Cordypine XL, Ultraretard 40mg pills, 20pcs

Composition

of 1 tab. :

– nifedipine 40 mg

Auxiliary substances:

microcrystalline cellulose,

cellulose,

lactose,

hypromellose (methylhydroxypropylcellulose),

magnesium stearate,

colloidal anhydrous silicon dioxide.

Shell composition:

hypromellose (methylhydroxypropylcellulose), macrogol 6000, macrogol 400, iron oxide red dye (E 172), titanium dioxide (E 171), talc.

Pharmacological action

Slow calcium channel blocker. Inhibits the flow of calcium ions through the membrane of heart muscle and vascular smooth muscle cells. Blocking the intake and accumulation of calcium ions inside cells leads to dilation of peripheral and coronary vessels, reduces OPSS, reduces afterload on the heart, reduces coronary blood flow and reduces the need for oxygen in the myocardium.

Mainly at the beginning of therapy, a decrease in heart rate and cardiac output is possible as a result of activation of the baroreceptor reflex.

With long-term nifedipine therapy, heart rate and cardiac output return to the values that were present before the start of therapy.

In patients with arterial hypertension, a more pronounced decrease in blood pressure is observed.

The effect of the drug lasts 24 hours, so a single appointment per day is sufficient.

Indications

• : angina pectoris,
• arterial hypertension.

Contraindications

• reduced blood pressure below 90 mm Hg
• severe heart failure
• hypersensitivity to Cordipine XL.

Side effects

• redness of the skin of the face and neck
• headache, nausea, weakness
• swelling, palpitations
• constipation, abdominal pain
• low blood pressure
• increased angina attacks, deterioration of the liver.

Interaction

The severity of blood pressure reduction increases with the simultaneous use of Cordipine CL with other antihypertensive agents, beta-blockers, nitrates, cimetidine (to a lesser extent – with ranitidine), inhaled anesthetics, diuretics, tricyclic antidepressants.

Drugs from the group of slow calcium channel blockers can further enhance the negative inotropic effect of antiarrhythmic drugs such as amiodarone and quinidine.

Nifedipine causes a decrease in the concentration of quinidine in the blood plasma, after the withdrawal of nifedipine, a sharp increase in the concentration of quinidine can occur.

Nifedipine increases plasma concentrations of digoxin and theophylline (when combined, monitoring of the clinical effect and plasma concentrations of digoxin and theophylline is required).

Inducers of microsomal liver enzymes (including rifampicin) reduce the concentration of nifedipine in blood plasma

When used concomitantly with nitrates, tachycardia increases.

The hypotensive effect is reduced by sympathomimetics, NSAIDs, estrogens, and calcium supplements.

Nifedipine is able to displace drugs that are characterized by a high degree of binding from plasma protein binding (including indirect anticoagulants coumarin and indandione derivatives, anticonvulsants, NSAIDs, quinine, salicylates, sulfinpyrazone), as a result of which their plasma concentrations may increase.

Nifedipine slows down the elimination of vincristine from the body and may cause an increase in the side effect of vincristine (with this combination, if necessary, the dose of vincristine should be reduced).

Lithium medications may increase the side effects of nifedipine (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

Concomitant use of cephalosporins (e. g., cefixime) and nifedipine increased the bioavailability of cephalosporin by 70%.

Nifedipine inhibits the metabolism of prazosin and other alpha-blockers, which may increase the hypotensive effect.

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

Grapefruit juice suppresses the metabolism of nifedipine, so during treatment with Cordipine CL, its use is contraindicated.

How to take, course of use and dosage

For oral use, the initial dose of the drug Kordipin XL-10 mg 3-4 times a day.

If necessary, the dose is gradually increased to 20 mg 3-4 times a day.

In special cases (severe arterial hypertension), the dose can be increased to 30 mg 3-4 times a day for a short time.

The maximum daily dose is 120 mg. For the treatment of hypertensive crisis, as well as an attack of angina pectoris, the drug Kordipin XL can be prescribed under the tongue for 10-20 mg (rarely 30 mg), then the drug will work in 15-20 minutes.

With long-term therapy, it is recommended to use retard tablets (long-acting) of 20 mg (less often 40 mg) 2 times a day.

Overdose

Symptoms: the drug causes peripheral vasodilation with severe and possibly prolonged hypotension: headache, hyperemia of the facial skin, prolonged marked decrease in blood pressure, sinus node depression, bradycardia and / or tachycardia, bradiarrhythmia. With severe poisoning – loss of consciousness, coma.

Treatment:  standard measures aimed at removing the drug from the body (use of activated charcoal, gastric lavage), stabilization of hemodynamic parameters; careful monitoring of the activity of the heart, lungs and excretory system.

The antidote is calcium supplements. Intravenous use of a 10% solution of calcium chloride or calcium gluconate is indicated, followed by switching to a long-term infusion.

Due to the high degree of binding to plasma proteins, hemodialysis is not effective.

It is recommended to monitor the level of glucose in the blood (the release of insulin may decrease) and electrolytes (potassium, calcium).

Nifedipine clearance increases in patients with hepatic insufficiency.

Special instructions

To accelerate the effect of the drug Cordipine XL can be chewed. If pain behind the sternum occurs during treatment, the drug should be discontinued.

Driving is not recommended at the beginning of treatment. Drinking alcohol leads to an excessive decrease in blood pressure.

It is not recommended to combine the drug Cordipine XL with nitrates. The combination with beta-blockers is often used with success, but requires an adequate selection of drug doses.

Form of production

Modified-release tablets.

Storage conditions

In a dark place, at a temperature not exceeding 25 °C.

Shelf

life is 3 years.

Active ingredient

Nifedipine

Conditions of release from pharmacies

By prescription

Dosage form

long-acting tablets