin. Strengthens side effects vincristine (reduces excretion). Increases the bioavailability of cephalosporins (cefixime). Cimetidine and ranitidine (to a lesser extent) may increase plasma levels. Diltiazem slows down metabolism (necessary dose reduction of nifedipine). Incompatible with rifampicin (accelerates biotransformation and does not allow creating effective concentrations). Grapefruit juice (large amount) increases bioavailability.

Overdose

Symptoms: severe bradycardia, bradyarrhythmia, arterial hypotension, in severe cases- collapse, slowing down conduction. When you receive a large number retard tablets, signs of intoxication appear no earlier than 3-4 hours later and can additionally be expressed in loss of consciousness up to coma, cardiogenic shock, convulsions, hyperglycemia, metabolic acidosis, hypoxia.

Treatment: gastric lavage, activated charcoal, the introduction of norepinephrine, calcium chloride or calcium gluconate in atropine solution (in/in). Hemodialysis is ineffective.

Routes of administration

Inside, sublingually, in / in.

Precautions Substance Nifedipine

The drug should be discontinued gradually (possibly the development of a withdrawal syndrome).

Use with caution while driving Vehicle and people whose profession is related to increased concentration attention.

special instructions

In patients with stable angina at the beginning of treatment, a paradoxical increase in anginal pain may occur, with severe coronary sclerosis and unstable angina- exacerbation of myocardial ischemia. It is not recommended to use short-acting drugs for long-term treatment angina pectoris or arterial hypertension, tk. development of unpredictable changes in blood pressure and reflex angina is possible.

Interactions with other active substances

Trade names

Many people ask questions about what Nifedipine looks like and instructions for use, at what pressure it is used. The drug was used back in the Soviet Union in the treatment of hypertension and other heart diseases. AT modern cardiology Nifedipine 10 mg is one of the most popular drugs.

Brief description of the effect on the body

Nifedipine belongs to the group of calcium channel blockers. It slows down the passage of calcium ions into the cells of the heart and the blood vessels that feed it. There is suppression electrical activity heart muscle cells. As a result, there is an increase in the lumen of the heart vessels and blood pressure decreases.

In addition to the antihypertensive effect, normalization of the heart rhythm occurs. In myocardial infarction, there is a decrease pain sensitivity. Increased coronary blood flow reduces the load on the heart muscle. Thus, the body's need for oxygen decreases and its work is normalized.

With prolonged use, more than 2-3 months, the effectiveness decreases, as addiction to the drug occurs. Tablets are the most optimal form of use, since the medicine dissolves quickly in the stomach and is absorbed by 100%. After passing through the digestive tract, the drug enters the liver. Due to the transformation in this organ, the bioavailability of the drug is the highest.

The maximum amount in the blood accumulates 3 hours after ingestion. Its main part is excreted by the kidneys without causing any changes. There are no accumulations in the body.

When can and can not use the drug?

Based on the mechanism of action of the drug on the body, it can be concluded that taking Nifedipine is recommended in case of poor oxygen delivery to the heart and heart muscle. There are several such diseases:

• hypertension, including;
• angina pectoris, ischemic heart disease;
• hypertrophic cardiomyopathy;
• pulmonary hypertension;
• broncho-obstructive syndrome.

Based on the mechanism of action of the drug, it is possible to distinguish diseases in which Nifedipine tablets are strictly forbidden to be taken. Among them:

1. Allergic reactions to the drug.
2. Myocardial infarction for up to 8 days.
3. Cardiogenic shock (acute and acute insufficiency force of heart contractions, complication of myocardial infarction).
4. Unstable angina.
5. Tachycardia.
6. Low blood pressure.
7. Severe aortic stenosis (narrowing of the aortic lumen).
8. Decompensated heart failure.
9. The period of pregnancy and lactation.
10. Breastfeeding is completely stopped for the period of drug treatment. There is a risk of passing through the placenta and into breast milk.

With special care, you need to pay attention to the appointment of treatment for diseases of the liver and kidneys. Transformation and excretion pass through these organs, therefore, when they are insufficient, metabolites remain and accumulate in the body. If the metabolism in the liver is disturbed, the quality of Nifedipine's work will also change.

Undesirable effects of Nifedipine

Like any systemic remedy, Nifedipine has an effect on all systems of organs and tissues:

1. Influence on the work of the heart and blood vessels. At the very beginning of the application, the face may periodically become redder. Sometimes tachycardia develops and the patient can feel his heartbeat. Less frequent decrease blood pressure and pain as in a myocardial infarction.
2. Influence on the hematopoietic system. It is extremely rare, but sometimes anemia, leukopenia or thrombocytopenia can be observed.
3. Influence on the nervous system and sensory organs. Headache and dizziness can become constant companions during treatment. Violation of the sensitivity of the limbs and vision are extremely rare.
4. Influence at gastrointestinal tract. Constipation, nausea, diarrhea sometimes complicate the process of taking the drug, but not significantly. AT rare cases the activity of liver enzymes increases, since the transformation of the drug occurs in this organ.
5. Influence on the respiratory system. Almost never occurs, although bronchospasm is sometimes possible.
6. Effect on the kidneys. In patients with kidney failure there is a risk of increasing daily diuresis and impaired excretory function.
7. Allergy. Perhaps in case of high susceptibility to the substances that make up the drug. Manifested in the form of itching, urticaria.

It should be remembered that in the presence of any side effects medication should be referred to a specialist. The therapist or cardiologist will select another remedy with a similar effect, but without undesirable effects.

See also the video: When to take pressure pills correctly.

What can be taken with Nifedipine?

Medications such as nitrates, beta-blockers, angiotensin II receptor blockers, diuretics, and antidepressants can further lower blood pressure. The use of these drugs is possible only under the supervision of the attending physician.

The intake of alcohol on the body acts in the same way, so it is worth abstaining from it for the duration of treatment. aspirin, omeprazole, antifungal drugs, hypoglycemic agents and immunosuppressants do not affect the effectiveness of Nifedipine in any way and can be taken at the prescribed dosage.

Antiepileptic drugs, the antibiotic Rifampicin, significantly reduce the degree of effect of the drug on the body. In the case of the use of these funds, it is better to choose another drug that will reduce pressure.

Dosage and overdose

At what dosage you need to take the pills for each specific patient, the attending physician decides. He will be able to assess how severe the disease is and whether the reaction to the therapy is normal. Self-administration of the dose is not recommended.

Treatment is emergency gastric lavage. Appointed Activated carbon and drugs that will increase blood pressure and lead to heartbeat back to normal. Calcium preparations are antidotes of Nifedipine. They are used in combination with therapy that is already underway. 10% calcium chloride is administered slowly intravenously.

How to take the drug with an increase in pressure?

Each of the diseases has its own peculiarities of application. Usually the doctor explains them when prescribing the drug, but it is also necessary to figure it out on your own. Such knowledge can be useful in conditions requiring emergency care. If Nifedipine is prescribed, the route of administration for different indicators pressure is as follows:

1. With hypertension. Forms used to treat arterial hypertension long-acting. They allow you to avoid a sharp relaxation of blood vessels. Most modern method- the use of special "therapeutic systems" that keep the amount of Nifedipine in the bloodstream at the same level all day.
2. In a hypertensive crisis, it is impossible to sharply reduce the pressure. First you need to reduce by about 10-15% of the original numbers. For treatment, short-acting forms are used, and Nifedipine is the drug of first choice. Tablets are placed under the tongue. The effect should come about 10 minutes after application and last until the ambulance arrives.
3. Cardiac ischemia. A stable course of angina pectoris, like hypertension, is treated with long-acting drugs. With the appointment of Nifedipine, the patient decreases the need for the use of nitroglycerins. Short-acting drugs are also used to stop angina attacks. The technique of their application corresponds to a hypertensive crisis.
4. Pulmonary hypertension. The drug at pulmonary hypertension administered in average therapeutic doses. After the start of use, the doctor observes how the patient's body reacts to the drug taken and whether there is an effect. If necessary, the dose can be increased after 3-5 days. Gradually, a balance is found between the desired effect and tolerability.

Any patient using Nifedipine needs to know its instructions for use and at what pressure figures it can be used. When prescribing, the doctor will tell you how and in what dosage to take. But this does not exclude the patient's responsibility for his own health.

Video: Drugs to lower blood pressure

In this medical article you can see drug Nifedipine. Instructions for use will explain at what pressure tablets can be taken, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the form of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Nifedipine, from which you can find out whether the drug helped in the treatment of angina pectoris and lowering blood pressure in adults and children, for which it is also prescribed. The instructions list analogues of Nifedipine, drug prices in pharmacies, as well as its use during pregnancy.

Nifedipine is an antihypertensive and antianginal drug. Instructions for use informs that tablets and dragees 10 mg, retard or prolonged 20 mg, capsules 5 mg and 10 mg effectively reduce pressure, improve coronary blood supply, and have a pronounced anti-ischemic effect.

Release form and composition

Nifedipine is available in the following dosage forms:

1. Capsules 5 mg and 10 mg.
2. Tablets 10 mg.
3. Long-acting tablets (retard), coated film sheath 20 mg.
4. Dragee 10 mg.

Nifedipine tablets are packaged in a blister of 10 pieces. A cardboard pack contains 5 blisters (50 tablets) and instructions for using the drug. The main active ingredient of the drug is nifedipine.

pharmachologic effect

The therapeutic effect of Nifedipine is aimed at reducing pressure, dilating the coronary and peripheral arteries, reducing the total peripheral vascular resistance, improving coronary blood supply and preventing calcium entry into cardiomyocytes and vascular smooth muscle cells.

In addition, the drug has an anti-ischemic effect. Nifedipine does not affect myocardial conduction and does not exhibit antiarrhythmic activity.

Indications for use

What helps Nifedipine? Tablets are prescribed if the patient has:

• Arterial hypertension (as a single drug or in combination with other antihypertensive drugs).
• Angina at rest and exertion (including variant) with coronary disease hearts.

At what pressure is prescribed?

Nifedipine is enough strong drug, which is accepted at high pressure(during jumps) from 150 to 110 mm Hg.

Instructions for use (at what pressure to take)

Nifedipine dragee or tablets

The dosage regimen is set individually, depending on the severity of the disease and the patient's response to therapy. It is recommended to take the drug during or after a meal with a small amount water.

Initial dose: 1 tablet (tablet) (10 mg) 2-3 times a day. If necessary, the dose of the drug can be increased to 2 tablets or dragees (20 mg) - 1-2 times a day. Maximum daily dose is 40 mg.

In elderly patients or patients receiving combined (antanginal or antihypertensive) therapy, as well as in violation of liver function, in patients with severe impairment cerebral circulation the dose should be reduced.

Retard tablets

Taken inside. Tablets should be swallowed whole, without chewing, during or after a meal, with a small amount of water. The recommended dose of the drug is 20 mg 2 times a day. With insufficient severity of the effect, it is possible to increase the dose of the drug to 40 mg 2 times a day. The maximum daily dose is 80 mg.

In case of impaired liver function, the daily dose should not exceed 40 mg. In elderly patients or patients receiving combined (antanginal or antihypertensive) therapy, smaller doses are usually prescribed. The duration of treatment is determined in each case individually.

Contraindications

Taking Nifedipine tablets is contraindicated in a number of pathological and physiological states organisms, which include:

• Arterial hypotension is a decrease in the level of systemic arterial pressure, in which systolic blood pressure is less than 90 mm Hg. Art.
• Children's age up to 18 years.
• Idiopathic hypertrophic subaortic stenosis, in which the cause of the narrowing remains unclear.
• Hypersensitivity to nifedipine or auxiliary components of the drug.
• Stenosis (narrowing) of the mitral or aortic valve hearts.
• Cardiogenic shock is acute and severe insufficiency pumping function of the heart, accompanied by vascular collapse.
• Pregnancy at any time during its course, breastfeeding.
• Expressed increased heart rate (tachycardia).
• Acute myocardial infarction (death of a section of the heart muscle due to acute violation blood circulation in it) for 4 weeks.
• Sick sinus syndrome is a functional insufficiency of the atrial pacemaker.
• Severe heart failure in the stage of decompensation.

With caution, Nifedipine tablets are used for chronic heart failure, a pronounced decrease in the functional activity of the liver and kidneys, severe violations blood circulation in the brain diabetes, especially at the stage of decompensation, malignant arterial hypertension.

Also, with extreme caution, the drug is used in people on hemodialysis (hardware blood purification) due to high risk development of a pronounced arterial hypotension. Before starting the use of Nifedipine tablets, you should make sure that there are no contraindications.

Side effects

Treatment with the drug can cause the following side effects:

• From the side digestive system: diarrhea, heartburn, nausea, worsening of the liver; in some cases - gingival hyperplasia. With prolonged use of the drug in high doses, dyspeptic symptoms, the development of intrahepatic cholestasis or an increase in liver transaminase activity may occur.
• From the peripheral nervous system and central nervous system: headaches. With long-term therapy at high dosages, muscle pain, paresthesia, sleep disturbances, tremors, and minor visual disturbances are possible.
• From the side endocrine system: development of gynecomastia.
• From the side of the cardiovascular system: a feeling of warmth, hyperemia skin, peripheral edema, arterial hypotension, tachycardia, asystole, ventricular tachycardia, increased angina attacks, bradycardia.
• From the urinary system: increased daily diuresis, impaired renal function (with long-term use at high doses). On the part of the hematopoietic system: extremely rarely - thrombocytopenia, leukopenia.
• Allergic reactions: rash on the skin.

At intravenous administration the drug causes a burning sensation at the injection site. With intracoronary administration of the drug within a minute after the start of the infusion, hypotension and an increase in heart rate may develop.

Children, during pregnancy and lactation

According to the instructions, Nifedipine is contraindicated during pregnancy and lactation. gynecological practice in some cases, it is practiced to prescribe the drug during pregnancy as antihypertensive drug when other drugs are ineffective.

It is also noted that Nifedipine during pregnancy helps to reduce the tone of the uterus, however, widespread use in this indication I have not received the drug yet.

Application in childhood

Nifedipine should not be used in children and adolescents under 18 years of age, as the safety and efficacy of the drug in this age group not installed.

special instructions

Nifedipine should only be used under the supervision of a physician, especially in diabetes mellitus, malignant hypertension, severe cerebrovascular accident, hypovolemia, and impaired renal and hepatic function.

Cancellation of the reception should be done gradually, since with a sharp cessation of the course, a withdrawal syndrome may be observed. During the period long-term use Nifedipine, you must stop drinking alcohol, and at the beginning of treatment, doctors recommend avoiding driving vehicles and engaging in other activities. dangerous species activities.

drug interaction

Rifampicin: acceleration of metabolism and, as a result, weakening of the action of nifedipine. Nitrates: increased tachycardia and hypotensive action nifedipine. Quinidine: decrease in its concentration in blood plasma.

Beta-blockers: the risk of a pronounced decrease in blood pressure, in some cases - aggravation of heart failure (such combined treatment should be done under close medical supervision).

Other antihypertensive drugs, diuretics, tricyclic antidepressants, ranitidine, cimetidine: increased severity of lowering blood pressure. Theophylline, digoxin: an increase in their concentration in blood plasma.

Nifedipine's analogs

According to the structure, analogues are determined:

1. Sponif 10.
2. Nifecard HL.
3. Nifelat Q.
4. Cordaflex.
5. Nifedex.
6. Nikardia.
7. Nifadil.
8. Nifelat R.
9. Fenigidin.
10. Nifesan.
11. Vero Nifedipine.
12. Nifedicap.
13. Calciguard retard.
14. Kordafen.
15. Nifebene.
16. Nifedicor.
17. Corinfar.
18. Osmo Adalat.
19. Corinfar retard.
20. Cordipin.
21. Nifelat.
22. Nifehexal.
23. Sanfidipin.
24. Nifecard.
25. Adalat.

Holiday conditions and price

The average cost of Nifedipine (tablets 10 mg No. 50) in Moscow is 28 rubles. Released by prescription.

The shelf life of the tablets is 3 years from the date of their manufacture. The drug should be stored in its original packaging, in a dark, dry place out of the reach of children at an air temperature not higher than +25 C.

One of prominent representatives antihypertensive drugs is Nifedepine, due to the blocking of calcium channels, smooth muscle relaxation occurs blood vessels, whereby the pressure is reduced short time before normal indicators. The drug has a number of advantages, and can be used both for stopping emergency conditions as well as for the treatment chronic processes. The drug is in great demand among hypertensive patients, so there is often a shortage of funds in the pharmacy. In this situation, the drug can be replaced with similar drugs. To date, analogues of Nifedipine have an identical pharmacological action and used in the treatment similar diseases. Consider what analogues of the drug exist, their advantages and disadvantages.

Trade names of analogues

There are two types of Nifedipine tablets: short and prolonged action. A short-acting drug used to normalize blood pressure or for pain in chest. Medication prolonged action used by patients in whom hypertension is in the stage of compensation.

All possible substitutes medicines contain active substance nifedipine

Analogues of the short-acting drug:

• Fenigidin;
• Nicardia;
• Procardia;
• Farmadipin.

Prolonged action substitutes:

• Nifedipine SS;
• Cordipin-retard
• Calciguard retard;
• Nifecard.

Before choosing an analogue, it is necessary to justify the purposes for which the drug is used and what effect is expected after using the drug. So in the treatment of hypertension, it is better to use analogues with prolonged action. To stop a hypertensive crisis, it is recommended to choose a short-acting analogue.

Before buying a drug, you need to carefully study the instructions, compare the indications with the symptoms of the disease, and select the necessary commercial name for the drug. Failure to follow recommendations may result in deterioration clinical picture and progression of the pathological process.

Advantages and disadvantages of Nifedipine substitutes

If it is necessary to replace Nefedipine with other drugs, their advantages and disadvantages should be taken into account.

Advantages of analogues:

• May have a local effect on the body (reveal healing effect only for circulatory system or act exclusively on the heart).
• Reduce risk negative impact on fetal development or breast health.
• In the case of taking funds while breastfeeding, there is no need to interrupt lactation.

Disadvantages of substitutes:

• The parallel use of several drugs instead of one to replace all the effects of the drug.
• Replacement therapy can cost the patient more than the cost of Nifedipine.

Which of the analogues to give preference?

All drug substitutes are of high quality and have similar properties. Therefore, the patient can opt for less expensive drug, however, it is important to consider the mechanism of action and the dose of the agent.

AT medical practice there are cases when the active substance in medicines from various pharmacological manufacturers has miscellaneous action. This phenomenon is explained by the fact that in pharmacology there are two types of drugs: original medicines and generic medicines. The original products were developed and released by one pharmaceutical company. Generics are copies of the original remedy, very often not very safe. Thus, it is better to give preference original drugs, but not more than 15 years from the date of their development.

In order not to purchase a fake analogue, it is recommended to shop in a network of pharmacies

However, the situation is reversed with Nifedipine. About 20 years have passed since the release of the drug, and all analogues this tool are no different from the original. Therefore, when purchasing a medication, you can save money and choose a less expensive substitute, since it will be similar to the original in terms of medicinal properties.

It is unlikely to buy at the pharmacy counterfeit medicine, which instead of the active substance will contain chalk, since Nifedipine inexpensive remedy which won't bring much benefit. In addition, an experienced hypertensive patient can easily detect a fake, because he knows what therapeutic effect should provide a remedy, and, as a result, he will not acquire it next time.

These nuances are related only to the tablets of the drug, since intravenous solutions of Nifedipine are produced under the same brand name Adalt. Therefore, there is no choice of the best replacement for the solution, since on given time analogues have not been developed.

Overview of the most popular substitutes

Before replacing the main drug with a similar one in action medicine it is necessary to consult with the attending physician for selection optimal dose, and identifying possible contraindications to taking medication.

Available in tablet form, has a prolonged action.

One tablet contains 10 mg of the active substance nifedipine

It is prescribed for the treatment of diseases of the heart and blood vessels, such as:

• arterial hypertension;
• ischemia of the myocardium;
• angina pectoris.

After abrupt discontinuation of the drug, hypertensive patients may develop a “withdrawal” syndrome, which is expressed in sharp rise blood pressure, myocardial insufficiency.

Belongs to the group of antihypertensive drugs, is quite common among patients suffering from hypertension for many years. The drug eliminates spasm coronary arteries, relaxes the walls of blood vessels, reduces myocardial oxygen demand. Cordaflex does not cause arrhythmia.

One tablet of the drug contains nafedipine at a dose of 10 and 20 mg

Indications for prescribing a medicine have some limitations, as the main diseases include:

• arterial hypertension at different stages;
• hypertensive crisis;
• stable angina.

The most popular analogue, since a single dose of the drug provides a constant concentration of the active substance in the bloodstream throughout the day. Due to this property, the productivity of treatment improves, the frequency of complications decreases, the target organs are not exposed to additional load. Due to a single dose of the drug, tablets are in demand among the population.

Tablet contains 40 mg of active ingredient

The use of long-acting substitutes requires strict adherence to the rules. They are forbidden to crush and dissolve under the tongue. Tablets should be taken unchanged with a sufficient amount of liquid. It is contraindicated to share single dose drug, if the instructions do not indicate such a possibility.

Nifedipine analogues in the treatment of hemorrhoids

Nifedipen has many medicinal properties, so it is used to eliminate the symptoms of hemorrhoids. The drug can be replaced with Relief, which promotes healing anal fissures, eliminates swelling of soft tissues and restores damaged vessels.

Any suitable substitute for Nifedipine can be used to treat hemorrhoids.

It is possible to independently make an analogue of Nifedipine ointment at home. To do this, you need to prepare all the necessary components:

• ointment Levomekol;
• Nifedipine tablets;
• Lidocaine;
• Cardiket.

Cooking method:

1. Grind to a powder one tablet of Kardiket and 8 tablets of Nifedipine.
2. To the powder add 30 gr. Levomekol and 5 gr. Lidocaine.
3. To stir thoroughly.
4. The resulting mixture is used as an ointment, applying it thin layer to problem areas.

The ointment is used once a day, in some situations it can be applied 2 times a day.

Nifedipine is available as a large number structural analogues, each of which has its own tradename. However, they all contain the same active substance and have a similar therapeutic effect.