The drug nifedipine. Reliable assistant in the treatment of cardiovascular pathologies Nifedipine: what is prescribed and how to take the medicine correctly. Tablets "Nifedipine" from what

"Nifedipine" is a drug widely used to treat patients with hypertension. It will help lower blood pressure in a relatively short time. It is also worth saying that when buying any type of Nifedipine preparation, you do not need a prescription, it is available in pharmacies for free sale.

Therapeutic action

What is the effectiveness of the drug? What properties does it have, are there any analogues of Nifedipine, what results do they give in treatment? This drug:

• Improves blood supply to the coronary arteries.
• Helps reduce peripheral resistance in blood vessels.
• Slightly reduces the myocardium.
• Reduces pressure.
• It is also a kind of blocker that does not allow calcium to enter the cells of the vascular muscles and has a positive effect in ischemia.

Release form

The drug "Nifedipine" is produced in the form of tablets, dragees, capsules, drops intended for oral administration.

The effectiveness and safety of taking it largely depends on which form of medication you have chosen. Since the beginning of the 70s of the last century, fast-acting Nifedipine tablets or capsules have been mainly used, and about 20 years ago, a prolonged form appeared in pharmacies. The drug, which in a short time lowers blood pressure, is also quickly excreted from the body. It has a rather low efficiency and tolerability is also not very good, when compared with those forms that act slowly and more effectively on the body during the day.

The fast-acting drug "Nifedipine" (the price for it is much lower - within 25-30 rubles per pack) in most cases helps out a lot, especially when a person has a sharp jump in pressure. It will help to reduce it in the shortest possible time, although this effect may not last long.

The effect of the drug depends on how much its concentration fluctuates in the blood, and how quickly it rises and falls. Ordinary pills dramatically lower blood pressure, the answer to this circumstance is reflex and other stimulating hormones. All of these hormones can cause a person to have headaches, fever, and even redness on the skin.

You also need to remember that when taking a fast-acting drug that is excreted from the body in a short time, a “rebound” symptom may occur. This means that after a short time, the pressure may jump even higher than it was before you took the pill. Therefore, although the price for prolonged Nifedipine is slightly higher - from 40 to 50 rubles per package (50 tablets), its effect on the body is softer and longer. Almost no harm to the human condition.

Tablets "Nifedipine" from what?

This medicine is prescribed for hypertension, coronary disease, which is accompanied by an attack of angina pectoris. In combination with a drug such as Verapamil, it is prescribed to patients who have kidney problems, or rather, to slow the development of kidney failure. With its help, a complex treatment of heart failure is performed, and together with drugs that expand the bronchi, it is used in the treatment of asthma.

Each drug has no exception and the drug "Nifedipine".

Side effects

For whatever purpose the doctor prescribes you to take such a drug, be prepared for the fact that it can also cause side effects, such as:

• Violation of the kidneys.
• Sleep and vision disturbance.
• Muscle pain.
• Skin rash.
• Heartburn and nausea.
• peripheral edema.

If the side effect persists, then it is worth consulting with your doctor, you may need to reduce the dosage or have to stop the drug.

The use of the medicinal product

To achieve positive results in treatment, you need to know how to take Nifedipine tablets correctly. The application is quite simple and does not require special knowledge and skills from you.

Take it for 1-2 months 3-4 times a day, 100 mg. With a hypertensive crisis, it is worth taking it as a sleepy. To do this, take one tablet and put it under your tongue. To make the resorption of the drug go even faster, you can bite the pill. During this procedure, the patient must be in a supine position.

After half an hour, the medication can be repeated, in some cases the number of tablets can be increased to 3 pieces.

The pharmacy also sells Nifedipine prolonged tablets. Instructions for their use gives a detailed regimen of administration, while noting that they give the desired effect only with long-term use.

If you need to bring the patient out of a hypertensive crisis, then use "Nifedipine" in solution, it must be administered within 4-8 hours.

Tablets "Nifedipine" from what else is used, for what diseases are they considered effective? Raynaud's phenomenon is one such disease.

The drug "Nifedipine" with Raynaud's phenomenon

Raynaud's phenomenon is considered one of the most "beautiful" diseases of the cardiovascular system. It affects the upper limbs and gives out a whole range of colors. It is the hands that this disease affects most often. Behind all this "beauty" lies a huge number of complications associated to a greater extent with microcirculation disorders at the ends of the fingers and numerous changes in the mysteries of this disease due to the fact that the causes of its occurrence are still not known, and no doctor can give 100 % guarantee that the patient really has this disease.

Assumptions of the occurrence of the Raynaud phenomenon

Until now, the causes of this disease have not yet been fully studied, but some of them still managed to be identified. Each person, especially in winter, supercooled, this is one of the reasons for the further development of the disease. Also, frequent stressful situations can affect the development of the disease. Chronic finger injuries can also affect, especially for those who work in the construction industry.

All these factors lead to Raynaud's phenomenon. And what symptoms should indicate a person to the disease:

1. Spasms of the vessels of the hand.
2. Edema and blue discoloration of terminal phalanges.
3. Tendency to ulcers and panaritiums.
4. necrotic events.

Also, very often a sign of the disease can be constant chilliness of the fingers and very severe pain during cooling.

There are two ways to treat the disease: the first of them is Nifedipine tablets or analogues of Nifedipine, and the second method is a surgical intervention in which the patient is cut through the nerve fibers that conduct impulses.

As for drug treatment, not only Nifedipine analogues, but the drug itself showed excellent results in treatment.

Can this medicine be used during pregnancy?

Many women are interested in whether Nifedipine can be taken during pregnancy? Reviews of doctors and expectant mothers showed that it can be taken only in extreme cases and under the supervision of the attending physician.

Although studies on pregnant women have not been conducted, animal experiments have shown that taking Nifedipine can lead to perinatal asphyxia, premature birth and intrauterine retention.

Although it is impossible to say for sure whether the drug causes such consequences, or whether some diseases of the mother lead to similar pathologies. But after careful study in pregnant women after taking this drug, similar symptoms were noted. Therefore, it is best not to take Nifedipine during pregnancy. Reviews about the drug are not confirmed by laboratory studies, and it is best not to risk the health of the mother and fetus.

I would also like to say that for children under 18 years old, the Nifedipine remedy is categorically contraindicated.

What can replace the drug "Nifedipine"?

Each patient often faced such a problem as the lack of the right medicine in the pharmacy. This often happens with the drug "Nifedipine". This is a very popular medicine, and it may not be available in pharmacies, but there are analogues of Nifedipine » . Among their huge number, you can choose the one that may suit your body even better.

If you are prescribed a Nifedipine emulsion, but the pharmacy does not have it, you can choose a similar drug from this list:

• "Adalat".
• Kordafen.
• "Cordaflex".
• "Corinfar".
• "Kordipin".
• "Nicardia".
• "Procardia".
• "Pharmadipin".
• "Fenigidin".

All these drugs are available in tablets or capsules, except for "Farmadipin" - it is in drops. There are also prolonged analogues of Nifedipine:

• "Adalat-SL".
• "Corinfar Uno".
• "Corinfar-retard".
• "Kordipin-retard".
• "Nifebene-retard".
• "Nifedipine SS".

As can be seen from the lists above, this drug has a large number of synonyms, and this is due to its popularity. Most pharmaceutical companies are engaged in the production of an analogue of the drug "Nifedipine". Reviews of patients indicate that most of them are in no way inferior to him in terms of effectiveness.

Before choosing the right analogue, you need to clearly indicate for yourself for what purposes and which one you need the drug, short-acting or extended.

So, a fast-acting drug is not recommended for long-term treatment of hypertension and diseases of the cardiovascular system. In these cases, it is better to stop the choice on a prolonged-acting drug, but in a hypertensive crisis, a quick-acting drug will become useful to you.

Before choosing an analogue or the main drug for yourself, carefully study the instructions for the drug "Nifedipine", indications and contraindications, so as not to harm your health with an incorrectly selected medicine.

But be also prepared for the fact that in a pharmacy a pharmacist can ask you a question: do you need the drug "Nifedipine" - gel or tablets? It is better to consult a doctor about this in advance.

"Nifedipine" (gel): indications

An emulsion or, as it is often called, a gel is a drug for the treatment of cracks in the anus, hemorrhoids in the early stages.

The composition of this drug includes lidocaine, nifedipine and isosorbite dinitrate, it is produced in tubes of 40 g.

Thanks to nifedipine, which is part of the gel, there is a relaxation of smooth muscle tissue and a rapid expansion of peripheral vessels. This substance in the composition of the emulsion relaxes the muscles of the anus, lowers rectal pressure.

Lidocaine, in turn, relieves pain, and isosorbite dinitrate also helps to dilate blood vessels, penetrating into smooth muscle cells. It is thanks to such a properly selected composition that Nifedipine (gel) helps in the healing of fissures, removes fallen hemorrhoid nodes, relieves pain and stops bleeding.

The instructions for the drug indicate that the pain after the start of the use of the drug will disappear after a couple of days, after 14 days all the cracks in the anus area are tightened, and a month later there is a complete recovery, subject to the regular use of the Nifedipine gel. Reviews of patients about the drug are only positive. Most of them note that in a short time they got rid of the pain and bleeding that tormented them.

The Israeli manufacturer of the Nifedipine emulsion claims that the drug has no side effects and contraindications, since its effect extends only to inflamed areas in the tissues and their healing. You can even prescribe the gel to pregnant women and those who are breastfeeding.

It is highly recommended to combine treatment with Nifedipine with a diet. The diet should contain dishes rich in fibers, a sufficient amount of liquid. Do not eat anything spicy or salty. If possible, do at least 10 minutes a day of physical therapy.

You can store an open package of Nifedipine gel for only two weeks, so you will need 2 packages to complete the entire course of treatment.

Summing up

In conclusion of our article, I would like to summarize and repeat the most important points. So, gel and tablets "Nifedipine" from what help?

The main role of "Nifedipine" and its analogues play in the treatment of hypertension in patients with complications such as diabetes and metabolic syndrome. That is why such a drug and its analogues do not disrupt metabolism, to put it simply, they do not affect blood sugar, cholesterol and triglycerides. But still, it is better to give preference to a daily drug in the form of GITS for patients with diabetes mellitus and a high risk of cardiovascular diseases.

"Nifedipine" of daily action will help not only to reduce the level of blood pressure in hypertension, but also protect all internal organs. Organoprotective qualities of the drug "Nifedipine":

• Reduces remodeling of the left ventricle of the heart.
• Optimizes blood circulation in all tissues of the human body.
• Positive effect on kidney function.
• Significantly improves the functional state of the retina.

In the treatment of hypertension, the drug "Nifedipine" is combined with almost all groups that are currently in great demand among doctors and patients:

• diuretics (diuretics);
• beta blockers;
• ACE inhibitors;
• angiotensin receptor blockers.

If you use the drug "Nifedipine" in combination with drugs from other groups, then you can significantly increase the effectiveness of treatment, reduce the dosage of tablets and reduce their unwanted side effects.

"Nifedipine" is a drug that helps with a hypertensive crisis and in general with hypertension. If the doctor makes an appointment and selects a few more drugs for him, then in this case you can be sure of the effectiveness of the treatment. Never self-medicate, so as not to harm the body and not aggravate the course of the disease.

Also, Nifedipine (gel) can help in the treatment of anal fissures and hemorrhoids, the results from its use are only positive.

Any drug has its contraindications. Be sure to read the instructions before starting treatment, even if the drug has no contraindications, no one will give you 100% guarantees that you will not experience your own discomfort from its use. There were cases that one tablet of "Nifedipine" quickly lowered the pressure, but at the same time a severe headache appeared. Always keep an eye on your health and take only those drugs prescribed by your doctor after completing a complete

In this article, we will consider the instructions for the use of Nifedipine: at what pressure this drug is prescribed, how effective it is and what contraindications it has. This remedy is one of the most prominent representatives of antihypertensive drugs. It blocks the calcium tubules, due to which the musculature of the vessels relaxes, which helps to lower the pressure to normal levels in a short time. This drug has a number of different advantages and can be used to treat chronic processes and relieve emergency conditions.

Nifedipine is in great demand among hypertensive patients, and therefore there is often a shortage of it in pharmacies. In such cases, the drug can be replaced with similar medicines. Today, Nifedipine analogues have identical pharmacological effects and are used in the treatment of similar diseases. Next, we will consider what substitutes this drug has, and find out what advantages and disadvantages they have. But first, let's study the instructions for using the medication.

The composition of the drug and its form of release

"Nifedipine" is a drug from the category of drugs for vascular and cardiotherapy. Release it in tablets. There are 2 types of them: short and prolonged effects on the body. The former are used to normalize pressure or in the presence of pain in the chest. Extended-release tablets are prescribed to patients who have hypertension that is in the compensation stage.

The main active ingredient of the drug is a derivative of dihydropyridine. This component is able to relax the muscles of the vascular system in the shortest possible time, expand the arteries and increase blood flow, which helps to reduce heart rate and reduce pressure. So, judging by the instructions for the use of Nifedipine, at what pressure this remedy is prescribed, there is no need to think. This is a drug for hypertensive patients.

The therapeutic effect occurs, as a rule, already 20 minutes after ingestion. More than 90% of the active ingredient is absorbed through the intestines, which makes it possible to reduce the load on the stomach and gallbladder, facilitating the work of the kidneys and liver.

How the drug works

The mechanism of action of "Nifedipine" is that the drug blocks the activity of slow calcium channels of cell membranes. Calcium ions enter in smaller quantities into the arteries of the heart, muscles, and also peripheral vessels. As a result:

• blood circulation in the heart is activated;
• the lumen of the coronary and arterial vessels increases;
• increased blood flow in the kidneys;
• pressure decreases;
• decreased vascular resistance to blood flow in the periphery.

Like other drugs in the form of tablets, Nifedipine also contains excipients, which are magnesium, sodium, potato and wheat starch, as well as microcrystalline cellulose, along with titanium dioxide, hypromelose and macrogol. The shell of the tablets is made of gelatin and talc.

Most of the above substances increase the impact of the main component on the body, which provides a high therapeutic effect. If necessary, a long course of administration is prescribed a prolonged form, and to combat acute attacks of angina pectoris and hypertension, short-acting tablets that do not have a shell are prescribed.

When to use the remedy

What are the indications for Nifedipine? It is prescribed in the following cases:

• If the patient has angina pectoris.
• With arterial hypertension as part of monotherapy or in combination with other antihypertensive drugs.

Please note that for the use of Nifedipine, the indications must be strictly observed.

How should the medication be taken

It is unacceptable to prescribe a remedy on your own. Its reception should be carried out under the supervision of a medical specialist, who is obliged to familiarize himself in detail with the condition of his patient and analyzes of his biological material, and in addition, with the results of an electrocardiogram. The age of the patient is of great importance when choosing the dosage and duration of the treatment course.

The maximum daily dose of the main active ingredient should not exceed 40 mg. It is better to take it with meals, and you should choose liquid, but at the same time light meals. You can not drink this medicine with natural juices or sparkling water, as they contain aggressive ingredients that can dissolve the tablet shell before it enters the intestines.

The course of therapy with Nifedipine is usually at least 60 days. The initial dose for any indication for the use of this drug is 10 milligrams twice a day. According to the results of the therapeutic effect, the doctor adjusts the single and daily intake, increasing or decreasing the dosage until the desired effect is achieved. In severe cases, it can reach 80 mg.

There are contraindications for taking Nifedipine. The tool is prohibited:

• with acute myocardial infarction;
• severe forms of heart failure;
• arterial hypotension;
• the presence of unstable angina;
• cardiogenic shock;
• tachycardia;
• narrowing of the mitral valve;
• bradycardia.

Manifestation of side effects of the drug

With an increase in the dosage of Nifedipine, side effects are not excluded. They may appear as follows:

1. From the side of the cardiovascular system - tachycardia, decreased pressure, chest pain, fainting, angina pectoris.
2. From the nervous system - dizziness, difficulty swallowing, fatigue, drowsiness, headaches, depression.

Duration of reception, as a rule, is determined individually. Abrupt withdrawal of the drug is not practiced, as this can cause unwanted side reactions in the form of increased heart rate, pressure surges and malfunctions of the intestines. There are also likely to be malfunctions in the work of the hematopoietic organs.

Nifedipine analogues and their trade names

As already noted, there are only 2 types of Nifedipine tablets: short and prolonged exposure. Analogues of the drug, which are short-acting, include Fenigidin, Nicardia, Procardia, Kordaflex and Farmadipin.

Substitutes for prolonged action are such drugs as "Corinfar Uno" along with "Kordipin-retard", "Calcigard retard" and "Nifekard".

Immediately before choosing one or another Nifedipine analogue, it is necessary to justify the purposes for which the drug will be used and determine what effect should be obtained after using the drug. For example, in the treatment of hypertension, it is best to use analogs with prolonged exposure. And to eliminate the hypertensive crisis, the choice of a short-acting analogue is recommended.

Among other things, before buying a drug, you should carefully study the attached instructions. But a doctor should prescribe it, since in case of non-compliance with the recommendations, the state of health and the progression of pathological processes may worsen.

Advantages and disadvantages

Consider the main advantages of Nifedipine analogues, as well as their disadvantages. If there is a need to replace "Nefedipin", it is necessary to take into account the pros and cons of the proposed funds:

• Some analogues of Nefedipine can have a local effect on the body, that is, they affect only the heart.
• Reduce the risk of negative effects on fetal development (if used during pregnancy).
• When breastfeeding, there is no need to interrupt the lactation period.

The disadvantages of substitutes include the following disadvantages:

• A parallel intake of several drugs at once is required instead of one to replace the effect of Nefedipine.
• Carrying out substitution therapy can cost the patient more than the cost of one Nifedipine.

Which analogue should be preferred

Absolutely all substitutes for "Nefedipin" are high-quality products and have the same properties as it. In this regard, the patient may opt for a less expensive drug, however, this will have to take into account the mechanism of action and the dosage of the drug.

In medical practice, there are many examples when the same active ingredient in medicines from different pharmacological manufacturers had different effects. But with Nifedipine, the situation is different. Almost twenty years have passed since the release of this drug, and all its analogues do not differ from the original. In this regard, when purchasing a medication, you can save money by choosing a less expensive substitute. According to the medicinal properties, the analogue of "Nifedipine" of prolonged action will be similar to the original.

I must say that it is extremely unlikely to purchase a fake drug in a pharmacy, which will contain chalk instead of the active ingredient, because Nifedipine is an inexpensive remedy, and the named replacement will definitely not bring significant benefits. In addition, an experienced hypertensive patient can easily identify a fake, since he knows what therapeutic effect the drug should have and will not buy it next time.

Review of the most popular substitutes for "Nefedipin": "Corinfar"

Before replacing this drug with a drug similar in effect, it is imperative to consult a doctor to select the optimal dosage and identify contraindications to the use of the drug. Next, consider the analogues of "Nifedipine" in action: "Corinfar", "Cordaflex" and "Corinfar Uno".

The first substitute for "Nifedipine" is produced in the form of tablets. It has a prolonged action, and it is prescribed for the treatment of diseases of the heart and blood vessels:

• if the patient has arterial hypertension;
• against the background of ischemia of the myocardium;
• in the presence of angina pectoris.

Treatment with Corinfar is easily tolerated by patients, without side effects. In this case, the analogue of "Nifedipine" should be taken only on the recommendation of a specialist and under his supervision.

It is important to know that after a sharp cessation of taking Corinfar, hypertensive patients may develop a withdrawal syndrome, which will be expressed in an increase in blood pressure, and in addition, in insufficient blood supply to the myocardium.

The drug "Cordaflex"

This is another analogue of Nifedipine, which belongs to the category of antihypertensive drugs. This substitute is quite common among people who have been suffering from hypertension for many years. The drug eliminates spasms of the coronary arteries, relaxing the vascular walls and reducing myocardial oxygen demand. I must say that Kordaflex does not cause arrhythmias. This drug is prescribed in the following cases:

• If the patient has arterial hypertension at different stages.
• Against the background of ischemic heart disease.
• With a hypertensive crisis.
• In the presence of stable angina pectoris.

"Corinfar Uno"

This is the most popular analogue of Nifedipine tablets, since a single dose of this drug can provide a constant concentration of the active ingredient in the bloodstream for a whole day. Thanks to this tool, the productivity of treatment increases, the frequency of various complications decreases, and the internal organs are not subjected to additional stress. Due to this, these tablets are in great demand among a certain category of patients.

The use of long-acting substitutes requires strict rules to be followed. The listed analogues of "Nifedipine" are forbidden to grind or dissolve under the tongue. Tablets must be taken in an unchanged state with a sufficient amount of liquid. You can not share a single dosage of the drug if the instructions for this possibility are not indicated.

Analogues in the treatment of hemorrhoids

The drug "Nifedipine" is endowed with many medicinal properties. So, it is also used to eliminate the symptoms of hemorrhoids. The named medication in this case can be replaced by the drug "Relief". This analogue promotes the healing of cracks, eliminating tissue swelling and restoring damaged vessels. As part of the treatment of hemorrhoids, you can use any suitable analogue of the gel "Nifedipine".

It is possible to make a healing drug on your own at home. To do this, you need to prepare the necessary components, namely, Levomekol ointment, Nifedipine, Lidocaine and Cardiket tablets are taken. The method of preparation of the analog of "Nifedipine" is as follows:

• One tablet of Kardiket and eight pills of Nifedipine are crushed to a powdery state.
• 30 g of Levomekol and 5 g of Lidocaine are added to the powder.
• Then everything is thoroughly mixed and the resulting mixture is used as an ointment. It is applied in a thin layer to problem areas.

This ointment is applied once a day, but in some situations it can be applied twice a day. In fact, "Nifedipine" is produced in the form of a large number of structural analogues, and each of these substitutes has its own name. But absolutely all of them contain the same active ingredient and have a similar therapeutic effect.

Comparative characteristics of Kapoten and Nifedipine

Some patients are trying to determine, for example, which is better - Kapoten or Nifedipine. There is no unambiguous opinion about which of these drugs is better for combating hypertension. Only the attending physician can decide what exactly should be taken by a particular patient to reduce pressure. Therefore, everything is purely individual. Sometimes it is enough to regularly take only Kapoten tablets in order to improve the condition and forget about the increase in pressure. But for some, "Capoten" for contraindications or for some other reason known to the doctor may not be suitable, and "Nifedipin", in turn, will effectively replace it.

By the way, Kapoten should never be used by people suffering from an increased heart rate, which exceeds 85 beats per minute. But at the same time, it must be emphasized that Kapoten is classified as the most harmless medicine. This analogue has a milder effect on the patient's body than Nifedipine, and practically does not have any side effects.

But Nifedipine has one definite advantage, which is that this drug is much cheaper than Kapoten. While about 300 rubles will have to be paid for Kapoten, Nifedipine costs patients three times cheaper.

Andipan or Nifedipine

"Andipan" is a combined drug that gives vasodilating, analgesic, antispasmodic and sedative effects. It is prescribed for pain associated with spasm of peripheral arteries, cerebral vessels, smooth muscles of the stomach and intestines. And also in the presence of arterial hypertension. They have similar contraindications and side effects.

Compound
1 dragee contains 10 mg of the active substance - nifedipine.
Excipients: milk sugar, wheat starch, cellulose
microcrystalline, talc, gelatin, magnesium stearate, sugar coating.

Description
Dragee of the correct form, yellow; at the break, the core is yellow, fine-grained.

Pharmacotherapeutic group:

ATC code: C08CA05.

Pharmacological properties
Pharmacodynamics
Nifedipine is a selective blocker of "slow calcium ropes", a derivative of 1,4-dihydropyridine. It has antianginal and antihypertensive action. Reduces the flow of extracellular calcium ions into cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries.
Reduces spasm and expands the coronary and peripheral (mainly arterial) vessels, lowers blood pressure, total peripheral vascular resistance, reduces afterload and myocardial oxygen demand. Increases coronary blood flow. Negative chrono-, dromo- and inotropic action is blocked by reflex activation of the sympathoadrenal system in response to peripheral vasodilatation. Enhances renal blood flow, causes moderate natriuresis. The onset of the clinical effect is 20 minutes, the duration of the clinical effect is 4-6 hours.
Pharmacokinetics
Nifedipine is rapidly and almost completely (over 90%) absorbed from the gastrointestinal tract. After oral administration, its bioavailability is 40-60%. Eating increases bioavailability. It has the effect of "first pass" through the liver. The maximum concentration in blood plasma is observed after 1-3 hours and is 65 ng / ml. Penetrates through the blood-brain and placental barrier, excreted in breast milk. Communication with blood plasma proteins - 90%. Completely metabolized in the liver. It is excreted by the kidneys in the form of inactive metabolites (70-80% of the dose taken). The half-life is 2-4 hours. There is no cumulative effect. Chronic renal failure, hemodialysis and peritoneal dialysis do not affect the pharmacokinetics. With prolonged use (within 2-3 months), tolerance to the action of the drug develops.

Indications for use

• ischemic heart disease - angina pectoris and rest (including variant);
• arterial hypertension (in the form of monotherapy or in combination with other antihypertensive drugs).

Contraindications

• hypersensitivity to nifedipine and other dihydropyridine derivatives;
• acute stage of myocardial infarction (first 4 weeks);
• cardiogenic shock, collapse;
• arterial hypotension (systolic blood pressure below 90 mm Hg);
• sick sinus syndrome;
• heart failure (in the stage of decompensation);
• severe aortic stenosis;
• severe mitral stenosis;
• tachycardia;
• idiopathic hypertrophic subaortic stenosis;
• pregnancy, lactation;
• age up to 18 years (efficacy and safety have not been established).

Use with caution in patients:
with chronic heart failure, severe violations of the liver and / or kidneys; severe disorders of cerebral circulation, diabetes mellitus, malignant arterial hypertension, patients on hemodialysis (due to the risk of arterial hypotension).

Dosage and administration
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, pouring a small amount of water. Initial dose: 1 tablet (10 mg) 2-3 times a day. If necessary, the dose of the drug can be increased to 2 tablets (20 mg) - 1-2 times a day. The 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 cerebrovascular accident, the dose should be reduced.

Side effect
From the side of the cardiovascular system: flushing of the face, feeling of heat, tachycardia, peripheral edema (ankles, feet, legs), excessive decrease in blood pressure (BP), syncope, heart failure, in some patients, especially at the beginning of treatment, angina attacks may occur, which requires discontinuation of the drug.
From the nervous system: headache, dizziness, fatigue, drowsiness. With prolonged ingestion in high doses - paresthesia of the extremities, tremor.
From the gastrointestinal tract, liver: dyspeptic disorders (nausea, diarrhea or constipation), with prolonged use - abnormal liver function (intrahepatic cholestasis, increased activity of "liver" transaminases).
From the musculoskeletal system: arthritis, myalgia.
Allergic reactions: pruritus, urticaria, exanthema, autoimmune hepatitis.
From the side of the hematopoietic organs: anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura.
From the urinary system: increase in daily diuresis, deterioration of kidney function (in patients with renal insufficiency).
Others:"flushing" of blood to the skin of the face, changes in visual perception, gynecomastia (in elderly patients, completely disappearing after withdrawal), hyperglycemia, gingival hyperplasia.
Overdose
Symptoms: headache, flushing of the skin of the face, lowering blood pressure, inhibition of the activity of the sinus node, bradycardia, arrhythmia.
Treatment: gastric lavage with the appointment of activated charcoal, symptomatic therapy aimed at stabilizing the activity of the cardiovascular system. The antidote is calcium, slow intravenous administration of 10% calcium chloride or calcium gluconate is indicated, followed by switching to a long-term infusion.
With a pronounced decrease in blood pressure - intravenous administration of dopamine or dobutamine. In case of conduction disturbances, the introduction of atropine, isoprenaline or the establishment of an artificial pacemaker is indicated. With the development of heart failure - intravenous administration of strophanthin. Catecholamines should be used only in life-threatening circulatory failure (due to their reduced effectiveness, a high dosage is required, as a result of which the risk of increasing the tendency to arrhythmia due to intoxication increases). It is recommended to control the content of glucose in the blood and electrolytes (potassium, calcium ions), as the release of insulin is impaired.
Hemodialysis is ineffective.

Interaction with other drugs
The severity of lowering blood pressure increases with the simultaneous appointment of nifedigin with other antihypertensive drugs, cimetidine, ranitidine, diuretics and tricyclic antidepressants.
In combination with nitrates, tachycardia and the hypotensive effect of nifedisch increase.

The simultaneous appointment of beta-blockers should be carried out under conditions of careful medical supervision, since this may cause an overly pronounced decrease in blood pressure, and in some cases, aggravation of symptoms of heart failure.
Nifedipine reduces the concentration of quinidine in plasma. Increases the concentration of digoxin and theophylpine in blood plasma, and therefore the clinical effect and / or the content of digoxin and theophylline in blood plasma should be monitored.
Rifampicin weakens the action of nifedipine (accelerates the metabolism of the latter by inducing the activity of liver enzymes).
special instructions
During the period of treatment, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions, and from the use of ethanol.
Cancellation of the drug is carried out gradually (the risk of developing the "withdrawal" syndrome).

Release form
Dragee 10 mg.
10 dragees in a blister of PVC and aluminum foil.
5 blisters of 10 tablets, together with instructions for use, are placed in a cardboard box.

Storage conditions
List B. In a dry, dark and inaccessible place for children, at a temperature not exceeding 25 ° C.

Best before date
3 years. Do not use after the expiration date indicated on the package.

Terms of dispensing from pharmacies
On prescription.

Manufacturer:

Calcium channel blockers, which include Nifedipine tablets, have been actively used in the treatment of hypertension and ischemic stroke since the 70s of the last century.

Recently, the drug has also been used in gynecology - both to normalize pressure and to reduce uterine hypertonicity during pregnancy in order to exclude premature birth. But in this case, the dosage is carefully selected, since its excess can harm the embryo.

Only the attending physician can prescribe Nifedipine for pressure - the drug is potent, has many side effects, and must be taken according to the scheme.

About the composition and principle of action

Nifedipine is a drug from the group of drugs for vascular and cardio therapy. The main active ingredient is a derivative of dihydropyridine. It is able to quickly relax the muscles of the vascular system, expand the arteries, increasing blood flow, which helps to reduce heart rate and pressure.

Due to this action, the drug can be used as an ambulance. The therapeutic effect occurs within 15-20 minutes after taking the drug. More than 90% of the active substance is absorbed through the villi of the intestinal tract, which reduces the load on the stomach, kidneys and liver, gallbladder.

Like other drugs in tablet form, Nifedipine also contains excipients. Before prescribing a remedy, the attending physician must make sure that the patient does not have intolerance to substances such as:

Most of the listed substances, with the exception of those from which the shell is made, are able to enhance the action of the main one, which ensures a high therapeutic effect.

With a long-term course of taking the drug, a prolonged form of the drug is prescribed, and for the relief of acute attacks of angina pectoris and hypertension, short-acting forms that do not have a shell.

In the reviews of medical specialists, there are often descriptions of the effective use of Nifedipine to relieve acute chest pain in patients with nitroglycerin intolerance.

How to take Nifedipine - instructions

Self-administration of Nifedipine is unacceptable, as well as its administration without the supervision of a medical specialist who has thoroughly familiarized himself with the patient's condition and analyzes of his biological materials, ECG results. The instructions for use of Nifedipine indicate that the age of the patient is of great importance when choosing the dosage and duration of the course of treatment.

The maximum daily dose of the main active substance should not exceed 40 mg. Taking the drug cannot be accompanied by simply drinking water - the pill is taken with food, and it is better to choose liquid, light meals.

You can not drink natural juices or carbonated drinks, as they may contain aggressive substances that will dissolve the tablet shell before it enters the intestines.

Based on the results of the therapeutic action, the attending physician adjusts the single and daily intake, increasing or decreasing the dosage until the desired effect is achieved. In serious cases, the daily dose can reach 80 mg.

The duration of admission is determined individually. Abrupt withdrawal of the drug is not practiced, as this can cause the manifestation of undesirable side effects - increased heart rate, jumps in blood pressure, malfunctions of the intestines and blood-forming organs. Cancellation of the drug should occur gradually, with a decrease in single and daily doses, frequency of administration.

Nifedipine during pregnancy - indications and features of treatment

Many future mothers sincerely do not understand why Nifedipine is prescribed during pregnancy?

1. Sudden drops in blood pressure
2. Increased tone of the uterus,
3. Pathology of the heart and blood vessels.

For each period of bearing a baby, there are rules for taking this potent drug. It is important to understand that Nifedipine should not be taken during pregnancy on the advice of a person who does not have a medical education and is unfamiliar with the results of the patient's examination. Only a gynecologist who has been observing the patient for a long time has the right to give such appointments.

In the first trimester, Nifedipine is categorically contraindicated! It can have a negative impact on the formation of organs and the neural tube of the fetus, which will result in serious pathologies and congenital diseases. During this period, the drug can be prescribed only if, without it, the expectant mother risks dying.

In the second and third trimester, indications for the use of Nifedipine may be:

Instructions for the use of Nifedipine during pregnancy are developed individually by a gynecologist, with the obligatory participation of a general practitioner, in exceptional cases, a cardiologist. In no case should you violate the recommendations, skip a dose or exceed, reduce the dosage on your own.

Taking Nifedipine by pregnant women should be accompanied by medical supervision, that is, the patient should be in the hospital. This is necessary in order to track any changes in the condition of the expectant mother and adjust the dosage of the drug in a timely manner.

Contraindications and side effects

Not only indications for the use of Nifedipine, but also contraindications are strictly monitored. The drug should not be taken by children and adolescents. To solve vascular and cardiological problems in such cases, less active and aggressive substances are used.

In addition, contraindications to taking Nifedipine are such health problems as:

Against the background of taking Nifedipine, side effects often develop, which must be reported to the doctor who prescribed the drug.

Any manifestations of allergic reactions, lethargy and drowsiness, headaches and disorientation, swelling, hot flashes, nausea and malfunctioning of the intestines, exacerbation of joint diseases should alert.

The course of treatment should be accompanied by regular collection of the patient's biological materials - blood from a finger and a vein, urine. The attending physician monitors the level of glucose in the blood, the functioning of the liver and kidneys, the intensity of urination, the concentration of the main elements of the blood.

The instructions for use of Nifedipine tablets indicate at what pressure it can be used. Do not take the drug to those patients whose second blood pressure indicator often falls below 90.

The drug can provoke its further and sharp decrease, which can be life-threatening. In case of an overdose of Nifedipine, seek medical attention immediately.

If Nifedipine is prescribed as part of a course of treatment or against the background of other therapy, it is necessary to compare its interaction with the drugs already taken.

Nifedipine should not be taken with substances of similar action - diuretics and phenothiazines. Beta-blockers against the background of the action of the drug can provoke heart failure.

Foods and medicines containing calcium in the composition reduce the therapeutic efficacy of Nifedipine. With its course intake, it is necessary to exclude dairy products, nuts, fish, herbs and some types of fruits and berries from the diet.

It is categorically impossible to combine the intake of Nifedipine with alcohol. It greatly enhances the effect of the main substance of the drug, which can lead to death and other dangerous irreversible consequences - paralysis, disability.

Cost and analogues

If the attending physician prescribes such a potent drug, then pharmacists do not recommend replacing it with analogues.

The price of Nifedipine is quite acceptable, the drug is available to all social categories. The cost of a package with 50 tablets ranges from 30 to 50 rubles, depending on the region of sales and the pricing policy of the pharmacy chain. Inpatient treatment using this tool is free.

It is possible to replace Nifedipine only if it is not available in the clinic where the patient is treated or in the pharmacy. The list of drugs with a similar effect includes such drugs as:

Complaints about high blood pressure are often received not only from elderly patients, but also from children, from women during pregnancy. To lower blood pressure, treat angina pectoris, doctors may prescribe a drug such as Nifedipine. Let us consider in more detail what Nifedipine tablets help with, we will study the instructions for using the medication, at what pressure it is prescribed, composition, contraindications for use and other useful information.

The trade name of the drug in question is Nifedipine. Its generic international name is Nifedipine. The drug is released in the form of a dragee. One tablet contains 10 mg of the active substance, which is represented by nifedipine.

Auxiliary substances in the manufacture of dragees are the following:

• wheat starch;
• gelatin;
• sugar coating;
• milk sugar;
• magnesium stearate;
• talc;
• cellulose microcrystalline.

The shell has the following composition:

• povidone;
• ethylcellulose;
• talc;
• silicon dioxide colloidal anhydrous;
• titanium dioxide;
• propylene glycol glyceryl oleate;
• quinoline yellow dye;
• sucrose;
• macrogol;
• dye sunset yellow;
• glycerol;
• polysorbate 20.

The shape of the dragees is correct, they have a yellow color. When broken, a fine-grained structure is visible, the middle is yellowish.

Pharmacological action, pharmacodynamics

The drug "Nifedipine" is classified as a selective blocker of "slow" calcium channels. It is a derivative of 1,4-dihydropyridine. The drug has the following actions:

• vasodilating;
• antihypertensive;
• antianginal.

Under the influence of the active substance of the drug, the current of calcium ions in cardiomyocytes, smooth muscle cells of the coronary, peripheral arteries decreases, the total peripheral vascular resistance decreases, blood pressure decreases, afterload decreases, myocardial oxygen demand decreases. Large doses of the drug help to suppress the release of calcium ions from intracellular depots.

Under the influence of the drug, coronary blood flow increases, there is an increase in renal blood flow, moderate natriuresis develops. The clinical effect occurs 20 minutes after taking the tablets. Its duration is about 4 - 6 hours.

Pharmacokinetics

Absorption of nifedipine from the gastrointestinal tract occurs very quickly and almost completely (over 90% of the active substance). The bioavailability of the drug after administration reaches 40 - 60%. An increase in bioavailability is observed with food intake. The drug is characterized by the effect of "first pass" through the liver.

The maximum plasma concentration is considered to be 65 ng / ml. It is reached after 1 - 3 hours after taking the medication. The drug is endowed with the ability to penetrate the placental, blood-brain barrier, excreted into breast milk. Communication with blood proteins reaches 90%.

Complete drug metabolism occurs in the liver. The kidneys excrete 70-80% of the dose taken in the form of inactive metabolites. The elimination half-life lasts 2 - 4 hours. There is no cumulative effect. Specialists do not observe the effects on the pharmacokinetics of such conditions:

• hemodialysis;
• chronic renal failure;
• peritoneal dialysis.

Long-term use of the drug for therapeutic purposes (2 - 3 months) can provoke the development of tolerance to the action of the drug.

Indications for use

There are not many indications for taking the drug in question. They are represented by the following states:

Contraindications

There are a lot of contraindications to the use of the medication in question. Let us consider in more detail the list of conditions in which the use of Nifedipine tablets is prohibited:

• cardiogenic shock;
• acute stage of myocardial infarction;
• hypersensitivity to the active substance of the tablets, as well as to their auxiliary components;
• collapse;
• tachycardia;
• heart failure (stage of decompensation);
• pronounced;
• weak sinus syndrome;
• pregnancy;
• arterial hypotension with systolic blood pressure below 90 mm Hg. Art.;
• lactation period;
• severe aortic stenosis;
• age under 18 years (no specific data on the effectiveness, safety of tablets in younger patients);
• idiopathic hypertrophic subaortic stenosis.

Instructions for use

Before use, it is necessary to study the annotation to "Nifedipine". The dosage should be determined by a specialist in each individual case. At the same time, he takes into account such factors as the severity of the disease, the patient's response to the treatment. It is recommended to take dragees in the process of eating. You can also take the tablets after meals with a small amount of water.

Initially, the doctor prescribes to the patient a single dose of 1 tablet. A day you need to drink 10 mg of the drug twice or thrice (only 2-3 tablets). If necessary, the doctor increases the dosage to 20 mg, which is equal to two tablets. In this case, 1-2 doses of medication are prescribed per day. The maximum daily dose is 40 mg of the active substance.

The specialist should reduce the dosage of the medication for patients of the following categories:

• elderly;
• undergoing combination therapy (antihypertensive, antianginal);
• having a violation of the functioning of the liver;
• suffering from severe disorders of cerebral circulation.

Side effects

The use of the drug can provoke quite a lot of side effects that manifest themselves in different body systems.

From the side of the cardiovascular system, the following side effects may occur:

• feeling of heat;
• hyperemia of the face;
• syncope;
• nose bleed;
• a strong decrease in blood pressure (hypotension);
• tachycardia;
• heart failure;
• chills;
• peripheral edema (feet, ankles, legs);
• angina attacks (they are a signal to cancel the pills).

From the side of the nervous system, the following side effects may occur:

From the side of the liver, the gastrointestinal tract, the following symptoms appear:

• abnormal liver function (increased active hepatic transaminases, intrahepatic cholestasis);
• dyspeptic disorders (constipation / diarrhea, nausea).

From the respiratory system:

• nasal congestion;
• pulmonary edema, which is accompanied by cough, shortness of breath.

From the side of the hematopoietic system are observed:

• leukopenia;
• thrombocytopenic purpura;
• thrombocytopenia;
• anemia.

On the part of the musculoskeletal system, the following side effects sometimes appear:

• myalgia;
• arthritis.

Sometimes allergic reactions appear in the form of:

• urticaria;
• autoimmune hepatitis;
• skin itching;
• exanthema.

From the urinary system can be observed:

• deterioration in kidney function;
• increase in daily diuresis.

Other side effects are sometimes recorded:

• change in visual perception;
• gum hyperplasia;
• flushes of blood to the dermis of the face;
• hyperglycemia;
• gynecomastia (more often it is observed in elderly patients. After discontinuation of the drug, the side effect disappears completely).

Overdose

Exceeding the dose indicated by the specialist may cause an overdose of the drug. In this case, the patient has the following symptoms:

• hyperemia of the dermis of the face;
• headache;
• arrhythmia;
• inhibition of the activity of the sinus node;
• lowering blood pressure;
• bradycardia.

In case of an overdose, the patient is prescribed specific treatment. It is represented by the following actions:

• gastric lavage;
• receiving activated charcoal;
• carrying out symptomatic treatment to stabilize the activity of the cardiovascular system.

Calcium is used as an antidote. The patient is recommended to carry out slow intravenous administration of 10% calcium chloride. You can also use calcium gluconate (10%). After the intravenous administration of these solutions, a subsequent switch to a long-term infusion is required.

If a patient has a pronounced decrease in blood pressure, he is prescribed intravenously such drugs:

• "Dobutamine".
• "Dopamine".

In the presence of conduction disorders, the following agents are administered:

• "Isoprenaline".
• "Atropine".

Also in this case, the patient may be prescribed the establishment of an artificial pacemaker.

If heart failure has developed, the patient is administered intravenously "Strophanthin".

Circulatory insufficiency, which threatens the patient's life, is an indicator for the use of catecholamines. The doctor must control the content of glucose in the blood, electrolytes (calcium, potassium ions). After all, circulatory failure is accompanied by a violation of the release of insulin.

In case of an overdose, hemodialysis is an ineffective procedure.

Interaction with other drugs

The instructions for use contain important information regarding the simultaneous administration of Nifedipine tablets with other drugs. The decrease in blood pressure is enhanced by the simultaneous use of Nifedipine with other antihypertensive drugs:

• "Ranitidine".
• "cimetidine".
• Tricyclic antidepressants.

If you use the drug with nitrates, there is an increase in tachycardia, the hypotensive effect of nifedipine.

If the doctor needs to simultaneously prescribe "Nifedipine" with, careful medical supervision will be required. This combination of medications can cause too much lowering of blood pressure. Sometimes the symptoms of heart failure can worsen.

Nifedipine lowers the level of quinidine in the blood plasma, lowers the level of digoxin, theophylline in the blood plasma. Therefore, it is necessary to control the indicators of these substances.

With the simultaneous use of the considered dragees with "Rifampicin", a weakening of the therapeutic effect of nifedipine is noted.

Interaction with alcohol

"Nifedipine" is forbidden to be taken simultaneously with ethanol.

Application in the therapy of children

In the treatment of children under 18 years of age, the drug is not used.

Use in pregnancy therapy

Studies under the supervision of specialists in the treatment of pregnant women with Nifedipine tablets have not been conducted. Similar experiments were carried out on animals (the drug was given in the period after the end of the stage of organogenesis). They have shown:

• embryotoxicity;
• fetotoxicity;
• placentotoxicity;
• teratogenicity.

Based on clinical data, no specific perinatal risk can be judged. There is information regarding the increase in the likelihood of such complications:

• C-section;
• asphyxia;
• intrauterine growth retardation;
• premature birth.

Doctors cannot say for sure what was the predisposing factor in these cases. This may be the disease itself (arterial hypertension), ongoing therapy, a consequence of the use of Nifedipine. Based on the available data, specialists cannot exclude the possibility of developing side effects that are dangerous to the fetus, the newborn. Given this information, doctors do not prescribe the pills in question after the 20th week of pregnancy. In extreme cases, the drug is prescribed after a thorough assessment of the risk/benefit ratio for the mother and baby.

special instructions

The medication in question is used with caution for the treatment of patients with such pathological conditions:

The drug is prescribed with caution to patients on hemodialysis because of the likelihood of arterial hypotension.

During the course of treatment with Nifedipine, the patient was advised to refrain from potentially hazardous activities that require a speed of psychomotor reaction and increased concentration.

Analogues

As structural analogues of the drug "Nifedipine" for the active substance, after consultation with the attending physician, the following medications can be used:

• "Calcigard retard".
• "Nifexal".
• "Adalat".
• "Nifesan".
• "Kordipin".
• "Nifedicor".
• "Nifedex".
• Kordafen.
• Osmo Adalat.
• "Corinfar".
• "Kordipin HL".
• "Nifedicap".
• "Vero Nifedipine".
• "Sanfidipin".
• "Nifelat".
• "Cordaflex".
• "Nifelat R".
• Sponif 10.
• "Nifekard".
• "Kordipin retard".
• Kordaflex RD.
• "Nicardia".
• "Fenigidin".
• Nifecard HL.
• "Corinfar retard".
• "Nikardia SD retard".
• "Nifebene".
• "Corinfar UNO".
• "Nifelat Q".
• "Nifadil".