Cordaflex, sustained release pills 20mg 30pcs

Composition

Pill:

• Nifedipine 20 mg;
• Auxiliary substances:
• microcrystalline cellulose, lactose monohydrate, sodium croscarmellose, hydroxypropylcellulose, polyvinyl butyral In 30 T, talc, magnesium stearate;
• shell composition:
• hypromellose, titanium dioxide, iron oxide red, magnesium stearate.

Pharmacological action

KORDAFLEX is a class II selective calcium channel blocker, a dihydropyridine derivative. Causes antianginal and hypotensive effects.

Dilates the coronary and peripheral arteries, reduces the need for oxygen in the myocardium by reducing the afterload on the heart. It has a slight negative inotropic effect.

It has practically no antiarrhythmic activity. It does not have a depressing effect on the conducting system of the heart. As a result of a decrease in peripheral vascular resistance and a decrease in blood pressure, it can cause a slight reflex tachycardia.

Indications

Coronary heart disease: for the prevention (in some cases – relief) of seizures in various forms of angina pectoris, including angiospastic (Prinzmetal angina pectoris); arterial hypertension of various origins; Raynaud’s syndrome.

Use during pregnancy and lactation

Kordaflex® is contraindicated for use in the first trimester of pregnancy.

The use of Kordaflex in pregnant women is indicated only in cases where normalization of blood pressure is impossible with the use of other antihypertensive drugs.

Since nifedipine is excreted in breast milk, you should avoid using Kordaflex during lactation or stop breastfeeding during treatment with the drug.

Contraindications

Cardiogenic shock; severe arterial hypotension (systolic blood pressure below 90 mm Hg); severe aortic stenosis, idiopathic hypertrophic subaortic stenosis; I trimester of pregnancy; severe heart failure; hypersensitivity to nifedipine.

Side effects

From the cardiovascular system: hyperemia of the facial skin, severe hypotension, peripheral edema, tachycardia; rarely-increased angina attacks (drug withdrawal is required), increased heart failure, fainting.

From the central nervous system and peripheral nervous system: headache, dizziness, fatigue, sleep disorders (drowsiness or insomnia); in isolated cases – lability of mood, visual disturbances; with prolonged use in high doses – paresthesia in the extremities, tremor.

From the digestive system: diarrhea, constipation, nausea, heartburn; rarely (with prolonged use of the drug) – dry mouth, flatulence, intrahepatic cholestasis, increased activity of hepatic transaminases; in some cases – gum hyperplasia, gingivitis, anorexia.

From the hematopoietic system: rarely-thrombocytopenia, thrombocytopenic purpura, leukopenia; in some cases-anemia.

From the urinary system: increased daily diuresis; rarely-deterioration of renal function in patients with chronic renal failure.

From the musculoskeletal system: myalgia; in some cases – arthritis.

From the endocrine system: in isolated cases – gynecomastia, hyperglycemia (completely disappear after discontinuation of the drug), changes in body weight, galactorrhea.

Allergic reactions: rarely-urticaria, exanthema, pruritus; in some cases-autoimmune hepatitis. Other: feeling hot; in isolated cases – weakness, sweating, fever, chills, photodermatitis.

Interaction

The combined use of nitrates with Kordaflex significantly enhances the antianginal effect.

The simultaneous use of Kordaflex and beta-blockers in most clinical situations is effective and safe, as it leads to the summation of antianginal and antihypertensive effects of drugs, but in some cases it is possible to develop severe arterial hypotension and heart failure.

Rational, from the point of view of enhancing the hypotensive effect, consider the combination of Kordaflex with clonidine (clonidine), alpha-methyldopa (dopegit), diuretics, captopril, octadine, prazosin, reserpine; do not use Kordaflex with apressin.

With the simultaneous use of Kordaflex and calcium preparations, the effect of nifedipine decreases due to the antagonistic interaction caused by an increase in the concentration of calcium ions in the extracellular space.

The hypotensive effect of Kordaflex when used concomitantly with cimetidine is significantly enhanced due to an increase in the concentration of nifedipine in blood plasma, which requires dose adjustment of drugs.

Under the influence of Kordaflex, the concentration of quinidine in the blood serum decreases significantly, which is probably due to a decrease in the bioavailability of quinidine, the induction of enzymes that inactivate it, an increase in blood flow in the liver and kidneys, an increase in the volume of distribution of the drug, and changes in hemodynamics.

When Kordaflex is discontinued after its simultaneous use with quinidine, a transient increase in the concentration (approximately 2 times) of the latter in serum is observed, which reaches its maximum level on the 3rd-4th day after withdrawal, as well as an extension of the QT interval on the ECG.

Therefore, caution should be exercised when using a combination of quinidine and Cordaflex, especially in patients with left ventricular depression.

When administered concomitantly with rifampicin, there will be a weakening of the effect of Kordaflex.

How to take, course of use and dosage

Adults Kordaflex 10 mg is prescribed 1 tab. 3-4 times / day. If necessary, the dose is gradually increased to 20 mg 2 times / day. The maximum daily dose is 40 mg.

During the course of therapy, it is recommended to use a prolonged form of the drug – Kordaflex Retard 20 mg. The drug is prescribed at 20-40 mg 2 times a day.

For the elderly, the initial dose of the drug is reduced by half.

The drug is taken regardless of food intake.

Overdose

Symptoms: severe hypotension, headache, collapse, tachycardia, sinus node depression, bradycardia, arrhythmia.

Treatment: given the absence of a specific antidote, in cases of early detoxification, gastric lavage is performed with the appointment of activated charcoal. Once, and then, as indicated, in the form of a long infusion,10% solutions of calcium gluconate or calcium chloride are administered intravenously.

With a sharp decrease in blood pressure, intravenous infusion of norepinephrine is indicated, with the development of heart failure – glycosides.

Special instructions

The antihypertensive effect of Kordaflex increases with hypovolemia. Reduced pulmonary artery pressure and hypovolemia after dialysis may also increase the effects of the drug, and therefore a dose reduction is recommended.

In rare cases, chest pain (angina due to paradoxical ischemia) may occur at the beginning of the course of treatment with Kordaflex or with an increase in its dose shortly after taking the drug. If a causal relationship is found between taking the drug and angina pectoris, treatment should be discontinued.

In patients with arterial hypertension or coronary vascular disease, abrupt withdrawal of nifedipine can cause a hypertensive crisis or myocardial ischemia (the “rebound” phenomenon).

If the patient needs surgery under general anesthesia during therapy, it is necessary to inform the anesthesiologist about the treatment with Cordaflex.

Elderly patients are more likely to have decreased cerebral blood flow due to severe peripheral vasodilation.

During the course of treatment with Kordaflex, the use of alcoholic beverages is not recommended due to the risk of excessive lowering of blood pressure.

Use in pediatrics

Due to the lack of sufficient clinical data, the drug is not recommended for use in children and adolescents under the age of 18 years.

Influence on the ability to drive motor vehicles and manage mechanisms

During the initial, individually determined period of application of Kordaflex, driving vehicles and engaging in other potentially dangerous activities that require rapid psychomotor reactions are not allowed. In the course of further treatment, the degree of restrictions is determined depending on the individual patient’s reaction to the drug.

Form of production

Long-acting coated tablets.

Storage conditions

In a dark place, at a temperature of 15-25 °C

Shelf life

4 years

Active ingredient

Nifedipine

Conditions of release from pharmacies

By prescription

Dosage form

long-acting tablets