Cordypine XL, 40 mg 20 pcs

Slow calcium channel blocker. Inhibits the flow of calcium ions through the membrane of cardiac muscle and vascular smooth muscle cells. Blockade of influx and accumulation of calcium ions inside the cells leads to dilation of peripheral and coronary vessels, reduces PPS, decreases post-load on the heart, decreases coronary blood flow and reduces myocardial oxygen demand.

Predominantly at the beginning of therapy it is possible to decrease HR and cardiac output as a result of baroreceptor reflex activation.

In prolonged therapy with nifedipine, HR and cardiac output return to the values that existed before the start of therapy.

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

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

Indications

Active ingredient

Composition

1 tablet:

– nifedipine 40 mg

Supplementary substances:

Microcrystalline cellulose,

Cellulose,

Lactose,

Hypromellose (methylhydroxypropylcellulose),

Magnesium stearate,

Silica colloidal anhydrous.

Composition of the shell:

Hypromellose (methylhydroxypropylcellulose), macrogol 6000, macrogol 400, iron oxide red dye (E172), titanium dioxide (E171), talc.

How to take, the dosage

For oral administration, the initial dose of Cordypine XL is 10 mg 3-4 times daily.

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

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

The maximum daily dose is 120 mg. To treat a hypertensive crisis as well as an attack of angina, Cordypine XL can be administered under the tongue in 10-20 mg (rarely 30 mg), then the drug will work in 15-20 minutes.

In long-term therapy, retard tablets (long-acting) of 20 mg (rarely 40 mg) twice daily are recommended.

Interaction

The severity of BP decrease is increased with concomitant use of Cordypine XL with other hypotensive agents, beta-adrenoblockers, nitrates, cimetidine (to a lesser extent with ranitidine), inhaled anesthetics, diuretics, tricyclic antidepressants.

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

Nifedipine causes a decrease in plasma quinidine concentrations; after nifedipine withdrawal there may be a sharp increase in quinidine concentrations.

Nifedipine increases plasma concentrations of digoxin and theophylline (monitoring of clinical effect and plasma concentrations of digoxin and theophylline is required in combination).

Hepatic microsomal enzyme inducers (including rifampicin) decrease plasma concentrations of nifedipine

Concomitant use with nitrates increases tachycardia.

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

Nifedipine is able to displace from plasma protein binding of drugs characterized by a high degree of binding (including indirect anticoagulants coumarin and indandion derivatives, anticonvulsants, NSAIDs, quinine, salicylates, sulfinpyrazone), resulting in possible increase of their plasma concentrations.

Nifedipine slows the elimination of vincristine from the body and may cause increased side effects of vincristine (with this combination, if necessary, the dose of vincristine should be reduced).

The lithium drugs may increase the side effects of nifedipine (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

The bioavailability of cephalosporins (e.g., cefixime) and nifedipine was increased by 70% when concomitantly administered.

Nifedipine inhibits metabolism of prazosin and other alpha-adrenoblockers; as a consequence, hypotensive effect may be increased.

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

Grapefruit juice inhibits the metabolism of nifedipine, so its use is contraindicated during treatment with Cordypine HL.

Special Instructions

The drug Cordypine XL may be chewed to speed up the effect. If during treatment pain in the chest occurs, the drug should be discontinued.

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

The combination of Cordypine XL with nitrates is not recommended. Combination with beta-blockers, on the other hand, is used frequently and with success, but requires adequate selection of the dosage of the drugs.

Contraindications

Side effects

Overdose

Symptoms: the drug causes peripheral vasodilation with severe and possibly prolonged arterial hypotension: headache, facial hyperemia, prolonged marked BP decrease, sinus node suppression, bradycardia and/or tachycardia, bradyarrhythmia. In severe poisoning – loss of consciousness, coma.

The treatment: standard measures aimed at elimination of the drug from the body (prescription of activated charcoal, gastric lavage), stabilization of hemodynamic parameters; careful control of the heart, lungs and excretory system.

The antidote is calcium preparations. IV administration of 10% calcium chloride solution or calcium gluconate is indicated, with subsequent switch to long-term infusion.

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

The monitoring of blood glucose (insulin release may decrease) and electrolytes (potassium, calcium) is recommended.

The clearance of nifedipine is increased in patients with impaired liver function.

Similarities