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

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

Pharmacological effect

CORDAFLEX is a selective class II calcium channel blocker, a dihydropyridine derivative. Causes antianginal and hypotensive effects. Expands coronary and peripheral arteries, reduces myocardial oxygen demand by reducing afterload on the heart.

Has a slight negative inotropic effect. It has virtually no antiarrhythmic activity. Does not have a depressing effect on the conduction system of the heart.

As a result of a decrease in peripheral vascular resistance and a decrease in blood pressure, it can cause minor reflex tachycardia.

Special instructions

The antihypertensive effect of Cordaflex is enhanced by hypovolemia. A decrease in 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, at the beginning of a course of treatment with Cordaflex or when its dose is increased, chest pain (angina due to paradoxical ischemia) may occur soon after taking the drug. If a causal relationship is found between taking the drug and angina pectoris, treatment should be discontinued.

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

If during therapy the patient requires surgery under general anesthesia, it is necessary to inform the anesthesiologist about the Cordaflex therapy being performed.

Elderly patients are more likely to have decreased cerebral blood flow due to acute peripheral vasodilation.
During a course of treatment with Cordaflex, the consumption of alcoholic beverages is not recommended due to the risk of an excessive decrease in 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 18 years of age.

Impact on the ability to drive vehicles and operate machinery

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

Active ingredient

Nifedipine

Composition

1 tab.:

– nifedipine 20 mg

Excipients:

microcrystalline cellulose,

lactose monohydrate,

sodium croscarmellose,

hydroxypropylcellulose,

polyvinylbutyral B 30 T,

talc, magnesium stearate.

Shell composition:

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

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

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

The use of Cordaflex 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 Cordaflex during lactation or stop breastfeeding during treatment with the drug.

Interaction

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

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

The combination of Cordaflex with clonidine (clonidine), alpha-methyldopa (dopegite), diuretics, captopril, octadine, prazosin, reserpine is considered rational, from the point of view of enhancing the hypotensive effect; Do not use Cordaflex with apressin.
With the simultaneous use of Cordaflex and calcium preparations, the effect of nifedipine is reduced due to an antagonistic interaction caused by an increase in the concentration of calcium ions in the extracellular space.

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

Under the influence of Cordaflex, the concentration of quinidine in the blood serum is significantly reduced, which is apparently 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, as well as changes in hemodynamics. When Cordaflex is discontinued after its simultaneous use with quinidine, a transient increase in the concentration (approximately 2 times) of the latter in the serum is observed, which reaches a maximum level on the 3-4th day after discontinuation, as well as a prolongation of the QT interval on the ECG. Thus, when using a combination of quinidine with Cordaflex, caution should be exercised, especially in patients with depressed left ventricular function.

When administered simultaneously with rifampicin, a weakening of the effect of Cordaflex will be observed.

Overdose

Symptoms: severe arterial hypotension, headache, collapse, tachycardia, depression of the sinus node, 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.

10% solutions of calcium gluconate or calcium chloride are administered intravenously and then, if indicated, as a long-term infusion. With a sharp decrease in blood pressure, intravenous infusion of norepinephrine is indicated, and with the development of heart failure – glycosides.

Storage conditions

The drug should be stored in a place protected from light at room temperature.

Shelf life

4 years.

Manufacturer

EGIS, Hungary