Indications and instructions for the use of the drug nifedipine - composition, active substance and contraindications. Nifedipine instructions for use, contraindications, side effects, reviews

In this article, we will consider the instructions for the use of Nifedipine: at what pressure this drug is prescribed, how effective it is and what contraindications it has. This remedy is one of the most prominent representatives of antihypertensive drugs. It blocks the calcium tubules, due to which the musculature of the vessels relaxes, contributing to a decrease in pressure to normal indicators in short time. This drug has a number of various benefits and can be used for the treatment of chronic processes and relief emergency conditions.

Nifedipine is in great demand among hypertensive patients, and therefore there is often a shortage of it in pharmacies. In such cases, the drug can be replaced with similar medicines. Today, analogues of "Nifedipine" have an identical pharmacological effects and are used in the treatment of similar diseases. Next, we will consider what substitutes this drug has, and find out what advantages and disadvantages they have. But first, let's study the instructions for using the medication.

The composition of the drug and its form of release

"Nifedipine" is a drug from the category of drugs for vascular and cardiotherapy. Release it in tablets. There are 2 types of them: short and prolonged effects on the body. The former are used to normalize pressure or in the presence of pain in chest. Extended-release tablets are prescribed to patients who have hypertension that is in the compensation stage.

The main active ingredient of the drug is a derivative of dihydropyridine. This component is capable of as soon as possible relax the muscles vascular system, dilate arteries and increase blood flow, which helps to reduce heart rate and reduce pressure. So, judging by the instructions for the use of Nifedipine, at what pressure is prescribed this remedy, no need to think. This is a drug for hypertensive patients.

The therapeutic effect occurs, as a rule, already 20 minutes after ingestion. Over 90% active component absorbed through the intestines, which makes it possible to reduce the load on the stomach and gallbladder facilitating the work of the kidneys and liver.

How the drug works

The mechanism of action of "Nifedipine" is that the drug blocks the activity of slow calcium channels of cell membranes. Calcium ions enter in smaller quantities into the arteries of the heart, muscles, as well as peripheral vessels. As a result:

• blood circulation in the heart is activated;
• the lumen of the coronary and arterial vessels increases;
• increased blood flow in the kidneys;
• pressure decreases;
• decreased vascular resistance to blood flow in the periphery.

Like other drugs in the form of tablets, Nifedipine also contains excipients, which are magnesium, sodium, potato and wheat starch, as well as microcrystalline cellulose, along with titanium dioxide, hypromelose and macrogol. The shell of the tablets is made of gelatin and talc.

Most of the above substances increase the impact of the main component on the body, which provides a high healing effect. If a long course is necessary, a prolonged form is prescribed, and to combat acute attacks angina pectoris and hypertension prescribe short-acting tablets that do not have a shell.

When to use the remedy

What are the indications for Nifedipine? It is prescribed in the following cases:

• If the patient has angina pectoris.
• With arterial hypertension as part of monotherapy or in combination with other antihypertensive drugs.

Please note that for the use of Nifedipine, the indications must be strictly observed.

How should the medication be taken

It is unacceptable to prescribe a remedy on your own. Its reception should be carried out under control medical specialist who is obliged to familiarize himself in detail with the condition of his patient and analyzes of his biological material, and in addition, with the results of the electrocardiogram. Great importance when choosing dosing and duration treatment course plays the age of the patient.

Maximum daily dose the main active ingredient should not exceed 40 mg. It is better to take it with meals, and you should choose liquid, but at the same time light meals. You can't take this medicine natural juices or carbonated water, as they contain aggressive ingredients that can dissolve the tablet shell before it enters the intestines.

The course of therapy with Nifedipine is usually at least 60 days. The initial dose for any indication for the use of this drug is 10 milligrams twice a day. According to the results of the therapeutic effect, the doctor adjusts the single and daily intake, increasing or decreasing the dosage until the desired effect is achieved. In severe cases, it can reach 80 mg.

There are contraindications for taking Nifedipine. The tool is prohibited:

• with acute myocardial infarction;
• severe forms heart failure;
• arterial hypotension;
• availability unstable angina;
• cardiogenic shock;
• tachycardia;
• constriction mitral valve;
• bradycardia.

Manifestation of side effects of the drug

With an increase in the dosage of "Nifedipine" side effects are not excluded. They may appear as follows:

1. From the side of the cardiovascular system - tachycardia, decreased pressure, chest pain, fainting, angina pectoris.
2. From the side nervous system- dizziness, difficulty swallowing, fatigue, drowsiness, headaches, depression.

Duration of reception, as a rule, is determined individually. Abrupt withdrawal of the drug is not practiced, as this can cause unwanted side effects. adverse reactions in the form of increased heart rate, pressure surges and malfunctions of the intestines. There are also likely to be malfunctions in the work of the hematopoietic organs.

Nifedipine analogues and their trade names

As already noted, there are only 2 types of Nifedipine tablets: short and prolonged exposure. Analogues of the drug, which are short-acting, include Fenigidin, Nicardia, Procardia, Kordaflex and Farmadipin.

Substitutes for prolonged action are such drugs as "Corinfar Uno" along with "Kordipin-retard", "Calcigard retard" and "Nifekard".

Immediately before choosing one or another Nifedipine analogue, it is necessary to justify the purposes for which the drug will be used and determine what effect should be obtained after using the drug. For example, in the treatment of hypertension, it is best to use analogs with prolonged exposure. And to eliminate the hypertensive crisis, it is recommended to choose an analogue short action.

Among other things, before buying a drug, you should carefully study the attached instructions. But a doctor should prescribe it, since in case of non-compliance with the recommendations, deterioration in well-being and progression is possible. pathological processes.

Advantages and disadvantages

Consider the main advantages of Nifedipine analogues, as well as their disadvantages. If there is a need to replace "Nefedipin", it is necessary to take into account the pros and cons of the proposed funds:

• Some analogues of Nefedipine can have a local effect on the body, that is, they affect only the heart.
• Reduce the risk of negative effects on fetal development (if used during pregnancy).
• When breastfeeding, there is no need to interrupt the lactation period.

The disadvantages of substitutes include the following disadvantages:

• A parallel intake of several drugs at once is required instead of one to replace the effect of Nefedipine.
• Holding replacement therapy can cost the patient more than the cost of one "Nifedipin".

Which analogue should be preferred

Absolutely all substitutes for "Nefedipin" are high-quality products and have the same properties as it. In this regard, the patient can opt for less expensive medicine, however, it will be necessary to take into account the mechanism of action and the dosage of the agent.

AT medical practice There are many examples when the same active ingredient in medicines from different pharmacological manufacturers had different effects. But with Nifedipine, the situation is different. Almost twenty years have passed since the release of this drug, and all its analogues do not differ from the original. In this regard, when purchasing a medication, you can save money by choosing a less expensive substitute. According to the medicinal properties, the analogue of "Nifedipine" of prolonged action will be similar to the original.

I must say that it is extremely unlikely to purchase a fake drug in a pharmacy, which will contain chalk instead of the active ingredient, because Nifedipine is an inexpensive remedy, and the named replacement will definitely not bring significant benefits. In addition, an experienced hypertensive patient can easily identify a fake, since he knows what therapeutic effect the drug should have and will not buy it next time.

Review of the most popular substitutes for "Nefedipin": "Corinfar"

Before replacement this drug for a drug similar in effect, it is imperative to consult a doctor to select the optimal dosage and identify contraindications to the use of the medication. Next, consider the analogues of "Nifedipine" in action: "Corinfar", "Cordaflex" and "Corinfar Uno".

The first substitute for "Nifedipine" is produced in the form of tablets. It has a prolonged action, and it is prescribed for the treatment of diseases of the heart and blood vessels:

• if the patient has arterial hypertension;
• against the background of ischemia of the myocardium;
• in the presence of angina pectoris.

Treatment with Corinfar is easily tolerated by patients, without side effects. In this case, the analogue of "Nifedipine" should be taken only on the recommendation of a specialist and under his supervision.

It is important to know that after a sharp cessation of taking Corinfar, hypertensive patients may develop a withdrawal syndrome, which will be expressed in an increase in blood pressure, and in addition, in insufficient blood supply to the myocardium.

The drug "Cordaflex"

This is another analogue of Nifedipine, which belongs to the category of antihypertensive drugs. This substitute is quite common among people who have been suffering from hypertension for many years. medicinal product eliminates spasms coronary arteries, relaxing the vascular walls and reducing myocardial oxygen demand. I must say that Kordaflex does not cause arrhythmias. This drug is prescribed in the following cases:

• If the patient has arterial hypertension on the different stages.
• Against the background of ischemic heart disease.
• With a hypertensive crisis.
• In the presence of stable angina pectoris.

"Corinfar Uno"

This is the most popular analogue of Nifedipine tablets, since a single dose of this drug can provide a constant concentration of the active ingredient in the bloodstream for a whole day. Thanks to this tool, the productivity of treatment increases, the frequency of various complications decreases, and internal organs are not subjected to additional loads. Due to this, these tablets are in great demand among a certain category of patients.

The use of long-acting substitutes requires strict rules to be followed. The listed analogues of "Nifedipine" are forbidden to grind or dissolve under the tongue. Tablets must be taken in an unchanged state, washed down with enough liquids. You can not share a single dosage of the drug if the instructions for this possibility are not indicated.

Analogues in the treatment of hemorrhoids

The drug "Nifedipine" is endowed with many medicinal properties. So, it is also used to eliminate the symptoms of hemorrhoids. The named medication in this case can be replaced by the drug "Relief". This analogue promotes the healing of cracks, eliminating tissue swelling and restoring damaged vessels. As part of the treatment of hemorrhoids, you can use any suitable analogue of the gel "Nifedipine".

It is possible to make healing drug and independently at home. To do this, you need to prepare the necessary components, namely, Levomekol ointment, Nifedipine, Lidocaine and Cardiket tablets are taken. The method of preparation of the analog of "Nifedipine" is as follows:

• One tablet of Kardiket and eight pills of Nifedipine are crushed to a powdery state.
• 30 g of Levomekol and 5 g of Lidocaine are added to the powder.
• Then everything is thoroughly mixed and the resulting mixture is used as an ointment. It is applied thin layer to problem areas.

This ointment is applied once a day, but in some situations it can be applied twice a day. In fact, "Nifedipine" is produced in the form of a large number structural analogues, and each of these substitutes has its own name. But absolutely all of them contain the same active ingredient and have a similar therapeutic effect.

Comparative characteristics of Kapoten and Nifedipine

Some patients are trying to determine, for example, which is better - Kapoten or Nifedipine. There is no unambiguous opinion about which of these drugs is better for combating hypertension. Only the attending physician can decide what exactly should be taken by a particular patient to reduce pressure. Therefore, everything is purely individual. Sometimes it is enough to regularly take only Kapoten tablets in order to improve the condition and forget about the increase in pressure. But for someone "Capoten" for contraindications or for some other reason, famous doctor, may not be suitable, and Nifedipine, in turn, will effectively replace it.

By the way, Kapoten should never be used by people suffering from increased heart rate which exceeds 85 beats per minute. But at the same time, it must be emphasized that Kapoten is classified as the most harmless medicine. This analogue has a milder effect on the patient's body than Nifedipine, and practically does not have any side effects.

But Nifedipine has one definite advantage, which is that this drug is much cheaper than Kapoten. While about 300 rubles will have to be paid for Kapoten, Nifedipine costs patients three times cheaper.

Andipan or Nifedipine

"Andipan" is combination drug, giving vasodilating, analgesic, antispasmodic and sedation. It is prescribed for pain associated with spasm peripheral arteries, cerebral vessels, smooth muscle stomach and intestines. And also in the presence of arterial hypertension. They have similar contraindications and side effects.

Drug treatment of arterial hypertension involves the use of different groups antihypertensive drugs. For soft and effective reduction AD often resort to the use of calcium channel blockers. The most commonly prescribed drug in this group is Nifedipine.

Nifedipine is a drug that has a vasodilating and hypotensive effect. It belongs to the group of calcium channel blockers. Stops vasospasm, simultaneously performing a cardioprotective function. The drug is different quick action. Literally 20 minutes after taking it, a mild decrease in blood pressure begins.

In what form is it produced, and how much does it cost?

The drug is available in the form of tablets for oral administration and ointment for external application. The price of the drug depends on the place of residence of the patient and the pharmacy where it will be purchased. The approximate cost of a pharmaceutical product is shown in the table.

These are only approximate prices at which Nifedipine can be purchased.

Compound

One tablet contains 10 or 20 mg of the active substance nifedipine. As additional components, the preparation contains milk sugar, microcrystalline cellulose, povidone 25, potato starch.

The composition of nifedipine ointment includes 3 active substances: nifedipine, lidocaine and isosorbide dinitrate. Auxiliary components are trace elements of the Dead Sea. The drug is water-based and has a liquid consistency.

Therapeutic effect

Nifedipine tablets contribute to the expansion of blood (coronary, peripheral) vessels, due to which a pronounced and persistent hypotensive effect is achieved. The drug helps to reduce the tone of the smooth muscles of the vessels, and also relieves their spasm.

The drug has a slight effect on myocardial contractility, helping to reduce afterload. This subsequently leads to a decrease in its oxygen demand.

Note. Long-term use medicines to prevent the formation of new cholesterol plaques on the walls blood vessels. And it plays a huge role in the prevention of atherosclerotic disease.

Nifedipine ointment is widely used in proctology. It has antipruritic, regenerating, anti-inflammatory and anesthetic effects. With its help, you can eliminate burning, swelling and discomfort in the perianal area. In addition, its effect is aimed at reducing hemorrhoids.

Indications and contraindications

At what pressure can this pharmaceutical agent be used? Tableted Nifedipine is intended to reduce elevated blood pressure in any degree of hypertension, as well as to relieve hypertensive crises.

Tablets

The tablet form of the drug is prescribed to patients only if there are strict indications, which include:

In addition, the drug is advisable to use in coronary artery disease and atherosclerotic processes in peripheral arteries.

The tablet form should not be used in patients with the following diseases:

• tachycardia;
• cardiogenic shock;
• collapse;
• heart failure in the decompensation phase.

The drug should not be used to treat persons under 18 years of age, hypotensive patients, as well as patients with idiopathic hypertrophic subaortic stenosis.

With extreme caution, Nifedipine is prescribed to diabetics, pregnant women, patients with CHF, malignant course arterial hypertension and severe renal impairment. Under the close supervision of a physician, treatment with this medication is carried out in patients undergoing hemodialysis sessions.

Ointment

Nifedipine gel emulsion is used to get rid of hemorrhoids, accompanied by bleeding, anal fissures, prolapse of pathological nodes or their compression. In addition, the medicine has proven itself in the fight against perianal dermatitis.

Manufacturers do not give information about contraindications to the use of ointment. The drug is allowed to be used during pregnancy.

Rules for treatment with Nifedipine

To avoid adverse reactions, Nifedipine must be used correctly, in accordance with the instructions and advice of specialists.

Tablets

The dosage of Nifedipine tablets is determined separately for each patient. At the same time, the diagnosis of the patient, the severity of his condition, and the therapeutic response to the treatment are taken into account.

The initial dosage is 1 tablet (10 mg) 2-3 times / day. In the absence of the expected results from therapy, the dose may be doubled. Maximum allowable daily dosage is 40 mg.

Note. Tablets should preferably be taken at regular intervals.

Ointment

Nifedipine ointment is applied to the cleansed skin of the perianal zone with a thin layer. In order for the product to be absorbed faster, it can be rubbed, but gently, making massaging movements. After the manipulation, it is necessary to lie down for at least a quarter of an hour so that the gel has time to act.

If the medicine did not lead to the development of side effects, then after a day it can be used rectally. For this not a large number of ointment should be injected with a finger or a sterile applicator into the anus. This should be done once to start.

If this time no side effects occur, you can inject the medicine into the rectum 3-4 times a day. The duration of therapy is individual for each patient. But do not stop treatment immediately after the disappearance of the unpleasant symptoms of hemorrhoids. To consolidate the results, it is recommended to extend it for another 2-3 days.

Can Nifedipine be used by pregnant and lactating women?

Despite the fact that during pregnancy, a tablet medication is contraindicated, doctors still sometimes resort to prescribing it. Increased tone uterus is a normal phenomenon only at the 9th month of pregnancy. If it arose earlier, especially in the first or second trimesters, this means that you need to act immediately. Eliminate uterine hypertension helps Nifedipine.

It is advisable to prescribe the drug to women in the 1-2 trimesters of pregnancy, but if there is a risk of premature onset labor activity, then on the third. The dosage does not depend on the term, since in any case the benefit of the drug for the expectant mother should exceed the potential risks to the fetus.

But first, Nifedipine is prescribed in the minimum dose - 10 mg (1 tablet) 4 times a day. The dosage can be doubled in the absence of the expected therapeutic effect. When urgent need the amount of the drug taken per day can be increased to 60 mg (6 tablets).

Drink the remedy 20-30 minutes before meals, drinking plenty of water without gas. The duration of treatment is set for each patient individually. It is not always possible to achieve an adequate therapeutic response of the body of a pregnant woman to the treatment, so its course can be prolonged by the attending physician.

Note. Often, expectant mothers taking Nifedipine are hospitalized in a hospital. Thus, they will be monitored around the clock by medical personnel which will significantly reduce the risk of complications from the therapy.

Nifedipine for HB

Nifedipine tablets are contraindicated in nursing mothers, since their components are able to penetrate into breast milk. If you cannot do without the use of the drug, lactation must be stopped for the duration of treatment.

Nifedipine ointment is allowed to be used both during gestation and during HB.

Possible side effects

The use of the drug Nifedipine in the form of tablets can cause side effects in the form of:

Prolonged use of the drug may cause Negative influence and the functioning of the cardiovascular system. So, the drug can cause hypotension, asystole, bradycardia or tachycardia, angina pectoris. Sometimes side effects from the gastrointestinal tract can disturb: nausea, diarrhea, heartburn attacks.

To replace the drug, you must consult a therapist, family doctor or a cardiologist.

Medicine Nifedipine effectively eliminates pain in the background of unstable angina pectoris, lowers blood pressure to normal levels, reduces ischemia in the coronary vessels.
It is taken as tablets orally. Absorbed quickly into bloodstream and has a selective effect on calcium channels, which conditionally belong to the second selective class. Due to the effect of inhibition of calcium metabolism, the process of entry of these ions into the cellular structures of the myocardium slows down. Also, the vascular bed of large arteries gets rid of excess calcium. The tension tone decreases, the vascular wall relaxes and the lumen of the artery and vein increases. According to the instructions, the use of nifedipine allows you to reduce the heart rate.
Against the background of the expansion of the coronary and cerebral main vessels there is an increase in the flow of blood enriched with glucose and oxygen to the tissues of the heart and brain. These processes create fertile ground for quick recovery cells affected by ischemia. Oxygen saturation increases, anginal manifestations are reduced.

Indications for use

Mode of application

Side effects

Contraindications

Nifedipine is contraindicated in pregnancy and lactation.
Caution is needed when prescribing the drug to drivers of transport and other professions that require a quick mental and physical reaction.

Interaction with other drugs

Pregnancy

Overdose

Storage conditions

Release form

Compound

Synonyms

Additionally

main parameters

The drug Nifedipine belongs to the drugs used in medical practice for hypertension, other pathologies of the heart and blood vessels. The drug belongs to calcium antagonists. Entering the body active ingredients Nifedipine has an anti-ischemic effect, lowers blood pressure, increases coronary blood flow. In addition to tablets and solutions for injection, there is Nifedipine ointment and a drug in the form of a gel, which are used to treat varicose veins veins in the rectum.

Release form and composition of the drug

The main active ingredient of the drug is nifedipine. Among the auxiliary components are milk sugar, potato starch, cellulose, magnesium stearate, talc, hypromelose, and other substances. international name- Nifedipine.

The release form of Nifedipine is as follows:

• short-acting film-coated tablets containing 10 mg of the active ingredient. Mainly used for periodic use to reduce pressure, eliminate chest pain;
• tablets Nifedipine retard - contain 20 mg of the active ingredient. This is long acting nifedipine. The drug is prescribed for daily use in patients with hypertension. This scheme allows you to maintain pressure on normal level, avoid other complications in patients;
• infusion solution in 50 ml ampoules;
• ampoules for intravascular injection of 2 ml.

A separate drug group is Nifedipine gel and a medicine in the form of a cream. These drugs are used in the complex therapy of hemorrhoids, contain 0.2% nifedipine, isosorbitol dinitrate and lidocaine.

Pharmacological effect of tablets and injections

What is the mechanism of action of the drug? Nifedipine retard and other forms of the drug block the activity of calcium channels cell membranes. Due to this, the flow of calcium ions into peripheral vessels, arteries of the heart muscle, muscle fibers the whole organism. These complex processes deep cellular level allow you to achieve the following effect:

• improve the blood supply to the heart;
• expand the lumen of arterial and coronary vessels;
• enhance renal circulation;
• activate the process of removing sodium and water from the body;
• reduce blood pressure, vascular smooth muscle tone.

Once in the body, the drug Nifedipine is rapidly absorbed by the organs. digestive system. The active components of the drug bind to blood proteins, long time are in the body. The substance is metabolized in the liver, excreted by the kidneys.

Important! You can use the drug only as directed by your doctor. Self-medication often causes negative consequences, sometimes incompatible with life.

The action of the ointment

Nifedipine gel emulsion and ointment are used in combination with other medicines to treat hemorrhoids. The drug can be used to treat all forms and stages of the disease. Manufacturers of the drug claim that the use of Nifedipine is an excellent alternative surgical intervention with pathology of the vessels of the anus.

Nifedipine gel is used for hemorrhoids

Thanks to active substances means, during the use of the drug, the smooth muscles of the vessels relax, the local blood pressure, the pain syndrome disappears. Additional components help to get rid of cracks and microdamages, have an antibacterial, anti-inflammatory effect, eliminate discomfort, itching and burning.

Indications for the use of injections and tablets

Instructions for use include such indications for the use of Nifedipine:

• hypertrophic cardiomyopathy;
• all degrees hypertension;
• cardiopulmonary failure, accompanied by congestive processes;
• Raynaud's syndrome;
• conditions that entail spasm of the coronary arteries;
• angina.

The drug Nifedipine is also used in cardiologists for the treatment of disorders cerebral circulation, with the onset of a hypertensive crisis, during the treatment of heart failure, coronary disease heart, for the treatment of bronchospasm, atherosclerosis of peripheral arteries and other conditions.

Indications for the use of gel and ointment

The form of release of the drug for topical application is used in the following conditions:

• acute and chronic hemorrhoids;
• hemorrhoidal fissures;
• the presence of external and internal cavernous formations;
• bleeding;
• prolapse of hemorrhoidal cones;
• thrombosis;
• pain syndrome;
• hyperemia, itching, burning, irritation of the rectal mucosa.

Nifedipine and the auxiliary components that make up the drug quickly relieve the main manifestations of hemorrhoids, make the patient feel better, and help prevent complications.

Contraindications

The drug Nifedipine can only be taken if the patient has no contraindications to its use. The following conditions in a patient are prohibited from therapy with Nifedipine:

• hypotension, other diseases accompanied by low blood pressure;
• offensive;
• vascular collapse;
• acute heart failure;
• recent myocardial infarction (less than 30 days ago);
• the first 4 weeks of pregnancy;
• the age of the patient is under 18 years;
• period of breastfeeding;
• allergy to any of the components of the product.

When prescribing a remedy, the doctor must take into account contraindications

If the contraindications of the drug are not taken into account, taking the medicine can provoke severe consequences for the body.

Important! The drug in the form of a cream and gel has no serious contraindications, except for personal intolerance, it is used among children and women in position.

Instructions for use

How to take Nifedipine? Use any drug form prescription medications. The dosage and dosage regimen is set by a specialist based on the patient's medical history and diagnosis.

Taking pills

At different states the dose of the drug is usually 1 tablet three times a day. It is recommended to take the medicine after meals. Wash down the tablet with water. If necessary, the dose is increased by the attending physician. This is possible with good tolerability of the drug and the absence of side effects. For elderly patients or patients suffering from kidney pathologies, the dose is reduced.

Use of injections

Indications for the use of Nifedipine injections include severe conditions in patients. Injections are used exclusively in a hospital during the period intensive care. Nifedipine is administered to patients intravenously or with a dropper.

The solution is available in finished form, dilution of the drug is not required. Before administration to a person, a sensitivity test to the drug component is carried out. If there is no reaction, the drug can be used. The dose is determined by the doctor. Usually it is from 15 to 30 mg for 24 hours.

Application of ointment

The use of the drug Nifedipine in the form of an ointment or gel can be carried out at home. Before applying the medicine, it is recommended to carry out hygiene procedures, cleanse the intestines. With external hemorrhoids, cavernous formations are treated with a small amount of ointment or gel, gently rubbing the agent into the skin. At internal form pathology ointment must be treated hemorrhoids located inside.

In some cases, the drug is used for setting compresses. To do this, a small amount of the product is applied to a linen or cotton fabric, applied to the affected area. This method is suitable for the treatment of external hemorrhoids.

How long does the drug take to work

Many patients are interested in how long Nifedipine begins to act? The therapeutic effect depends on the dose of the drug taken and individual characteristics organism. Tablets begin to act more slowly compared to injections. This is explained by the fact that during the injection, the active components immediately enter the bloodstream. Usually this time is from 40 minutes to an hour. The effect of the drug in the form of a gel or ointment is observed within a few minutes after application.

The effect of the drug comes in half an hour

special instructions

To prevent side effects and complications, patients should adhere to special instructions during treatment with Nifedipine. You can not combine the drug with alcoholic beverages. Such an interaction can provoke serious side effects, up to a fatal outcome.

Termination of therapy with the drug should be according to a certain scheme. Despite the fact that the drug does not have a withdrawal syndrome, treatment should not be abruptly interrupted.

Together with Nifedipine, beta-blockers should be used carefully. They combine medicines exclusively under the strict supervision of a doctor, since this union often provokes a rapid decrease in blood pressure.

Many patients stop taking the remedy, feeling relieved. This can not be done, because hypertension often occurs without visible symptoms.
Among patients with severe renal insufficiency and patients on hemodialysis, nifedipine is used very carefully, since therapy can lead to sharp drop pressure.

The standard dose of the drug for people with liver pathologies should be selected on an individual basis. If necessary, the dosage is reduced.

Important! The drug can affect the concentration of memory and attention of a person, therefore, drive vehicles and engage in other dangerous species activities should be done with extreme caution.

drug interaction

The therapeutic effect of the drug is enhanced when used simultaneously with drugs such as nitrates, diuretics, tricyclic antidepressants, inhalation antiseptics.

The effectiveness of Nifedipine is reduced when combined with Rifampicin. With mutual use with nitrates, the patient has an increase in tachycardia. Fluoxetine increases the likelihood of developing side effects of the drug. With prolonged use with beta-blockers, the patient may experience heart failure.

Use in pregnant women

In the first weeks after the onset of conception, it is forbidden to drink Nifedipine. Studies on the effect of the drug on the fetus have not been conducted. Papaverine is used to reduce the tone of the uterus. From the 16th week, the medicine is prescribed to women if the mother's condition requires it and the risk to her health is higher than the risk of exposure to Nifedipine on the fetus.

Pregnant women are prescribed with extreme caution

Pediatric use

Among patients under 18 years of age, Nifedipine is contraindicated.

Overdose and side effects

Side effects Nifedipine is more often associated with disruption of the cardiovascular system. Complications associated with the functioning of the respiratory, digestive and musculoskeletal systems are less common.

From the side of the heart and blood vessels:

• redness of the dermis of the face;
• reflex tachycardia;
• rapid heartbeat;
• chest pain;
• rapid pressure drop.

From the side of the central nervous system:

• migraine;
• feeling of goosebumps on the body;
• dizziness;
• nausea.

From the side of digestion:

• violation of the chair;
• pain in the stomach and intestines;
• nausea;
• flatulence.

From the bone and muscular systems may be observed muscle pain, trembling limbs. On the part of breathing - shortness of breath, bronchospasm.

An overdose of Nifedipine causes such serious complications like bradycardia, sudden jump pressure, bradyarrhythmia. In severe cases, there is an onset vascular collapse. The most pronounced signs of an overdose are a few hours after taking a large dose of the drug. The patient develops coma, cardiogenic shock, hypoxia, convulsions and other manifestations.

Important! With the development of even minor signs of an overdose, it is necessary to call ambulance. With absence necessary treatment death comes.

Other names for Nifedipine

The RLS drug database includes several names of the drug Nifedipine. The Nifedipine group includes the following agents:

• Kordafen;
• Corinfar;
• Captopril;
• Nifedipine farm;
• Fenigidin;
• Nifedipine elevit;
• Farmadipin;
• Nikardia and others.

Many modern companies produce drug analogues that have a fast or prolonged action. Information about these drugs can be found in the table.

Many patients are interested in how to choose an analogue, which medicine to choose, Fenigidin or Kapoten, Cardofen, Krinpharm and others. In order to choose the right one or another analogue, you need to figure out what a short or prolonged effect of the drug means. A short-acting drug is not recommended for the treatment of hypertension and other pathologies of the heart and blood vessels. This option is suitable for emergency care. An extended-release agent is suitable for use among patients during the period long-term treatment. Such drugs are taken in courses, they slowly and safely reduce pressure.

Price and where to buy

You can buy a medication at any of the pharmacies with a doctor's prescription. The approximate cost of the drug is from 20 to 30 rubles.

Gross formula

Pharmacological group of the substance Nifedipine

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Nifedipine

Calcium channel blocker is a derivative of 1,4-dihydropyridine.

Yellow crystalline powder. Practically insoluble in water, hardly soluble in alcohol. Molecular mass 346,3.

Pharmacology

It blocks calcium channels, inhibits the transmembrane entry of calcium ions into the smooth muscle cells of arterial vessels and cardiomyocytes. Expands peripheral, mainly arterial, vessels, incl. coronary, lowers blood pressure (possible slight reflex tachycardia and increased cardiac output), reduces peripheral vascular resistance and afterload on the heart. Increases coronary blood flow, reduces the force of heart contractions, the work of the heart and myocardial oxygen demand. Improves myocardial function and helps to reduce the size of the heart in chronic heart failure. Decreases pressure in the pulmonary artery positive influence on cerebral hemodynamics. It inhibits platelet aggregation, has anti-atherogenic properties (especially with prolonged use), improves post-stenotic circulation in atherosclerosis. Increases the excretion of sodium and water, lowers the tone of the myometrium (tocolytic effect). Long-term use (2-3 months) is accompanied by the development of tolerance. For long-term therapy of arterial hypertension, it is advisable to use fast-acting dosage forms at a dose of up to 40 mg / day (with an increase in the dose, the development of concomitant reflex reactions). In patients with bronchial asthma, it can be used with other bronchodilators (sympathomimetics) for maintenance treatment.

When taken orally, it is rapidly and completely absorbed. The bioavailability of all dosage forms is 40-60% due to the "first pass" effect through the liver. About 90% of the administered dose binds to plasma proteins. With intravenous administration, T 1/2 is 3.6 hours, the volume of distribution is 3.9 l / kg, plasma Cl is 0.9 l / min, and the constant concentration is 17 ng / ml. After oral administration, C max in plasma is created after 30 minutes, T 1/2 - 2-4 hours. About 80% is excreted by the kidneys in the form of inactive metabolites and approximately 15% - with faeces. In small quantities, it passes through the BBB and the placental barrier, penetrates into breast milk. In patients with impaired liver function, the total Cl decreases and T 1/2 increases. When capsules are taken orally, the effect manifests itself after 30-60 minutes (chewing accelerates the development of the effect) and lasts 4-6 hours, with sublingual use, it occurs after 5-10 minutes and reaches a maximum within 15-45 minutes. The effect of tablets with a two-phase release develops in 10-15 minutes and lasts 21 hours. It does not have mutagenic and carcinogenic activity.

The use of the substance Nifedipine

Arterial hypertension, including hypertensive crisis, prevention of angina attacks (including Prinzmetal's angina), hypertrophic cardiomyopathy (obstructive, etc.), Raynaud's syndrome, pulmonary hypertension, broncho-obstructive syndrome.

Contraindications

hypersensitivity, acute period myocardial infarction (first 8 days), cardiogenic shock, severe aortic stenosis, chronic heart failure in the stage of decompensation, severe arterial hypotension, pregnancy, breastfeeding.

Application restrictions

Age up to 18 years (safety and effectiveness of use have not been determined).

Use during pregnancy and lactation

Contraindicated in pregnancy.

At the time of treatment should stop breastfeeding.

Side effects of the substance Nifedipine

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis: often (at the beginning of treatment) - flushing of the face with a feeling of heat, palpitations, tachycardia; rarely - hypotension (up to fainting), pain similar to angina pectoris, very rarely - anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura.

From the nervous system and sensory organs: at the beginning of treatment - dizziness, headache, rarely - stupor, very rarely - changes in visual perception, impaired sensitivity in the arms and legs.

From the digestive tract: often - constipation, rarely - nausea, diarrhea, very rarely - gingival hyperplasia (with long-term treatment), increased activity of hepatic transaminases.

From the respiratory system: very rarely - bronchospasm.

From the musculoskeletal system: very rarely - myalgia, tremor.

Allergic reactions: itching, urticaria, exanthema, rarely - exfoliative dermatitis.

Others: often (at the beginning of treatment) - swelling and redness of the hands and feet, very rarely - photodermatitis, hyperglycemia, gynecomastia (in elderly patients), burning sensation at the injection site (with intravenous administration).

Interaction

Nitrates, beta-blockers, diuretics, tricyclic antidepressants, fentanyl, alcohol increase the hypotensive effect. Increases theophylline activity, reduces the renal clearance of digoxin. Enhances the side effects of vincristine (reduces excretion). Increases the bioavailability of cephalosporins (cefixime). Cimetidine and ranitidine (to a lesser extent) may increase plasma levels. Diltiazem slows down metabolism (necessary dose reduction of nifedipine). Incompatible with rifampicin (accelerates biotransformation and does not allow creating effective concentrations). Grapefruit juice (large amount) increases bioavailability.

Overdose

Symptoms: severe bradycardia, bradyarrhythmia, arterial hypotension, in severe cases - collapse, slow conduction. When taking a large number of retard tablets, signs of intoxication appear no earlier than after 3-4 hours and can additionally be expressed in loss of consciousness up to coma, cardiogenic shock, convulsions, hyperglycemia, metabolic acidosis, hypoxia.

Treatment: gastric lavage, activated charcoal, the introduction of norepinephrine, calcium chloride or calcium gluconate in atropine solution (in/in). Hemodialysis is ineffective.

Routes of administration

Inside, sublingually, in / in.

Precautions Substance Nifedipine

The drug should be discontinued gradually (possibly the development of a withdrawal syndrome).

Use with caution during work for drivers of vehicles and people whose profession is related to increased concentration attention.

special instructions

In patients with stable angina at the beginning of treatment, a paradoxical increase in anginal pain may occur, with severe coronary sclerosis and unstable angina - aggravation of myocardial ischemia. It is not recommended to use short-acting drugs for the long-term treatment of angina pectoris or arterial hypertension, because. development of unpredictable changes in blood pressure and reflex angina is possible.

Interactions with other active substances

Trade names