Corinfar uno - official instructions for use. Visitor survey results. Application restrictions

- 10 mg;

Shell composition: titanium dioxide - 0.77 mg, macrogol 6000 - 0.48 mg, quinoline yellow dye - 0.27 mg, talc- 0.38 mg, hypromellose - 2.88 mg, macrogol 35000- 0.22 mg.

One tablet Corinfara Retard includes:

• nifedipine - 20 mg;
• excipients: lactose monohydrate - 31.6 mg, potato starch - 31.4 mg, microcrystalline cellulose - 31 mg, K25 povidone - 5.4 mg, magnesium stearate - 0.6 mg.

Shell composition: titanium dioxide - 1.377 mg, hypromellose - 5.188 mg, quinoline yellow dye - 0.143 mg, talc - 1.038 mg, macrogol 6000 - 0.861 mg, macrogol 35000 - 0.393 mg.

One tablet Corinfara UNO includes:

• nifedipine - 40 mg;
• excipients - lactose monohydrate - 30 mg, microcrystalline cellulose - 48.5 mg, cellulose - 10 mg, hypromellose 4000 cp - 20 mg, magnesium stearate - 1.5 mg, colloidal silicon dioxide - 0.75 mg.

Shell composition: titanium dioxide - 2 mg, macrogol 6000 - 0.07 mg, hypromellose - 2 mg, iron oxide red - 0.9 mg, macrogol 400 - 1.1 mg, talc - 1 mg.

Release form

corinfar and Corinfar Retard are tablets of prolonged action, which are coated with a straw-colored shell, biconvex, round, with a beveled edge; on the cut - a homogeneous substance of yellow color.

10 such tablets corinfara or Corinfara Retard in blisters, three blisters in a cardboard box. Or 50 of these tablets corinfara or Corinfara Retard in a dark glass bottle, one such bottle in a cardboard box. Corinfar is also available separately in the amount of 100 tablets in a dark glass bottle and a cardboard box.

Corinfar UNO- prolonged-release tablets, coated dark red, biconvex, round. 10 such tablets in a blister; 5, 2 or 10 such blisters in a paper pack.

pharmachologic effect

The drug has hypotensive and antianginal .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

This medicine is a selective blocker (inhibitor) slow» calcium channels, chemically related to derivatives dihydropyridine . It inhibits the movement of Ca2 + from the intercellular space to cardiomyocytes and cells of smooth muscles, peripheral and cardiac arteries; in high doses, it inhibits the release of Ca2+ from intracellular depots.

In therapeutic doses, it normalizes the intercellular exchange of Ca2 +, which can be disturbed in a number of pathological conditions (and others). Does not affect the tone of the veins. Increases coronary blood flow, enhances blood supply to ischemic areas myocardium without the development of the “steal” syndrome, stimulates the work of collaterals. Expands the peripheral arteries, reduces the total peripheral vascular resistance, myocardial tone, the heart's need for oxygen. Does not affect atrioventricular and sinoatrial nodes , has a small antiarrhythmic action. Also, the drug activates the renal blood flow.

The time for the appearance of the clinical effect is close to 20 minutes, the duration of the effect is 5-6 hours.

Pharmacokinetics

Up to 90% of the drug is absorbed in the intestine. Bioavailability is about 60%. Food intake increases bioavailability. 95% of the drug binds to plasma proteins. Maximum concentration nifedipine in the blood of ingestion of two tablets (20 mg of nifedipine) occurs after 2-3 hours. Completely converted in the liver.

Excreted by the kidneys as an inert metabolite (70%), with bile (30%). The half-life is about 3-5 hours.

Renal failure, conduction do not change the pharmacokinetics of Corinfar. In persons with liver disease, clearance decreases and the half-life is prolonged. With long-term use (more than two months), tolerance to the drug may develop.

Indications for Corinfar's use

Indications for use Corinfara Retard (corinfara) and indications for use Corinfara UNO are the same - the choice of the drug is carried out by the attending physician, depending on the severity of the disease and individual sensitivity.

• Vasospastic angina (Prinzmetal's angina ).
• Chronic tension.

Contraindications

• Allergy to nifedipine and any other derivative dihydropyridine or drug components.
• Low pressure (systolic pressure less than 90 mm Hg).
• Unstable.
• Cardiogenic shock .
• Chronic decompensated cardiac insufficiency , heavy aortic stenosis .
• First four weeks.
• First 13 weeks of pregnancy.
• Period.
• Reception.

It is necessary to use the drug with caution when mitral valve stenosis , heavy tachycardia or bradycardia , malignant , syndrome sinus node weakness , hypovolemia , expressed violations cerebral circulation , with insufficiency of left ventricular function, intestinal obstruction , liver and kidney failure, (possible development of arterial hypotension), 14-40 weeks of pregnancy, age less than 18 years, joint intake, beta blockers .

Side effects

• From the circulatory system: tachycardia , peripheral edema, excessive vasodilation (decrease in blood pressure, aggravation of heart failure, flushing of the face, a feeling of heat), a strong decrease in pressure, fainting. In a small number of patients, seizures may occur at the beginning of therapy or after increasing the dose, and in very rare cases -.
• From the nervous system: dizziness, headache, weakness, fatigue, drowsiness. With long-term treatment with the drug in high doses - trembling, extrapyramidal disorders (mask-like face, ataxia, change in gait), .
• From the digestive system: dry mouth, flatulence , increased appetite. Less commonly, gingival hyperplasia disappears after treatment is stopped. With prolonged use - liver damage ( cholestasis, increased activity of liver enzymes).
• From the musculoskeletal system: myalgia , swelling of the joints, cramps of the limbs.
• Hypersensitivity reactions: rarely - autoimmune hepatitis , .
• From the hematopoietic system: leukopenia , anemia , thrombocytopenia , agranulocytosis .
• From the excretory system: increase diuresis , impaired renal function (in persons with kidney failure).
• Other: rarely - visual impairment, temporary gynecomastia , hyperglycemia, galactorrhea, bronchospasm, increase in body weight.

Instructions for use Corinfar

Instructions for use Corinfara Retard and corinfara explains how to take this medicine. Tablets are used after meals orally, without chewing and drinking plenty of water. Simultaneous intake with food inhibits adsorption active substance from the intestine. Usually the drugs are taken in the morning and in the evening, but it is worth remembering that Corinfar UNO 40 mg can only be used once a day.

The dose and frequency of taking the drug is selected by the attending physician individually, taking into account the severity of the disease and other clinical aspects.

At vasospastic angina and voltage : 1 tablet Corinfara Retard or corinfara

Essential hypertension : 1 tab. Corinfara Retard or corinfara(depending on severity and individual sensitivity) 2 times a day. With a mild effect, the dose of the drug is slowly increased to two tablets 2 times a day.

With a double prescription of the drug per day, the interval between doses should be an average of 12 hours. Corinfar UNO the same time of day is taken with an interval of 24 hours, preferably before lunch, 1 tablet (40 mg) once a day.

Overdose

Symptoms: flushing of the face, headache, bradycardia/ , a strong long-term decrease in blood pressure, suppression sinus node . In severe cases - fainting,.

Therapy: symptomatic. As a rule, gastric lavage is carried out, they are used. The antidote will be calcium preparations - intravenously 10% solution calcium chloride or . With a strong decrease in blood pressure, slow intravenous administration is recommended. , norepinephrine or . In the event of heart failure - administered intravenously. With development - isoprenaline , .

Hemodialysis in case of overdose is ineffective, it is recommended plasmapheresis .

Interaction

The following effects from interactions with the following medicinal products should be taken into account:

• With tricyclic antidepressants, antihypertensives, vasodilators - increased hypotensive effect;
• With beta-blockers - pronounced decrease in blood pressure;
• c - suppression of metabolism;
• With quinidine - a sharp decrease in concentration quinidine in the blood, after withdrawal nifedipine - sharp rise in content quinidine in blood;
• With carbamazepine , phenobarbital – content reduction nifedipine in blood.

Terms of sale

In Ukraine, the drug can only be bought with a prescription; in Russia, the drug is on the OTC list.

Storage conditions

Store at temperatures up to 30 degrees in the original packaging. Keep away from children.

Best before date

special instructions

• It is necessary to stop therapy with the drug gradually.
• At the beginning of treatment, it may occur, especially if there has been a sharp cancellation recently. beta blockers (they also need to be phased out).
• With severe heart failure Corinfar should be dosed with caution.
• In persons with severe obstructive cardiomyopathy there is a risk of increased frequency, severity and duration of seizures angina pectoris after use nifedipine ; in this case, the drug is canceled.
• In persons with severe kidney failure , which are on hemodialysis , have high blood pressure and reduced blood volume, the drug is recommended to be used with caution, as there is a risk of a sharp drop in blood pressure.
• If surgery is planned using general anesthesia, it is necessary to inform the anesthetist about the appointment. nifedipine .
• The drug affects the ability to drive vehicles. You need to be careful when driving.

Corinfar uno analogs are presented, in accordance with medical terminology, called "synonyms" - drugs that are interchangeable in terms of effects on the body, containing one or more identical active substances. When choosing synonyms, consider not only their cost, but also the country of origin and the reputation of the manufacturer.

Description of the drug

The onset of the clinical effect is 30 minutes, its duration is 12-24 hours. With prolonged use (2-3 months), tolerance to the drug's action develops.

List of analogues

Note! The list contains synonyms Corinfar UNO, which have a similar composition, so you can choose a replacement yourself, taking into account the form and dose of the medicine prescribed by your doctor. Give preference to manufacturers from the USA, Japan, Western Europe, as well as well-known companies from Eastern Europe: Krka, Gedeon Richter, Actavis, Egis, Lek, Geksal, Teva, Zentiva.

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Official instructions for use

Corinfar® UNO

Pharmacological properties

Indications for use

A drug Corinfar Uno - selective calcium antagonist with a predominant effect on the vessels.
Nifedipine is a calcium antagonist of the 1,4-dihydropyridine type. Calcium antagonists reduce the flow of calcium ions through the "slow" channels of calcium into the cells. Nifedipine acts mainly on the smooth muscles of the coronary arteries and peripheral vessels, with virtually no effect on the myocardium when used in therapeutic doses.
At the beginning of therapy with the use of calcium antagonists, a reflex increase in heart rate and an increase in cardiac output may be observed. However, this is not enough to compensate for vasodilation.
In cases of long-term therapy with nifedipine, the primary increase in cardiac output returns to the previous values. A significant decrease in blood pressure during the use of nifedipine can be observed in patients with arterial hypertension.

Pharmacokinetics

Indications for use

Mode of application

Side effects

In cases of long-term use of nifedipine, gingival hyperplasia is possible, which completely disappears after discontinuation of the drug.
From the musculoskeletal system: myalgia, arthralgia, muscle cramps, swelling of the joints.
From the side of the kidneys and urinary tract: a temporary decrease in kidney function in patients with renal insufficiency, polakiuria, dysuria, nocturia, increased frequency of urination, an increase in the amount of daily urine output.
From the reproductive system and mammary glands: gynecomastia, the process is reversible, the symptoms disappear after stopping nifedipine, erectile dysfunction.
General disorders: fatigue, malaise, fever, non-specific pain, chills.

Contraindications

Pregnancy

Interaction with other drugs

Overdose

Storage conditions

Release form

Compound

Additionally

main parameters

Corinfar is a calcium channel blocker drug that has a pronounced antianginal and hypotensive effect. The composition of the drug Corinfar includes the active substance nifedipine, a synthetic derivative of dihydropyridine. Nifedipine is a representative of the first generation of selective calcium channel blockers, derivatives of dihydropyridine. The mechanism of action of the drug is associated with its ability to slow down the penetration of calcium ions into the cells of the smooth muscle layer of blood vessels and the heart through slow L-type calcium channels. Due to a decrease in the concentration of calcium ions in the cells of the myocardium and the smooth muscle layer of the vessels, there is a decrease in the contractile activity of the cells of the vascular wall, the expansion of peripheral and coronary vessels. The drug does not affect the walls of the vessels of the venous bed, does not change the preload, does not cause the development of orthostatic hypotension. In various diseases that are accompanied by a violation of the transmembrane current of calcium ions, including arterial hypertension, Corinfar helps to normalize the passage of calcium ions through slow calcium channels.

Indications and dosage:

Essential hypertension

IHD (stable exertional angina, vasospastic angina)

Doses of the drug are selected by the doctor individually, taking into account the severity of the disease and the patient's sensitivity to the drug. Depending on the clinical picture, the dose is gradually increased. The condition of patients with impaired liver function is carefully monitored, if necessary, the dose of the drug is reduced. With concomitant severe violation of cerebral circulation (severe cerebrovascular disease), the drug is prescribed in reduced doses. Essential hypertension The drug is prescribed in an average daily dose of 1 tablet 1 time per day (40 mg 1 time per day). Stable exertional angina and vasospastic angina. The drug is prescribed in an average daily dose of 1 tablet per day (40 mg 1 time per day). The drug is taken orally in the morning during meals, without chewing and drinking a sufficient amount of liquid (a glass of water). Simultaneous ingestion of food increases the bioavailability and maximum concentrations of the active substance in the blood plasma. The duration of treatment is determined by the doctor.

Overdose:

Symptoms of acute intoxication with nifedipine:

Impairment of consciousness, up to the development of coma

Arterial hypotension

Tachycardia/bradycardia

hyperglycemia

metabolic acidosis

hypoxia

Cardiogenic shock with pulmonary edema.

Treatment. The most important therapeutic measures are the removal of the drug from the body and the restoration of the stability of the functioning of the cardiovascular system. After oral administration, it is recommended to completely empty the stomach, if necessary, in combination with small bowel lavage. In case of intoxication caused by drugs with a prolonged release of the active substance, it is necessary to remove the drug from the body as completely as possible, including from the small intestine, to prevent absorption of the active substance. When using laxatives, it should be borne in mind that calcium antagonists lead to a decrease in the tone of the intestinal muscles up to intestinal atony. Since nifedipine is characterized by a high degree of binding to blood plasma proteins and a relatively small volume of distribution, hemodialysis is ineffective, but plasmapheresis is recommended. Bradycardia can be treated with β-adrenergic blockers. With life-threatening bradycardia, the use of an artificial pacemaker is recommended. Arterial hypotension resulting from cardiogenic shock and vasodilation can be stopped with calcium preparations (10-20 ml of 10% calcium chloride or calcium gluconate solution is injected slowly in / in, then repeated if necessary). As a result, serum calcium levels may reach the upper limit of normal or be elevated. If calcium administration is not effective enough, the use of dopamine, dobutamine, epinephrine or norepinephrine is advisable. The doses of these drugs are determined taking into account the achieved therapeutic effect. The additional administration of fluid should be approached very carefully, since this increases the risk of overloading the heart.

Side effects:

The drug is usually well tolerated by patients, however, in some patients, especially at the beginning of therapy with Corinfar, the following side effects may develop:

From the gastrointestinal tract and liver: nausea, vomiting, discomfort in the stomach, impaired stool, reversible gingival hyperplasia. With prolonged use of the drug in isolated cases, the development of undesirable effects on the part of the liver was noted, including a violation of the outflow of bile, hepatitis, an increase in the activity of liver enzymes, a transient increase in the level of serum transaminases.

From the side of the cardiovascular system: blood flow to the head and upper body, which is accompanied by hyperemia of these areas and a feeling of heat, reflex tachycardia, a sharp decrease in blood pressure, increased angina attacks, swelling of the extremities. In isolated cases, patients developed myocardial infarction.

On the part of the hematopoietic system: anemia, thrombocytopenic purpura, thrombocytopenia, leukopenia.

From the side of the central and peripheral nervous system: headache, dizziness, paresthesia, irritability, drowsiness, disturbed sleep and wakefulness, fatigue, tremor.

Allergic reactions: skin rash, itching, urticaria, exfoliative dermatitis.

Others: there have been isolated cases of hyperglycemia in patients with diabetes mellitus. In elderly men who took the drug Corinfar, in isolated cases, the development of gynecomastia was noted, which disappeared after discontinuation of the drug. In addition, the use of the drug may develop visual impairment and myalgia.

With a sharp withdrawal of the drug, the development of arterial hypertension and myocardial ischemia is possible, therefore it is recommended to stop taking the drug by gradually reducing the dose.

Contraindications:

Hypersensitivity to nifedipine or other components of the drug,

Acute period of myocardial infarction (in the first 4 weeks)

Unstable angina

Severe aortic stenosis

Concomitant use of rifampicin

During pregnancy and breastfeeding

Interaction with other drugs and alcohol:

Antihypertensive drugs, as well as tricyclic antidepressants, nitrates, ranitidine and cimetidine, when used simultaneously, enhance the effects of Corinfar.

With the simultaneous use of nifedipine and beta-blockers, the risk of arterial hypotension and the development of symptoms of circulatory failure increases.

With simultaneous use, the drug reduces the concentration of quinidine in the blood.

With the simultaneous use of nifedipine increases the plasma concentrations of theophylline and digoxin.

Composition and properties:

1 film-coated tablet Corinfar contains: Nifedipine - 10 mg; Excipients.

1 film-coated tablet Corinfar Retard contains: Nifedipine - 20 mg; Excipients.

1 film-coated tablet Corinfar UNO with modified release contains: Nifedipine - 40 mg; Excipients.

Release form:

Corinfar tablets, film-coated, 10 pieces in a blister, 3 blisters in a carton.

Corinfar tablets, film-coated, 50 or 100 pieces in a dark glass bottle, 1 bottle in a carton.

Selective calcium channel blocker, a derivative of 1,4-dihydropyridine. It has antianginal and hypotensive effect. Reduces the flow of extracellular calcium into cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries, in high doses inhibits the release of calcium from intracellular depots. Reduces the number of functioning calcium channels without affecting the time of their activation, inactivation and recovery. Uncouples the processes of excitation and contraction in the myocardium (mediated by tropomyosin and troponin) and in vascular smooth muscle (mediated by calmodulin). In therapeutic doses, it normalizes the transmembrane current of calcium ions, which is disturbed in a number of pathological conditions, primarily in arterial hypertension. Does not affect the tone of the veins. Enhances coronary blood flow, improves blood supply to ischemic areas of the myocardium without the development of the "steal" phenomenon, activates the functioning of collaterals. Expanding the peripheral arteries, reduces OPSS, myocardial tone, afterload. Almost no effect on the sinoatrial and AV node, has a weak antiarrhythmic activity. Enhances renal blood flow, causes moderate natriuresis. Negative chrono-, dromo- and inotropic effects are overridden by reflex activation of the sympathoadrenal system in response to peripheral vasodilation.

The onset of the clinical effect is 30 minutes, its duration is 12-24 hours. With prolonged use (2-3 months), tolerance to the drug's action develops.

Pharmacokinetics

Suction

After taking the drug inside, nifedipine is highly absorbed from the gastrointestinal tract (more than 90%). Bioavailability is 40-60% and increases when taken simultaneously with meals. The dosage form of the modified release tablet provides a gradual release of the active substance into the systemic circulation. Cmax in blood plasma is reached after 2.3-7.7 hours and is 17-41.4 ng / ml.

Distribution

Penetrates through the BBB and the placental barrier, excreted in breast milk. Binding to plasma proteins - 90%. There is no cumulative effect.

Metabolism and excretion

Subject to the effect of "first pass" through the liver. Completely metabolized in the liver. It is excreted by the kidneys in the form of inactive metabolites (70-80% of the dose taken). 20% - with bile.

Pharmacokinetics in special clinical situations

In patients with hepatic insufficiency, the total clearance decreases and the half-life increases.

Indications

- stable angina pectoris (angina pectoris);

- variant angina (Prinzmetal's angina);

- arterial hypertension.

Instructions for use / dosage

Tablets are taken in the morning with meals as a whole, without chewing and drinking plenty of liquid.

Cancellation of the drug should be carried out gradually.

Side effect

From the side of the cardiovascular system: hot flashes, flushing of the skin of the face, a feeling of heat, tachycardia, arrhythmia, peripheral edema (ankles, feet, legs), excessive decrease in blood pressure, syncope, heart failure; in some patients, especially at the beginning of treatment, angina attacks may occur, which requires discontinuation of the drug. Isolated cases of myocardial infarction have been described.

From the side of the central nervous system and peripheral nervous system: headache, dizziness, general weakness, fatigue, drowsiness, paresthesia. With prolonged use in high doses - extrapyramidal (parkinsonian) disorders (ataxia, mask-like face, shuffling gait, stiffness of the movements of the arms and legs, tremor of the hands and fingers, difficulty swallowing), depression.

From the digestive system: dry mouth, increased appetite, dyspepsia (nausea, diarrhea or constipation), gingival hyperplasia (completely disappearing after discontinuation of the drug). With prolonged use, liver dysfunction is possible (intrahepatic cholestasis, increased activity of liver enzymes).

From the musculoskeletal system: arthritis, myalgia; rarely - arthralgia, swelling of the joints.

From the hematopoietic system: anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.

From the urinary system: increase in daily diuresis, deterioration of kidney function (in patients with renal insufficiency).

Allergic reactions: itching, urticaria, exanthema, exfoliative dermatitis, photodermatitis, autoimmune hepatitis, acute allergic generalized reactions - swelling of the mucous membranes, swelling of the larynx, bronchospasm (up to the development of shortness of breath, threatening the life of the patient).

Others: visual impairment (including transient blindness when the maximum concentration of nifedipine in plasma is reached), gynecomastia (in elderly patients, completely disappearing after discontinuation of the drug), galactorrhea, hyperglycemia, pulmonary edema, weight gain.

Contraindications

- cardiogenic shock;

- acute period of myocardial infarction (during the first 4 weeks);

- unstable angina;

- severe aortic stenosis;

- severe arterial hypotension (systolic blood pressure below 90 mm Hg);

- concomitant use of rifampicin;

- pregnancy;

- lactation (breastfeeding);

- age up to 18 years (efficacy and safety have not been established);

- hypersensitivity to nifedipine and other derivatives of 1,4-dihydropyridine.

FROM caution use the drug for severe mitral valve stenosis, hypertrophic obstructive cardiomyopathy, severe bradycardia or tachycardia, SSSU, chronic heart failure, mild or moderate arterial hypotension, severe cerebrovascular accident, gastrointestinal obstruction, renal and hepatic insufficiency (especially in patients who are on hemodialysis, due to the high risk of excessive and unpredictable reduction in blood pressure), in the elderly.

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

Application for violations of liver function

FROM caution use the drug for liver failure.

Application for violations of kidney function

FROM caution use the drug for renal failure (especially in patients on hemodialysis, due to the high risk of excessive and unpredictable decrease in blood pressure).

special instructions

The patient should be warned about the need to take the drug regularly, regardless of well-being.

In patients on hemodialysis, with high blood pressure and irreversible renal dysfunction and with a reduced total amount of blood, the drug should be used with caution, because. a sharp drop in blood pressure is possible.

In case of impaired liver function, patients require careful monitoring and, if necessary, a reduction in the dose of the drug or the use of other dosage forms of nifedipine.

With severe heart failure, dose selection of nifedipine should be carried out carefully.

The simultaneous appointment of beta-blockers should be carried out under conditions of careful medical supervision, since this may cause an excessive decrease in blood pressure, and in some cases, aggravation of the phenomena of heart failure.

During treatment, positive results are possible when performing a direct Coombs test and laboratory tests for antinuclear antibodies.

It should be borne in mind that angina pectoris may occur at the beginning of treatment, especially after the recent abrupt withdrawal of beta-blockers (the latter should be canceled gradually).

Diagnostic criteria for prescribing the drug in vasospastic angina pectoris are: the classic clinical picture, accompanied by an increase in the ST segment, the occurrence of ergonovine-induced angina or spasm of the coronary arteries, the detection of coronary spasm during angiography or the detection of an angiospastic component without confirmation (for example, with a different threshold of tension or with unstable angina, when ECG data indicate transient angiospasm).

Caution should be given simultaneously with disopyramide and flecainamide due to a possible increase in the inotropic effect.

If the patient requires surgery under general anesthesia, it is necessary to inform the anesthesiologist about the nature of the therapy being carried out.

Caution should be exercised in elderly patients due to the high likelihood of age-related renal dysfunction.

Against the background of ongoing therapy, you should not drink alcohol.

Influence on the ability to drive vehicles and control mechanisms

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.

Overdose

Symptoms: headache, flushing of the skin of the face, prolonged pronounced decrease in blood pressure, inhibition of the activity of the sinus node, bradycardia and / or tachycardia, bradyarrhythmia; in severe overdose - loss of consciousness, coma.

Treatment: washing the stomach and small intestine. Calcium preparations are an antidote, it is shown in / in the introduction of a 10% solution of calcium chloride or calcium gluconate, followed by a long-term infusion. With a pronounced decrease in blood pressure - slow intravenous administration of dopamine, dobutamine, epinephrine (adrenaline) or norepinephrine (norepinephrine). For conduction disorders - atropine, isoprenaline or an artificial pacemaker. It is recommended to control the content of glucose in the blood (the release of insulin may decrease) and electrolytes (potassium, calcium). Hemodialysis is not effective.

drug interaction

The hypotensive effect of nifedipine is enhanced by simultaneous use with other antihypertensive drugs, nitrates, cimetidine (to a lesser extent - with ranitidine), inhalation anesthesia, diuretics.

It should be borne in mind that calcium channel blockers can enhance the negative inotropic effect of amiodarone and quinidine.

When used together, nifedipine causes a decrease in the concentration of quinidine in the blood plasma, after the abolition of nifedipine, a sharp increase in the concentration of quinidine may occur.

With simultaneous use, nifedipine increases the concentration of digoxin and theophylline in blood plasma (the use of this combination requires monitoring of clinical efficacy and the content of digoxin and theophylline in blood plasma).

Inducers of microsomal liver enzymes (including rifampicin) reduce the concentration of nifedipine.

With the combined use of nifedipine with nitrates, tachycardia increases.

The hypotensive effect of nifedipine is reduced when used simultaneously with sympathomimetics, NSAIDs, estrogens, calcium preparations.

Nifedipine can displace drugs with a high degree of binding from protein binding (including indirect anticoagulants - coumarin and indandione derivatives, anticonvulsants, NSAIDs, quinine, salicylates, sulfinpyrazone), as a result of which their concentration in blood plasma may increase.

When used together, nifedipine inhibits the metabolism of prazosin and other alpha-blockers, as a result of which an increase in the hypotensive effect is possible.

Nifedipine inhibits the excretion of vincristine from the body and may increase the side effects of vincristine (if necessary, reduce the dose of vincristine).

When used together, lithium preparations can increase toxic effects (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

With the simultaneous appointment of cephalosporins (for example, cefixime) and nifedipine, the bioavailability of cephalosporin increases by 70%.

Procaine, quinidine and other drugs that cause QT prolongation increase the negative inotropic effect and increase the risk of significant prolongation of the QT interval.

Diltiazem inhibits the metabolism of nifedipine in the body (the use of this combination requires careful monitoring and, if necessary, a dose reduction of nifedipine).

Grapefruit juice inhibits the metabolism of nifedipine in the body, and therefore it is contraindicated to use it with nifedipine.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored in a place protected from light, out of the reach of children, at a temperature not exceeding 30°C. Shelf life - 3 years.