Nifedipine

When ATH:
C08CA05

Characteristic

A calcium channel blocker - 1,4-dihydropyridine derivative.

Yellow crystalline powder. Practically insoluble in water, it is soluble in alcohol. Molecular weight 346,3.

Pharmacological action

Antianginalnoe, gipotenzivnoe.

Application

Arterial hypertension, including hypertonic Kriz, prevention of angina attacks (incl. Prinzmetal angina), gipertroficheskaya cardiomyopathy (obstruktivnaya and others.), Raynaud's disease, pulmonary hypertension, bronchial obstruction.

Contraindications

Hypersensitivity, acute phase of myocardial infarction (first 8 days), cardiogenic shock, Heavy aortalnыy stenosis, heart failure decompensation, severe hypotension, tachycardia, pregnancy, lactation.

Restrictions apply

It should refrain from using the drug in pediatric practice, because the safety and efficacy of their use in children is not identified.

Pregnancy and breast-feeding

Contraindicated in pregnancy.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding.

Side effects

Cardio-vascular system and blood (hematopoiesis, hemostasis: often (at the beginning of treatment) - facial flushing with heat, heartbeat, tachycardia; rarely - hypotension (until syncope), pain, such stenokardicheskie, very rarely - anemia, leukopenia, thrombocytopenia, trombotsitopenicheskaya purpura.

From the nervous system and sensory organs: at the beginning of treatment - dizziness, headache, rarely - oglušennostʹ, very rarely - change of visual perception, violation of the sensitivity of the hands and feet.

From the digestive tract: often - constipation, rarely - nausea, diarrhea, very rarely - gingival hyperplasia (long-term treatment), increase in liver transaminases.

From the respiratory system: very rarely - bronchospasm.

On the part of the musculoskeletal system: very rarely - myalgia, tremor.

Allergic reactions: itch, hives, exanthema, rarely - exfoliative dermatitis.

Other: often (at the beginning of treatment) - swelling and redness of hands and feet, very rarely - fotodermatit, giperglikemiâ, gynecomastia (in elderly patients), burning sensation at the injection site (at / in the introduction).

Cooperation

Nitrates, beta-blockers, Diuretic, tricyclic antidepressants, Fentanyl, alcohol - increase the hypotensive effect. Increases the activity of theophylline, reduces the renal clearance of digoxin. Increases the side effects of vincristine (reduces the excretion). Increases the bioavailability of cephalosporins (cefixime). Cimetidine and ranitidine increase the plasma levels. Diltiazem slows metabolism (It required a dose reduction of nifedipine). Incompatible with rifampicin (accelerates biotransformation and does not allow to create effective concentration). grapefruit juice (a large number of) increases the bioavailability.

Overdose

Symptoms: severe bradycardia, ʙradiaritmija, hypotension, in severe cases - collapse, conduction slowing. When receiving a large number of retard tablets signs of intoxication occur no sooner than 3-4 hours, and may further be expressed in loss of consciousness until coma, cardiogenic shock, convulsions, giperglikemii, metabolic acidosis, hypoxia.

Treatment: gastric lavage, administration of activated charcoal, a norepinephrine, calcium chloride or calcium gluconate in a solution of atropine (I /). Hemodialysis nyeeffyektivyen.

Dosing and Administration

Inside, sublingually, I /. Inside, during or after a meal, as tablets, capsules, drop, adults - 10 mg 3-4 times a day. In special cases (variant angina, severe hypertension) - may increase the dose up to 20 mg 4-6 times a day for a short time. The maximum daily dose - 120 mg. When hypertension - on 10 mg 3 once a day (if necessary, increase the dose for 7-14 days to 20-30 mg per reception. For relief of hypertensive crisis and angina 10-20 mg single oral dose or sublingual, if necessary - through 10 min again as capsules and tablets of prolonged action (capsule recommended to pierce or bite through) - 20-40 mg 2 once a day (angina Printsmetalla - up 120 mg / day); as tablets ultraretard - 40-80 mg 1 once a day (Table. do not chew). B / (relief of hypertensive crisis) - 5 mg over 4-8 hours (0,0104-0.0208 mg / min), or from 6.3 to 12.5 ml / h). The maximum dose - 15-30 mg / day (It can be used not more than 3 days).

Precautions

Elderly patients are recommended to reduce the daily dose (lowering metabolism). Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention. Canceling the drug should be gradually (may develop withdrawal).

Cautions

In patients with stable angina, early treatment can occur paradoxical strengthening of anginal pain, when expressed koronaroskleroza and unstable angina - the aggravation of myocardial ischemia. It is not recommended to use a short-acting drugs for long-term treatment of angina or hypertension, tk. possible development of unpredictable changes in blood pressure and reflex angina.

Cooperation