Cordaflex, 20 mg 60 pcs

CORDAFLEX is a class II selective calcium channel blocker, a dihydropyridine derivative. It produces antianginal and hypotensive effects. It dilates coronary and peripheral arteries, reduces myocardial oxygen demand by reducing the post-load on the heart.

It has a slight negative inotropic effect. It practically has no antiarrhythmic activity. Does not have depressing effect on cardiac conduction system.

It can cause slight reflex tachycardia as a result of decreased peripheral vascular resistance and decreased BP.

Indications

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

Active ingredient

Composition

1 tablet:

– nifedipine 20 mg

Supplementary substances:

Microcrystalline cellulose,

Lactose monohydrate,

Sodium croscarmellose,

Hydroxypropylcellulose,

Polyvinylbutyral B 30 T,

Talc, magnesium stearate.

Coating composition:

Hypromellose, titanium dioxide, iron oxide red, magnesium stearate.

How to take, the dosage

Adults are prescribed 1 tablet of Cordaflex 10 mg. 3-4 times per day. If necessary, the dose is gradually increased to 20 mg 2 times per day. The maximum daily dose is 40 mg.

In case of course therapy, a prolonged form of the drug, Cordaflex Retard 20 mg, is recommended. The drug is prescribed in doses of 20-40 mg 2 times a day.

The starting dose of the drug is reduced by half in elderly people.

The drug is taken regardless of meals.

Interaction

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

The concomitant use of Cordaflex and beta-adrenal blockers is effective and safe in most clinical situations, since it leads to summation of antianginal and antihypertensive effects of the drugs, but in some cases pronounced arterial hypotension and heart failure may occur.

The combination of Kordafleks with clonidine (clofelin), alpha-methyldopa (dopegit), diuretics, captopril, octadine, prazosin, reserpine is considered rational in terms of strengthening the hypotensive effect; Kordafleks with apressin is not used.
Co-administration of Cordaflex and calcium preparations decreases effect of nifedipine due to antagonistic interaction caused by increased concentration of calcium ions in extracellular space.

The hypotensive effect of Cordaflex when used concomitantly with cimetidine is significantly increased due to the increased concentration of nifedipine in plasma, which requires adjusting the doses of the drugs.

The serum concentration of quinidine decreases significantly under the influence of Cordaflex apparently due to decreased bioavailability of quinidine, induction of enzymes inactivating it, increased hepatic and renal blood flow, increased drug distribution volume as well as changes in hemodynamics. At cancellation of Cordaflex after its concomitant use with quinidine, a transient increase in serum concentrations (approximately 2-fold) of the latter is observed, which reaches maximum levels on day 3-4 after cancellation, as well as QT interval prolongation on ECG. Thus, caution should be exercised when using a combination of quinidine and Cordaflex, especially in patients with depressed left ventricular function.

When concomitant administration with rifampicin, impairment of action of Cordaflex will be observed.

Special Instructions

The antihypertensive effect of Cordaflex is enhanced in hypovolemia. Decrease of pulmonary artery pressure and hypovolemia after dialysis may also enhance the effects of the drug, therefore reduction of the drug dose is recommended.
In rare cases, chest pain (angina pectoris due to paradoxical ischemia) may occur soon after taking the drug at the beginning of Cordaflex treatment or when its dose is increased. If a causal association between taking the drug and angina pectoris is found, treatment should be discontinued.

In arterial hypertension or coronary artery disease, abrupt withdrawal of nifedipine may cause a hypertensive crisis or myocardial ischemia (ricochet phenomenon).

If the patient requires surgery under general anesthesia during therapy, the anesthesiologist should be informed about the therapy with Cordaflex.

In elderly patients, decreased cerebral blood flow due to acute peripheral vasodilation is more likely.
Drinking alcoholic beverages is not recommended during the course of treatment with Cordaflex because of the risk of excessive BP decrease.

Pediatric use

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

Impact on driving and operating machinery

In the initial, individually determined period of use of Cordaflex, driving and engaging in other potentially hazardous activities requiring quick psychomotor reactions are not allowed. During further treatment, the degree of restriction is determined depending on the patient’s individual response to the drug.

Contraindications

Cardiogenic shock; severe arterial hypotension (systolic BP below 90 mmHg).);

pronounced aortic stenosis, idiopathic hypertrophic subaortic stenosis;

First trimester of pregnancy;

pronounced heart failure;

hypersensitivity to nifedipine.

Side effects

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

The use of Cordaflex® in pregnant women is indicated only when BP normalization is not possible with other hypotensive drugs.

Because nifedipine is excreted with breast milk, use of Cordaflex during lactation should be avoided or breastfeeding should be stopped during drug therapy.

Overdose

Symptoms: marked arterial hypotension, headache, collapse, tachycardia, sinus node suppression, bradycardia, arrhythmia.

Treatment: given the lack of a specific antidote, in cases of early detoxification, gastric lavage is performed with the administration of activated charcoal.

Once and then, if indicated, as a prolonged infusion, 10% solutions of calcium gluconate or calcium chloride are administered intravenously. In case of a sharp decrease in BP an intravenous infusion of norepinephrine is indicated, in the development of heart failure – glycosides.

Similarities