Nifedipine solution. Nifedipine tablets are a powerful remedy for normalizing systolic blood pressure.

Recipe (International)

Rp: Nifedipini 0.01
D.t.d: No. 10 in tab.
S: Inside, 1 tab. 3 r / d.

Recipe (Russia)

Rp: Nifedipini 0.01
D.t.d: No. 10 in tab.
S: Inside, 1 tab. 3 r / d.

Prescription form - 107-1 / y

Active substance

pharmachologic effect

Nifedipine - selective blocker slow calcium channels, 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 dilates 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 overlapped by reflex activation of the sympathoadrenal system in response to peripheral vasodilation. 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 gastrointestinal tract. After oral administration, its bioavailability is 40-60%. Eating increases bioavailability. It has the effect of "first pass" through the liver. Cmax in blood plasma is observed after 1-3 hours and is 65 ng / ml. Penetrates through the BBB and the placental barrier, excreted with 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). T1 / 2 is 24 hours. There is no cumulative effect.

Chronic kidney 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.

Mode of application

For adults:

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 of water.

Initial dose: 1 tablet (10 mg) 2-3 times / day. If necessary, the dose of the drug can be increased to 2 tablets (20 mg) - 1-2 times / 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.

Indications

- coronary artery disease: angina pectoris and rest (including variant);
— arterial hypertension(as monotherapy or in combination with other antihypertensive drugs).

Contraindications

— hypersensitivity to nifedipine and other dihydropyridine derivatives;
— acute stage myocardial infarction (first 4 weeks);
- cardiogenic shock, collapse;
— arterial hypotension(systolic blood pressure below 90 mm Hg);
- syndrome of weakness of the sinus node;
- 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 liver and/or kidney function; severe disorders of cerebral circulation, diabetes, malignant arterial hypertension, patients on hemodialysis (due to the risk of arterial hypotension).

Side effects

- from the side of cardio-vascular system:
hyperemia of the face, feeling of heat, tachycardia, peripheral edema (ankles, feet, legs), excessive decrease 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 side of the central 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 - liver dysfunction (intrahepatic cholestasis, increased activity of hepatic 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).

Other: flushing of the skin of the face, change visual perception, gynecomastia (in elderly patients, completely disappearing after cancellation), hyperglycemia, gingival hyperplasia.

Release form

Tab., cover shell, 10 mg: 50 pcs.
Release form, composition and packaging
Coated tablets yellow color, round, biconvex.
1 tab. = nifedipine 10 mg
Excipients:
lactose monohydrate - 50 mg, microcrystalline cellulose - 48.2 mg, wheat starch - 5 mg, gelatin - 2 mg, magnesium stearate - 1.2 mg, talc - 3.6 mg.
e.

ATTENTION!

The information on the page you are viewing was created for informational purposes only and does not promote self-treatment in any way. The resource is designed to familiarize healthcare professionals with additional information about certain medicines, thereby increasing the level of their professionalism. The use of the drug "" in without fail provides a consultation with a specialist, as well as his recommendations on the method of application and dosage of the medicine you have chosen.

Nifedipine is an effective drug that reduces high blood pressure and relieves pain during angina attacks. It is a selective calcium channel blocker.

This drug helps to reduce the flow of smooth muscle cells of peripheral and coronary arteries and extracellular calcium ions. It expands the peripheral and coronary vessels, reduces spasmolytic phenomena, increases coronary blood flow, reduces overall vascular resistance and myocardial oxygen demand. The positive effect of taking this medication occurs 20 minutes after it enters the human body, and the duration of the clinical effect is 4 to 7 hours.

With long-term treatment, this medicine has an anti-atherogenic effect. It inhibits platelet aggregation, increases the excretion of sodium and water, and also reduces the tone of the myometrium. After ingestion, Nifedipine is rapidly absorbed. Its maximum plasma concentration is observed after 30 minutes. The half-life of the drug is 2-4 hours.

What are Nifedipine tablets prescribed for?

• treatment of heart failure;
• relief of single crises;
• impaired blood supply to the retina, brain;
• medical therapy of coronary heart disease;
• maintenance therapy for arterial hypertension;
• treatment of angina pectoris.

Side effect

When treated with this drug, some patients experience the following side effects:

• a feeling of heat, lowering blood pressure, peripheral edema;
• dizziness, drowsiness, headaches;
• anemia;
• diarrhea, nausea.

If you feel worse while taking the medicine, it is recommended to immediately notify your doctor and stop using the drug.

The drug is produced in the form of tablets. The dosage regimen is set individually depending on the patient's condition. Doctors recommend taking this medicine after eating or during this process, drinking plenty of fluids.

On the initial stage treatment, doctors recommend drinking 10 mg 2 to 3 times a day. If necessary, the dose can be increased to 20 mg 1-2 times a day. The maximum allowable daily dosage is 40 mg. In elderly patients, in people with impaired functioning internal organs and the brain, as well as in patients who receive combined antihypertensive therapy, the dosage should be reduced. The period of drug withdrawal should be done gradually.

Special instructions and contraindications

Doctors advise against taking this medicinal product in cases such as:

• collapse or cardiogenic shock;
• sensitivity to the components of the drug;
• low blood pressure;
• myocardial infarction;
• pregnancy and lactation period;
• heart failure;
• various types of stenosis;
• dysfunction of the liver or kidneys;
• tachycardia;
• diabetes;
• children's age up to 18 years.

If you suffer from at least one of the above diseases, be sure to tell your doctor about it and refuse treatment with this drug. Your healthcare professional will advise you on any safe analogue Nifedipine.

In the absence of contraindications for use, take this medicinal product in accordance with the instructions. At the same time, for the duration of treatment, it is recommended to refrain from engaging in hazardous activities that require quick reactions, increased concentration and attention, as well as from drinking alcoholic beverages.

Storage conditions and shelf life

The drug should be stored in a dry place, closed from sunlight, the temperature in which should not exceed 25 ° C. The shelf life is three years.

14.05.2017

Nifedipine tablets are necessary for hypertensive patients and are a common remedy for pressure , eliminating pain, reducing ischemia.

The drug is produced in several versions:

• adalat - solution for intravenous administration;
• briefly active tablets capableremove the crisis (cordaflex, nifedipine, cordafen, cordipin, fenigidin);
• long-acting drug that is drunklong-term (cordaflex rd, corinfar, nifecar chl, calciguard retard, osmo-adalat).

Listed medicines for pressure combines the active substance, the mechanism of action on the body and pharmacological effect. Differ from downgrading AD drugs by the duration of the result obtained, the speed of the onset of the effect from the moment of taking / administering the medication. Given the differences, each form has its own indications, which the doctor must know about.

How does nifedipine affect the body?

Learn more about Nifedipine instructions for use, at what pressureand how to take adverse reactions and contraindications. However, it is not necessary to understand medical terminology. The active substance is classified as a Ca-channel blocker. This means that the channels in the cell wall through which calcium enters are blocked.

Many calcium channels in the muscles, including the heart. Penetrating into the cell, calcium provokes excitation, causing a contraction of muscle tissue.

Under conditions of blocking calcium channels, much of it will not enter the cell, which means that the lumen in the vessels will expand, because their walls of their circular muscle fibers will not actively contract under the influence of calcium.

Due to the expansion of the cardiac arteries, blood flow to the myocardium improves, and the increased lumen of distant arteries provides a decrease pressure . The vascular walls relax, the lumen of the veins and arteries increases, the frequency of myocardial contractions succeeds reduce.

Dilated blood vessels, through which blood circulates to the heart and brain, provide blood flow to the main organs, the supply of glucose and oxygen. Against the backdrop of such favorable conditions cells affected by ischemia and pathologies do not recover well.

When is Nifedipine prescribed?

pressure medication appoint at different pathologies, choosing each time the appropriate form of medicine:

• as a prophylaxis for angina pectoris in patients with ischemic disease;
• in order to reduce vasospasm in patients with Prinzmetal's angina;
• for downhill pain in the chest if nitroglycerin is not possible accept ;
• to control blood pressure in hypertensive patients in the long term;
• to quickly to stop a hypertensive crisis;
• with Raynaud's syndrome to relieve spasms of distant blood vessels.

An intravenous liquid form of the drug is administered in a hospital if the patient is in serious condition. Short acting tablets fast reduce blood pressure, used in case of an acute attack of angina pectoris and hypertension.

For long-term treatment of hypertension, indicators pressure normalized with prolonged-release tablets.

Dosage of the drug

If the patient has read the instructions and knows what dosagereduces pressure, with hypertension, act according to the principle: “what I want, then drink ' is dangerous. The doctor can prescribe pills, they act individually for each patient.

The standard daily dosage is 30-80 g. If short-acting tablets are taken, then the daily dose is divided into 3-4 doses, and if long-acting tablets are prescribed, they are taken 1-2 times a day. For severe hypertension and variant angina for some time, you can increase the daily dosage to 120 mg, but as prescribed by the doctor and when the drug is well tolerated. The maximum daily dose is 120 mg.

When you need to remove the pressure surge, put a 10-20 mg tablet under the tongue, which will work for 15 minutes. Do the same for chest pain. In the hospital, an angina attack or crisis is stopped intravenous administration Nifedipine in a volume of 5 mg / h, daily rate while 30 mg.

An overdose of the drug is manifested by facial swelling, headache, prolonged pressure drop, bradycardia, bradyarrhythmia and the absence of a pulse in distant arteries. In case of severe intoxication, loss of consciousness and collapse are possible.

To provide first aid, you need to do a gastric lavage, then prescribe Activated carbon at the rate of 1 tablet per 10 kg of body weight. Nifedipine's drug antidote is calcium, to help the patient is administered calcium chloride or calcium gluconate in 10% solution.

Adverse reactions

Like other pressure pills, Nifedipine causes side reactions in the body:

• from the gastrointestinal tract: diarrhea, nausea, heartburn and liver failure. If you take the drug for a long time in high doses, this will affect the liver in the form of cholestasis or an increase in transaminases;
• from the side of the cardiovascular system: swelling of the skin and extremities, a strong drop in pressure, a feeling of warmth, asystole, tachycardia, bradycardia, angina pectoris;
• from the central and peripheral nervous system: headaches, long-term use muscle pain, sleep problems, tremors and visual disturbances;
• from the side genitourinary system: increased diuresis, on the background long-term use- failure of the kidneys;
• on the part of hematopoiesis: leukopenia and thrombocytopenia;
• from the side endocrine system- a manifestation of gynecomastia.

As an allergy to the components of Nifedipine, a rash on the skin, burning at the injection site is possible. With intravenous administration, an increase in the frequency of myocardial contractions and the development of hypotension are possible.

Contraindications

Nifedipine is not prescribed for hypotension, collapse, aortic stenosis in severe form, cardiogenic shock, severe heart failure, acute myocardial infarction, tachycardia, minor age.

Pregnant and lactating Nifedipine is not recommended, although in gynecological practice there are cases when the drug was necessary in case of ineffectiveness of the drugs. In such cases, the doctor weighs the risks, and may prescribe the drug for later dates pregnancy, to stop the hypertensive crisis and normalize the condition of the expectant mother.

In pregnant women, Nifedipine reduces uterine tone, but clinical research has not been done on this issue. It is strictly forbidden for pregnant women to drink the medicine on their own, the decision should be made by the doctor.

A similar appointment with caution applies to patients with diabetes mellitus, malignant arterial hypertension, serious circulatory disorders in the brain, malfunctions of the kidneys and liver.

The effectiveness of Nifedipine

Since the development of the drug, there have been enough international studies on the effectiveness, according to the results, reports have been presented on the benefits, safety and feasibility of prescribing Nifedipine. In 2000, the results of the INSIGHT study were presented, according to which the drug is safe, effectively helps with hypertension, is well tolerated compared to diuretic drugs, and helps reduce the risk of heart attack and stroke in hypertensive patients.

The results of the Action study confirmed the safety of long-acting nifedipine, its ability to reduce the need for coronary artery bypass grafting and coronary angiography. In combination with other drugs, Nifedipine improves the prognosis in hypertensive patients and patients with angina pectoris, including the state after myocardial infarction.

In the recommendations of the European Society of Cardiology there are notes on the positive effect of long-acting nifedipine on the health of patients with stable angina, both in monotherapy and in combination with nitrates and beta-blockers.

Short term tablets are recommended as a remedy emergency assistance with a hypertensive crisis, if they are taken for a long time, then this is fraught with complications.

Drug Interactions

Before prescribing pills for pressure, the doctor will assess the patient's condition, refer him for diagnosis, select the dosage and regimen of therapy. You need to tell your doctor if you are taking medications, as Nifedipine does not work well with all of them.

The combined use of Nifedipine with diuretics, nitrates, tricyclic antidepressants leads to an accumulation of the effect and an increase in the pressure-reducing effect.

In combination with beta-blockers, the hypotensive effect increases, heart failure develops. Cimetidine together with Nifedipine increases the concentration of the latter in the blood plasma. If you take Rifampicin against the background of Nifedipine, then the metabolism of the latter will accelerate, the effectiveness of its action on the body will decrease.

It is important to consider that long-term treatment of patients with high blood pressure or coronary artery disease is carried out with long-acting drugs. It is valid for 12-24 hours. As for short-term tablets, they should be used as an ambulance for a hypertensive crisis, when you need to effectively and quickly reduce blood pressure.

According to research and practice, if you use short-acting Nifedipine for a long time, this is fraught with a stroke or heart attack.

The doctor selects the dosage of tablets individually in each individual case. Self-treatment, relying on the instructions for the drug - is not worth it, this can lead to dangerous consequences.

Nifedipine - has antianginal and antihypertensive effects. It relaxes vascular smooth muscles (relieves spasm), dilates coronary and peripheral (mainly arterial) vessels, lowers blood pressure and peripheral vascular resistance, and reduces afterload. Possessing the action of a cardioprotector, it reduces the need for oxygen in the heart muscle. Increases coronary blood flow.

Nifedipine effectively reduces pressure, and also helps relieve muscle spasms. Without affecting the heart rhythm, it significantly lowers blood pressure. After taking Nifedipine begins to act after 20 minutes. (chewing accelerates the effect) and lasts up to 12 hours.

Active ingredient - tablets and capsules 0.005 and 0.01 g. Dragee 0.01 g. Retard tablets 0.02 and 0.04 g.

Nifedipine - indications for use

Prevention of angina attacks (including Prinzmetal's angina pectoris). As part of combination therapy drug is used in the treatment of coronary heart disease ( stable angina, vasospastic angina) and arterial hypertension.

To lower blood pressure in various types hypertension (including unclear etiology), including renal hypertension.

In some cases, it is used for Raynaud's disease and as part of combined treatment CHF.

At present, there is evidence of inappropriateness therapeutic use nifedipine in hypertension - this is associated with an increased risk of myocardial infarction, as well as deaths in patients with coronary heart disease with long-term use Nifedipine.

Take nifedipine at what pressure?
The instructions for use of the drug clearly indicate that nifedipine is used for high blood pressure to lower blood pressure. Nifedipine for pressure is taken by general scheme listed below, unless otherwise directed by the attending physician.

Nifedipine during pregnancy and uterine tone

What is nifedipine prescribed for during pregnancy with tone? The drug relieves spasm and relaxes smooth muscles (including the uterus), is used to suppress premature contractions.

The dosage of nifedipine with tone in particular, and use during pregnancy in general, should be strictly under medical supervision. Instructions for use prohibits treatment with the drug during pregnancy and lactation. Self-prescribe nifedipine with uterine tone is strictly prohibited! See below for details.

Nifedipine: instructions for use and dosage

How to take Nifedipine tablets? Doses and duration of treatment are set by the attending physician individually, taking into account the patient's condition and the specific dosage form of the drug.

The tablet form of Nifedipine is taken orally with a sufficient amount of water. Long-acting Nifedipine is recommended for a long course of treatment.

The initial dose is 10 mg 2 times a day, if necessary, the dose can be increased to 20 mg 2 times a day. If necessary, the dose is gradually increased to 20 mg of nifedipine 3-4 times a day. The maximum daily dose is 80 mg.

With arterial hypertension, nifedipine tablets are taken 3 times a day, 10 mg each, if necessary, the dose is increased to 20–30 mg (3 times a day).

Accelerated action in crises - a tablet of nifedipine is kept unchewed, without swallowing, under the tongue. The drug is absorbed within a few minutes. With this method, the patient must lie down for half an hour, due to possible sharp decline HELL.

In elderly patients and burdened with other diseases, the maximum daily dose should be reduced.

In case of impaired liver function, in patients with severe cerebrovascular accident, the dose should be reduced.

It is necessary to stop taking nifedipine gradually, gradually reducing the daily dose by half.

How long can you take? The course of treatment is prescribed by a doctor and can be up to 2 months.

During the period of treatment, alcohol intake is strictly prohibited. The regularity of therapy is important, regardless of the state of health, the patient may not feel the symptoms of arterial hypertension.

Contraindications when using Nifedipine

• severe disorders of cerebral circulation,
• arterial hypotension (systolic blood pressure below 90 mm Hg),
• vascular and cardiogenic shock,
• first week of acute myocardial infarction,
• severe heart failure
• liver failure, renal failure (especially patients on hemodialysis),
• pregnancy and lactation,
• hypersensitivity to nifedipine and other components of the drug.
• children under 18 years of age (efficacy and safety of use have not been studied).

It is forbidden to use Nifedipine tablets in patients with lactose intolerance.

The use of Nifedipine during pregnancy is prohibited. Experimental studies conducted on animals, revealed the risk of growth retardation and retardation in the development of the fetus and the occurrence of miscarriage.

Taking the drug Nifedipine during pregnancy with uterine tone is justified in case of an increased risk of angina pectoris, heart attack, as well as congestive heart failure, disorders heart rate, lack of oxygen in the tissues (hypoxia) and renal failure.

Analogues of Nifedipine, list

This is a very popular medicine, and it may not be available in pharmacies, but there are analogues of Nifedipine tablets:

• Adalat SL
• Kordafen
• Vero-Nifedipine
• Cordaflex
• Nifadil
• Nifesan
• Sanfidipin
• Fenigidin

Long-acting nifedipine analogues:

• Corinfar Uno;
• Nifedipine SS;
• Cordipin-retard;
• Nifebene retard.

Many famous pharmaceutical companies are engaged in the production of an analogue of the drug Nifedipine. Patient reviews say that most of them are in no way inferior to him in terms of effectiveness.

Be careful - instructions for use of Nifedipine, price and reviews of analogues may not correspond, due to differences in concentration active ingredient and others excipients. When choosing an analogue, it is recommended to consult a doctor.

In this article, you can read the instructions for use medicinal product Nifedipine. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of medical specialists on the use of Nifedipine in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Nifedipine, if available structural analogues. Use to treat angina pectoris and lower blood pressure in adults, children, and during pregnancy and lactation.

Nifedipine- a selective blocker of "slow" calcium channels, a derivative of 1,4-dihydropyridine. It has a vasodilatory, antianginal and antihypertensive effect. Reduces the current of calcium ions in cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries; in high doses inhibits the release of calcium ions from intracellular depots. Reduces the number of functioning channels without affecting the time of their activation, inactivation and recovery.

Dissociates 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, disturbed in a number of pathological conditions especially 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. By expanding the peripheral arteries, it reduces the total peripheral vascular resistance, myocardial tone, afterload, myocardial oxygen demand and increases the duration of diastolic relaxation of the left ventricle. It practically does not affect the sinoatrial and atrioventricular nodes and does not have antiarrhythmic activity. Enhances renal blood flow, causes moderate natriuresis. Negative chrono-, dromo- and inotropic effects are blocked by reflex activation of the sympathoadrenal system and an increase in heart rate in response to peripheral vasodilation.

The onset of the effect is 20 minutes, the duration of the effect is 12-24 hours.

Compound

Nifedipine + excipients.

Pharmacokinetics

Absorption - high (more than 92-98%). Bioavailability - 40-60%. Eating increases bioavailability. It has the effect of "first pass" through the liver. Retard molds provide gradual release active substance into the systemic circulation. Penetrates through the blood-brain (BBB) ​​and placental barrier, excreted in breast milk. Completely metabolized in the liver. Excreted as inactive metabolites, mainly by the kidneys (80%) and bile (20%).

Indications

• chronic stable angina pectoris (angina pectoris);
• vasospastic angina (Prinzmetal's angina);
• arterial hypertension (in monotherapy or in combination with other antihypertensive drugs);
• Raynaud's disease and syndrome.

Release form

Dragee 10 mg.

Tablets 10 mg.

Long-acting tablets (retard), coated film sheath 20 mg.

Capsules 5 mg and 10 mg.

Instructions for use and dosage

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 of 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.

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.

Retard tablets

inside. Tablets should be swallowed whole, without chewing, during or after a meal, with a small amount of water.

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.

Side effect

• peripheral edema (feet, ankles, legs);
• symptoms of vasodilation (reddening of the skin of the face, a feeling of heat);
• tachycardia;
• heart palpitations;
• pronounced decrease in blood pressure;
• fainting;
• chest pain (angina pectoris) up to the development of myocardial infarction;
• development or aggravation of the course of chronic heart failure;
• arrhythmias;
• headache;
• dizziness;
• drowsiness;
• asthenia;
• nervousness;
• increased fatigue;
• tremor;
• mood lability;
• nausea;
• pain in the stomach and intestines;
• diarrhea;
• constipation;
• dryness of the oral mucosa;
• increased appetite;
• dyspnea;
• pulmonary edema (difficulty breathing, coughing, stridor breathing);
• swelling of the joints;
• myalgia;
• muscle cramps;
• anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis;
• deterioration of kidney function (in patients with renal insufficiency);
• skin itching;
• hives;
• photosensitivity;
• angioedema;
• toxic epidermal necrolysis;
• visual impairment (including transient loss of vision against the background of the maximum concentration of nifedipine in the blood plasma);
• Pain in the eyes;
• gynecomastia (in elderly patients; completely disappearing after discontinuation of the drug);
• galactorrhea;
• erectile disfunction;
• weight gain;
• chills;
• nose bleed;
• nasal congestion.

Contraindications

• arterial hypotension (systolic blood pressure below 90 mm Hg);
• cardiogenic shock;
• collapse;
• severe aortic or subaortic stenosis;
• acute heart failure;
• chronic heart failure in the stage of decompensation;
• unstable angina;
• acute period of myocardial infarction (during the first 4 weeks);
• hypertrophic obstructive cardiomyopathy;
• sick sinus syndrome;
• AV blockade 2-3 degrees;
• pregnancy (up to 20 weeks);
• lactation period;
• age up to 18 years (efficacy and safety of use have not been studied);
• hypersensitivity to nifedipine or other components of the drug.

Use during pregnancy and lactation

Controlled studies of the use of the drug Nifedipine in pregnant women have not been conducted.

Animal tests have shown the presence of embryotoxicity, placentotoxicity, fetotoxicity and teratogenicity when taking nifedipine during and after the period of organogenesis.

Based on the available clinical data, no specific perinatal risk can be judged. However, there is evidence of an increase in the likelihood of perinatal asphyxia, caesarean section, premature birth and intrauterine growth retardation. It is not clear whether these cases are due to the underlying disease (hypertension), ongoing treatment or the specific effect of the drug Nifedipine. The available information is insufficient to rule out the possibility of side effects posing a risk to the fetus and newborn. Therefore, the use of the drug Nifedipine after the 20th week of pregnancy requires a careful individual assessment of the risk-benefit ratio for the patient, fetus and / or newborn and can be considered only in cases where other methods of therapy are contraindicated or ineffective.

Careful monitoring of blood pressure in pregnant women should be carried out when using the drug Nifedipine simultaneously with intravenous administration of magnesium sulfate due to the possibility of an excessive decrease in blood pressure, which is dangerous for both the mother and the fetus and / or newborn.

Nifedipine is contraindicated during lactation, as it is excreted in breast milk. If therapy with Nifedipine is absolutely necessary, it is recommended to stop breastfeeding.

Use in children

Contraindicated in children under 18 years of age.

special instructions

During the period of treatment it is necessary to refrain from drinking alcohol.

Despite the absence of "slow" calcium channel blockers of the "withdrawal" syndrome, a gradual reduction in doses is recommended before stopping treatment.

The simultaneous appointment of beta-blockers must be carried out under conditions of careful medical supervision, since this can cause an excessive decrease in blood pressure, and in some cases, aggravation of the phenomena of heart failure. During treatment, it is possible positive results when conducting a direct Coombs reaction and laboratory tests for antinuclear antibodies.

The regularity of treatment is important, regardless of how you feel, since the patient may not feel the symptoms of arterial hypertension.

Diagnostic criteria for prescribing the drug for vasospastic angina pectoris are: classic, clinical picture, accompanied by characteristic changes in the electrocardiogram (ST segment elevation); the occurrence of ergometrine-induced angina pectoris or spasm of the coronary arteries; detection of coronary spasm on angiography or detection of an angiospastic component, without confirmation (for example, at a different voltage threshold or at unstable angina when the electrocardiogram data indicate transient angiospasm).

For patients with severe hypertrophic cardiomyopathy there is a risk of an increase in the frequency, severity of manifestation and duration of angina attacks after taking nifedipine; in this case, it is necessary to cancel the drug.

In patients on hemodialysis, with high blood pressure, irreversible insufficiency of kidney function, with a decrease in circulating blood volume, the drug should be used with caution, since a sharp drop in blood pressure may occur.

Patients with impaired liver function are carefully monitored and, if necessary, reduce the dose of the drug and / or use other dosage forms nifedipine.

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 are recommended to be canceled gradually).

If during therapy the patient is required to surgical intervention under general anesthesia, it is necessary to inform the surgeon-anesthesiologist about the nature of the therapy being carried out.

In in vitro fertilization, in some cases, blockers of "slow" calcium channels caused changes in the head of the spermatozoa, which could lead to dysfunction of the spermatozoa. In cases in which IVF failed for no clear reason, calcium channel blockers, including nifedipine, were considered possible cause failures.

Influence on the ability to drive vehicles and control mechanisms

During treatment, care must be taken when administering vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

drug interaction

The severity of lowering blood pressure increases with the simultaneous use of nifedipine with other antihypertensive drugs, nitrates, cimetidine, ranitidine (to a lesser extent), inhalation anesthetics,

diuretics and tricyclic antidepressants.

Under the influence of nifedipine, the concentration of quinidine in the blood plasma is significantly reduced. Increases the concentration of digoxin in the blood plasma, and therefore should be monitored clinical effect and the content of digoxin in blood plasma.

Rifampicin is a potent inducer of the CYP3A4 isoenzyme. At joint application with rifampicin, the bioavailability of nifedipine is significantly reduced and, accordingly, its effectiveness is reduced. The use of nifedipine in conjunction with rifampicin is contraindicated. In combination with citrates, tachycardia and the antihypertensive effect of nifedipine are enhanced. Calcium preparations can reduce the effect of "slow" calcium channel blockers. When used together with nifedipine, the anticoagulant activity of coumarin derivatives increases.

May displace from protein binding medicines, characterized a high degree binding (incl. indirect anticoagulants- derivatives of coumarin and indandione, anticonvulsants, quinine, salicylates, sulfinpyrazone), as a result of which their concentration in blood plasma may increase. Suppresses the metabolism of prazosin and other alpha-blockers, which may increase the antihypertensive effect.

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

Simultaneous use with magnesium sulfate in pregnant women can cause blockade of neuromuscular synapses.

Cytochrome P450 3A system inhibitors such as macrolides (eg erythromycin), fluoxetine, nefazodone, protease inhibitors (eg amprenavir, indinavir, nelfinavir, ritonavir or saquinavir), antifungals(ketoconazole, itraconazole or fluconazole) lead to an increase in plasma concentrations of nifedipine. Taking into account the experience of using the "slow" calcium channel blocker nimodipine, the following interactions with nifedipine cannot be ruled out: carbamazepine, phenobarbital - a decrease in the concentration of nifedipine in the blood plasma; quinupristin, dalfopristin, valproic acid - an increase in the concentration of nifedipine in the blood plasma.

With caution, nifedipine should be administered simultaneously with disopyramide and flecainide due to a possible increase in the inotropic effect.

Nifedipine inhibits the excretion of vincristine from the body and may cause an increase in its side effects; if necessary, the dose of vincristine is reduced.

Grapefruit juice inhibits the metabolism of nifedipine in the body, and therefore their simultaneous administration is contraindicated.

Analogues of the drug Nifedipine

Structural analogues according to active substance:

• Adalat;
• Vero Nifedipine;
• Calciguard retard;
• Kordafen;
• Cordaflex;
• Cordaflex RD;
• Cordipin;
• Cordipin XL;
• Cordipin retard;
• Corinfar;
• Corinfar retard;
• Corinfar UNO;
• Nicardia;
• Nicardia SD retard;
• Nifadil;
• Nifebene;
• Nifehexal;
• Nifedex;
• Nifedicap;
• Nifedicor;
• Nifecard;
• Nifecard HL;
• Nifelat;
• Nifelate Q;
• Nifelat R;
• Nifesan;
• Osmo Adalat;
• Sanfidipin;
• Sponif 10;
• Fenigidin.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.