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

angina pectoris
arterial hypertension.

Pharmacological effect

Slow calcium channel blocker. Inhibits the flow of calcium ions through the membrane of cardiac muscle cells and vascular smooth muscles. Blockade of the entry and accumulation of calcium ions inside cells leads to dilation of peripheral and coronary vessels, reduces peripheral vascular resistance, reduces afterload on the heart, reduces coronary blood flow and reduces myocardial oxygen demand.

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 therapy with nifedipine, heart rate and cardiac output return to the values ​​​​that existed 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 dose per day is sufficient.

Special instructions

To speed up the effect, Cordipin XL can be chewed. If chest pain 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 Cordipin XL with nitrates. The combination with beta blockers is often used with success, but requires adequate selection of drug doses.

Active ingredient

Nifedipine

Composition

1 tab.:

– nifedipine 40 mg

Excipients:

microcrystalline cellulose,

cellulose,

lactose,

hypromellose (methylhydroxypropylcellulose),

magnesium stearate,

anhydrous colloidal silicon dioxide.

Shell composition:

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

Contraindications

decrease in blood pressure below 90 mm Hg.
severe heart failure
hypersensitivity to the drug Cordipin XL.

Side Effects

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

Interaction

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

Medicines 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 discontinuation of nifedipine, a sharp increase in the concentration of quinidine may occur.

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

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

When used simultaneously with nitrates, tachycardia increases.

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

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

Nifedipine slows down 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).

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

With the simultaneous administration of cephalosporins (for example, cefixime) and nifedipine, the bioavailability of the cephalosporin increased by 70%.

Nifedipine inhibits the metabolism of prazosin and other alpha-blockers, as a result of which the hypotensive effect may be enhanced.

Procainamide, quinidine, and other drugs known to prolong the QT interval enhance the negative inotropic effect and may increase the risk of significant QT prolongation.

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

Overdose

Symptoms: the drug causes peripheral vasodilation with severe and possibly prolonged arterial hypotension: headache, flushing of the facial skin, prolonged pronounced decrease in blood pressure, depression of the sinus node, bradycardia and/or tachycardia, bradyarrhythmia. In case of severe poisoning – loss of consciousness, coma.

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

The antidote is calcium preparations. IV administration 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 blood glucose (insulin release may decrease) and electrolytes (potassium, calcium).

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

Storage conditions

In a place protected from light, at a temperature not exceeding 25 °C.

Shelf life

3 years.

Manufacturer

Siegfried Malta Ltd, Switzerland