Skin reactions to nifedipine. Special instructions and contraindications

Cardiological and antihypertensive medication Nifedipine is quite popular among patients with arterial hypertension. It is used as monotherapy and as part of complex treatment.

There are several dozen analogues and trade names, the active ingredient of which is nifedipine. Instructions for use provide information about the rules and methods of using the medication.

The therapeutic effect of this medicine(LS) is provided by the composition of Nifedipine. Active ingredient is a derivative of 1,4-dihydropyridine - the chemical compound nifedipine.

The auxiliary ingredients, in addition to calcium stearate, povidone, cellulose and potato starch, contain the milk sugar lactose. This should be taken into account by people who suffer from intolerance to this carbohydrate or a deficiency of the enzyme that helps absorb it (lactase).

The release form of Nifedipine is tablets.

Pharmacological group and mechanism of action

Instructions for use indicate which pharmacotherapeutic cluster Nifedipine belongs to. This is a pharmacological group of selective (that is, selective), which is usually denoted by the abbreviation BMKK.

Pharmacodynamics (mechanism of action) of Nifedipine and medications of this group is based on reducing the leakage of calcium ions into the cells of the myocardium and the smooth muscle layer of the coronary and peripheral vessels.

The medication does not have an effect on the venous vessels, sinoatrial and atrioventricular nodes, and does not have an antiarrhythmic effect.

Helps reduce:

• total peripheral vascular resistance (TPVR);
• cardiac muscle tone and afterload;
• myocardial oxygenation needs (oxygen saturation),

as well as an increase in the duration of left ventricular diastole.

In response to a negative inotropic effect (decreased strength of heart contractions), the drug Nifedipine causes a reflex acceleration of the pulse.

What are these pills for?

The drug Nifedipine is prescribed for high pressure. Moreover, it is precisely appointed medical specialist subject to prior diagnostic examination patient. It is impossible to take Nifedipine, which the patient or his family considers appropriate in their own opinion. For example, these tablets should not be given to hypotensive patients with a single episode of physiological increase blood pressure(BP), say, if it jumped from the use of tonics.

Indications

Let us clarify which specific pathologies are indicated in the instructions for use of Nifedipine in the indications for use. Like many others antihypertensive drugs, this medication is indicated not only for the treatment hypertension, but also for diseases that often accompany hypertension. Therefore, the annotation for Nifedipine indicates:

• , manifested by exertional angina, including variant.

These are the ones pathological conditions, for which Nifedipine tablets are prescribed as a monotherapeutic agent or one of the medications in complex therapy.

Why is hypertension dangerous?

At what pressure and pulse is it used?

In the description of the drug Nifedipine, the instructions for use do not indicate at what pressure it is prescribed. Obviously, with blood pressure levels that give the doctor grounds to diagnose arterial hypertension (AH).

If the medication is prescribed for, then the value of blood pressure should be taken into account here too. According to the instructions for Nifedipine, it should not be< 90 мм рт.ст. по систолическому показателю.

Can it be used during a hypertensive crisis?

IN official instructions Nifedipine is not included in the indications for use. Patients with hypertension should receive constant antihypertensive therapy to prevent a rise in blood pressure, and not to use medications sporadically in emergency cases.

However practical experience application confirmed the ability of this medication to quickly and effectively reduce high blood pressure when administered sublingually.

1. To lower blood pressure with Nifedipine during hypertensive crisis You should put 1 tablet of Nifedipine 10 mg under your tongue and wait for it to completely dissolve (usually the effect occurs within a few minutes).
2. At this time, it is advisable for the patient to be in a lying or reclining position (dizziness may occur).
3. If there is no effect, it is allowed to take the pill again no earlier than half an hour after the first dose.
4. The maximum dose for hypertensive crisis is 30 mg, taken in 3 doses with an interval of 30 minutes.

Before everyone next step It is necessary to measure blood pressure and, if it normalizes, stop taking Nifedipine tablets.

Instructions for use of the drug

Before using Nifedipine tablets, the instructions for use should be studied with special care.

Perhaps during your visit to the doctor you forgot about some concomitant diseases, in which taking the medication is contraindicated. Or you are simultaneously taking other medications that can weaken or, conversely, enhance the effect of BMCC.

No information contained in the instructions for use of the drug should be neglected.

How to use?

The method of using Nifedipine for blood pressure is standard for tablets from the BMKK group. They are drunk during a meal or immediately after it, used for washing down clean water. This is important because taking Nifedipine with certain liquids, in particular grapefruit juice, you can’t - it completely suppresses the metabolism of BMCC.

Is it possible under the tongue?

For occasions emergency assistance during a hypertensive crisis, you can put Nifedipine under the tongue - this will speed up its action and lead to a decrease in blood pressure. But during prolonged therapy, Nifedipine tablets to lower blood pressure should be swallowed whole.

Dosage

Regarding the dosage, you should strictly adhere to the doctor’s prescriptions, who will select it individually.

The starting dose of Nifedipine is usually 5-10 mg (½-1 tablet), the number of doses per day is 2-3 times. After a week, you can increase the therapeutic dose to 20 mg by taking Nifedipine 20 mg 1-2 times a day, or 2 tablets morning and evening of Nifedipine 10 mg. Instructions for use indicate the maximum daily dose – 40 mg.

Nifedipine dosage adjustment is required for patients:

• taking other antihypertensive and antianginal drugs;
• with severe cerebral perfusion disorders;
• with impaired liver function;
• elderly.

Any changes in doses and dosage regimen should be agreed with your doctor.

How long does it take for it to start working?

When describing the pharmacodynamic properties of Nifedipine, the instructions for use provide the following information on the question of how long after Nifedipine begins to act:

• for oral administration – 20 minutes;
• with sublingual – 5-10 minutes.

The duration of the effect is 4-6 hours for tablets short acting and 12-24 hours – for prolonged.

special instructions

The section of the instructions for use about special instructions for Nifedipine blood pressure tablets begins with a warning.

1. It is forbidden to drink alcohol during treatment with Nifedipine. The active ingredient of these tablets, which belongs to the BMKK pharmaceutical group, is absolutely incompatible with ethanol.
2. The instructions for use warn that initial stage angina pectoris may develop, and with simultaneous use of beta-blockers, increased signs of heart failure may occur.
3. Nifedipine should be taken with caution in patients on hemodialysis, with hypovolemia and irreversible renal failure.

As indicated in the instructions for use, if necessary surgical intervention The doctor should be notified about Nifedipine therapy.

A separate paragraph in the instructions for use provides information on the use of the drug during the perinatal and lactation periods. Before the 20th week of pregnancy, the medication is definitely contraindicated. If necessary (and only under the supervision of a doctor), this medicine is allowed to be taken by women in a position with minimal therapeutic doses. But the instructions for use warn that drugs such as Nifedipine should be used with caution by pregnant women and only in consultation with a doctor.

Contraindications

The drug Nifedipine also has contraindications. This is a standard list for BMCC of conditions in which taking drugs can provoke effects dangerous to health and life. It is prohibited to be treated with Nifedipine if:

• (and for 4 weeks after);
• pregnancy and lactation period;
• decompensated CHF;
• simultaneous treatment with Rifampicin;
• (GARDEN< 90 мм);
• cardiogenic shock, collapse;
• intolerance to any of the ingredients of the drug.

Due to the lack of clinical data on the safety and effectiveness of use in persons under 18 years of age, Nifedipine is contraindicated for them.

Possible overdose

As already mentioned, drugs should be taken strictly in the dosage that the attending physician will select for the drug Nifedipine. An overdose, the symptoms of which can occur even if the maximum dose is slightly exceeded, usually manifests itself:

• bradycardia (significant slowing of heart rate);
• suppression of function sinus node, which is expressed by inadequacy of heart rate, deterioration of blood supply to the myocardium;
• strong and prolonged decrease in blood pressure;
• redness of the face;
• headache.

In case of severe intoxication with Nifedipine, the following is necessary:

• gastric lavage;
• reception activated carbon;
• slow, over 5 minutes, introduction of antidotes - 10% calcium chloride or gluconate under the control of its concentration in plasma.

In case of severe hypotension, dobutamine or dopamine is administered intravenously; in case of AHF, strophanthin is administered. The hemodialysis procedure is ineffective in such a situation. Treatment of overdose should be carried out in a hospital setting.

Side effects

The following table will tell you about the side effects of Nifedipine and the frequency of their occurrence.

Often	Infrequently	Occasionally
Heart and blood vessels: disorder heart rate(tachycardia, etc.), “heat” of the face, “hot flashes”	Excessive vasodilation (narrowing of blood vessels leading to a drop in blood pressure), heart failure	Fainting, angina attacks (especially at the beginning of therapy), extremely rarely - to the point of heart attack
CNS: dizziness, headaches, nervousness, fatigue	General weakness, sleep disturbances (drowsiness or insomnia)	Tremor and paresthesia (tingling, burning, goosebumps) of the limbs, depression
Circulatory system: various anemias, thrombocytopenia, leukopenia	Thrombocytopenic purpura	Asymptomatic agranulocytosis
Digestive system: dry mouth, increased appetite, dyspepsia	Swelling, tenderness, or bleeding gums	Increased activity of liver transaminases, stagnation of hepatic bile
Musculoskeletal system:	Myalgia (muscle pain)	Swelling and tenderness of the joints
Urinary system:	Increase in daily urine output	Renal dysfunction (usually in renal failure)
Other:	Allergic manifestations in the form of autoimmune hepatitis, exanthema, urticaria, skin itching	Violations visual function, weight gain, pulmonary edema, increased blood sugar levels, spontaneous leakage of colostrum from the nipples outside the lactation period, enlarged mammary glands in men (transient)

Majority unwanted effects are transient (transient) in nature and quickly disappear when the medication is discontinued.

Can it be combined with Elevit?

The multivitamin and mineral-containing product Elevit is often prescribed to pregnant and lactating women for the treatment and prevention of micro- and macronutrient deficiency and hypovitaminosis. Women who are forced to take BMCC even during this period are interested in whether it is possible to take Nifedipine with Elevit, and what the instructions for use say about the compatibility of these drugs.

An impressive list of restrictions on the compatibility of Nifedipine casts doubt on the possibility of its simultaneous administration with Elevit.

Elevit contains the trace element magnesium in the form of oxide, stearate and hydrogen phosphate trihydrate. And the instructions for use of Nifedipine indicate that simultaneous administration with drugs containing magnesium sulfate can provoke blockade of neuromuscular synapses (points of contact between neurons and effector cells) in pregnant women. Clinical studies no such combination has been carried out regarding safety, and the lack of data can be considered a strong argument against combining drugs, especially when we're talking about about therapy for pregnant women.

What is better when compared with other drugs?

Let's try to compare Nifedipine with other antihypertensive medications or similar action. Long-term therapy sometimes requires rotation of the drugs used, so familiarization with the most common medications will not be superfluous.

The basis of white cylindrical Amlodipine extended-release tablets is amlodipine besylate, a substance belonging to the second generation BMCC.

This is also a dihydropyridine derivative, the effect of which is to block calcium channels, reducing the transmembrane penetration of Ca ions into the cell. According to the instructions for use, it has not only a hypotensive, but also an anti-ischemic effect. Available in dosages of 5 and 10 mg, it contains lactose. When comparing which is better - Nifedipine or Amlodipine, you need to remember the duration of action of both drugs.

Andipal

Instructions for use Andipala calls this drug a combined analgesic drug, the active core of which consists of a non-narcotic analgesic (metamizole sodium), an antispasmodic (papaverine), a vasodilator (bendazole or dibazole) and a barbiturate (phenobarbital). A slight vasodilating effect has an effect on the smooth muscle layer of the walls of blood vessels; indications for use include migraines, all kinds of colic and others pain syndromes. The section of the instructions for use on interactions talks about the ability of Andipal tablets to enhance the hypotensive effect of BMCC, ACE inhibitors, nitrates and other antihypertensive drugs. Therefore, it is not correct to compare Nifedipine or Andipal, which is better.

Ginipral

Ginipral tablets are prescribed when there is a threat premature termination pregnancy (uterine tone), starting from the 20th week. Today this medicine is difficult to find in pharmacies, and you can often hear that Nifedipine is prescribed to women instead of Ginipral. This is where their question arises - which is better, Ginipral or Nifedipine. If we compare these medications in terms of their effect on the tone of the uterus, then without a doubt Ginipral is preferable. But some women (it has been noticed that they have hypertension) tolerate Nifedipine well. Others, judging by the reviews, advise to refrain from taking it, as they are faced with side effects. This means that you need to select a medication individually. We should not forget that these medications, according to their instructions for use, have completely different indications for use, so it is wrong to talk about their interchangeability.

The drug Capoten belongs to pharmacological group(ACE) prolonged action. Indicated for hypertension, left ventricular dysfunction in the post-infarction period, chronic heart failure, diabetic nephropathy, accompanying diabetes Type 1.

It is the drug of choice for a huge number of patients with arterial hypertension, not burdened by severe kidney or liver failure and other severe pathologies. The active ingredient is captopril. In patients with bronchial obstruction or a tendency to bronchospasm, taking an ACE inhibitor may cause a side effect in the form of a dry, hysterical cough. In this case, when choosing Capoten or Nifedipine, BMKK Nifedipine is preferable.

The same active substance is the core of the drug of the same name - Captopril. To compare Nifedipine or Captopril, which is better, you should focus on the lists of contraindications and side effects, as well as the individual tolerance of the components, and select the medicine in accordance with these factors. Another factor that is worth paying attention to is the possibility of using Nifedipine in the treatment of pregnant women from the 20th week, which cannot be said about Captopril. ACEIs are contraindicated for pregnant women at any stage.

One thing can be said about the drug Cordaflex - it is a direct, or structural, analogue of Nifedipine, and all indications for use, lists of side effects and warnings in the instructions for use of this medication are presented for active substance nifedipine. True, the indications include, in addition to hypertension and coronary artery disease, Raynaud's syndrome, as well as the prevention of Prinzmetal's angina. Those who prefer European manufacturers can pay attention to Cordaflex made in Hungary or Switzerland.

Nifedipine - has antianginal and antihypertensive effects. Relaxes vascular smooth muscle (relieves spasm), dilates coronary and peripheral (mainly arterial) vessels, reduces blood pressure and peripheral vascular resistance, and reduces afterload. Possessing a cardioprotector effect, it reduces the need for oxygen in the heart muscle. Increases coronary blood flow.

Nifedipine effectively reduces blood pressure and also helps relieve muscle spasms. Without affecting the heart rhythm, it significantly lowers blood pressure. After administration, Nifedipine begins to act within 20 minutes. (chewing accelerates the effect) and lasts up to 12 hours.

Active ingredient: tablets and capsules 0.005 and 0.01 g. Dragee 0.01 g. Retard tablets 0.02 and 0.04 g.

Nifedipine - indications for use

Prevention of angina attacks (including Prinzmetal's angina). Included combination therapy the drug is used in the treatment of coronary heart disease (stable angina, vasospastic angina) and arterial hypertension.

To lower blood pressure during various types hypertension (including unknown etiology), including renal hypertension.

In some cases used for Raynaud's disease and as part of combination treatment CHF.

Currently, there is evidence that it is inappropriate medicinal use nifedipine for arterial hypertension - this is associated with an increased risk of myocardial infarction, as well as deaths in patients with coronary disease hearts at long-term use Nifedipine.

Should I take nifedipine at what blood pressure?
The instructions for use of the drug clearly indicate that nifedipine is used for high blood pressure to lower blood pressure. Nifedipine for blood pressure is taken according to general scheme indicated below, unless otherwise directed by your attending physician.

Nifedipine during pregnancy and uterine tone

What is Nifedipine prescribed for toning during pregnancy? The drug relieves spasms and relaxes smooth muscles (including the uterus), and is used to suppress premature contractions.

The dosage of nifedipine for tone in particular, and use during pregnancy in general, should be strictly under medical supervision. Instructions for use prohibit treatment with the drug during pregnancy and lactation. Self-prescribing nifedipine for uterine tone is strictly prohibited! See below for more details.

Nifedipine: instructions for use and dosage

How to take Nifedipine tablets? Doses and duration of treatment are established by the attending physician individually, taking into account the patient’s condition and the specific dosage form of the drug.

The tablet form of Nifedipine is taken orally with a sufficient amount of water. Long-acting Nifedipine is recommended for long-term treatment.

The initial dose is 10 mg 2 times a day; if necessary, the dose can be increased to 20 mg 2 times a day. If necessary, the dose is gradually increased to 20 mg of nifedipine 3-4 times a day. Maximum daily dose- 80 mg.

For arterial hypertension, nifedipine tablets are taken 3 times a day, 10 mg, if necessary, the dose is increased to 20–30 mg (3 times a day).

Accelerated action during crises - nifedipine tablets are kept unchewed, without swallowing, under the tongue. The drug is absorbed within a few minutes. With this method, the patient must lie down for half an hour, due to possible sharp decline HELL.

In elderly patients and those with other diseases, the maximum daily dose should be reduced.

In case of liver dysfunction, in patients with severe impairment cerebral circulation the dose should be reduced.

It is necessary to stop taking nifedipine gradually, gradually reducing the daily dose by half.

How long can I take it? The course of treatment is prescribed by a doctor and can last up to 2 months.

During the treatment period, alcohol intake is strictly prohibited. Importance has regularity of therapy regardless of health, the patient may not feel the symptoms of arterial hypertension.

Contraindications for the use of Nifedipine

• severe cerebrovascular accidents,
• arterial hypotension (systolic blood pressure below 90 mm Hg),
• vascular and cardiogenic shock,
• first week acute heart attack myocardium,
• severe heart failure,
• liver failure, renal failure(especially patients on hemodialysis),
• pregnancy and lactation,
• increased sensitivity to nifedipine and other components of the drug.
• children under 18 years of age (the effectiveness and safety of use have not been studied).

Patients with lactose intolerance should not take Nifedipine tablets.

The use of Nifedipine during pregnancy is prohibited. Experimental studies conducted on animals, revealed the risk of slowed growth and developmental delays in the fetus and the occurrence of frozen pregnancy.

Taking Nifedipine during pregnancy with uterine tone is justified if increased risk angina pectoris, heart attack, as well as congestive heart failure, heart rhythm disturbances, lack of oxygen in tissues (hypoxia) and renal failure.

Analogues of Nifedipine, list

This is a very popular medicine, and pharmacies may not have it, but there are analogues of Nifedipine tablets:

• Adalat SL
• Cordafen
• Vero-Nifedipine
• Cordaflex
• Nifadil
• Nifesan
• Sanfidipin
• Phenigidine

Long-acting Nifedipine analogues:

• Corinfar Uno;
• Nifedipine SS;
• Cordipin retard;
• Nifebene-retard.

Many well-known pharmaceutical companies are producing an analogue of the drug Nifedipine. Reviews from patients say that most of them are in no way inferior to it in terms of effectiveness.

Be careful - instructions for use of Nifedipine, price and reviews of analogues may not correspond due to differences in concentration active component and other excipients. When selecting an analogue, it is recommended to consult a doctor.

Nifedipine is an antagonist of calcium ions, inhibits their entry into cardiomyocytes and smooth muscle cells coronary and peripheral arteries through slow membrane channels. Dilates coronary and peripheral arterial vessels, reduces myocardial oxygen demand, lowers peripheral vascular resistance and blood pressure.
Rapidly absorbed into digestive tract(when used in the form of a solution or tablets with regular release of the active substance). The maximum concentration in blood plasma when taking conventional dosage forms achieved in 30-60 minutes. When using various retard forms, the maximum concentration of nifedipine in the blood plasma is observed several hours after oral administration, the duration of action is on average 10-12 hours, for some dosage forms - up to 24 hours.

Indications for use of the drug Nifedipine

Angina pectoris (especially stable angina pectoris and variant angina pectoris), essential and symptomatic hypertension (arterial hypertension).

Use of the drug Nifedipine

Orally, regardless of food intake, 10-30 mg 3-4 times a day. To relieve a hypertensive crisis, apply sublingually in a dose of 10 mg in the form of an oral solution (or after chewing the tablet), if necessary, after 20-30 minutes, nifedipine is repeated, sometimes increasing the dose to 20-30 mg; or the drug is administered intravenously at a dose of 5 mg for 4-8 hours, the maximum dose is 15-30 mg/day (for no more than 3 days). For long-term treatment Hypertension (arterial hypertension) and/or angina pectoris should be used in the form of retard forms, which are prescribed 1-2 times a day.

Contraindications to the use of the drug Nifedipine

Pregnancy and lactation, severe heart failure, sick sinus syndrome, severe arterial hypotension, porphyria, hypersensitivity to nifedipine or other dihydropyridine derivatives.

Side effects of the drug Nifedipine

headache, drowsiness, dizziness, tachycardia, nausea, swelling lower limbs, hyperemia of the skin of the face and upper body. In these cases, the dose should be reduced.

Special instructions for the use of the drug Nifedipine

Persons managing vehicles or working with others potentially dangerous mechanisms, caution should be exercised when taking nifedipine, especially at the beginning of treatment.
Patients with hypertrophic cardiomyopathy, unstable angina, diabetes, severe liver disease, pulmonary hypertension, as well as elderly people, when treated with nifedipine, should be under medical supervision. Nifedipine should be used with extreme caution in patients with unstable angina and myocardial infarction, since reflex tachycardia that occurs during treatment can worsen the course of the disease.
Nifedipine may affect the value of some laboratory parameters and tests (alkaline phosphatase, LDH, ALT, AST, false-positive Coombs test). These changes are usually not accompanied by clinical signs, although there are cases when an increase in the activity of serum transaminases was accompanied by the appearance of cholestasis and jaundice. Nifedipine may have a moderate antiplatelet effect.

Drug interactions Nifedipine

At simultaneous administration other antihypertensive drugs, including beta-adrenergic blockers, diuretics, as well as organic nitrates, the synergistic effect of nifedipine must be taken into account. Concomitant administration of fentanyl potentiates the hypotensive effect of nifedipine; Treatment with nifedipine should be discontinued 36 hours before planned anesthesia with fentanyl. Nifedipine increases the concentration of digoxin, carbamazepine, phenytoin and theophylline in the blood. Cimetidine increases the concentration of nifedipine in the blood serum.

Nifedipine overdose, symptoms and treatment

Manifests arterial hypotension, bradycardia, heart failure, shock, metabolic acidosis and cramps. Gastric lavage, intake of activated charcoal, monitoring of hemodynamic parameters and symptomatic treatment(replenishment of blood volume, administration of sympathomimetics, calcium chloride).

List of pharmacies where you can buy Nifedipine:

• Saint Petersburg

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

Nifedipine is a drug that has a vasodilator and hypotensive effect. Belongs to the group of calcium channel blockers. It relieves vasospasm, while simultaneously performing a cardioprotective function. The drug is different quick action. Literally 20 minutes after taking it, a gentle decrease in blood pressure levels 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 patient’s place of residence and the pharmacy where it will be purchased. The approximate cost of the pharmaceutical product is shown in the table.

These are only approximate prices at which you can purchase the drug Nifedipine.

Compound

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

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

Therapeutic effect

Nifedipine tablets promote the expansion of blood (coronary, peripheral) vessels, thereby achieving a pronounced and persistent hypotensive effect. The drug helps reduce tone smooth muscle blood 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 medication helps prevent the formation of new cholesterol plaques on the walls blood vessels. And this 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 be used? pharmaceutical? Nifedipine tablets are intended to reduce high blood pressure in any degree of hypertension, as well as to relieve hypertensive crises.

Pills

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

In addition, it is advisable to use the drug for ischemic heart disease and atherosclerotic processes in peripheral arteries.

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

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

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

Nifedipine is prescribed with extreme caution to diabetics, pregnant women, patients with CHF, malignant arterial hypertension and severe renal impairment. Under the careful 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, loss of pathological nodes or their compression. In addition, the medicine has proven itself in the fight against perianal dermatitis.

Manufacturers do not provide information about contraindications to the use of ointment. The medication can 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.

Pills

The dosage of Nifedipine tablets is determined separately for each patient. In this case, the patient’s diagnosis, 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. If there are no expected results from therapy, the dose may be doubled. Maximum permissible daily dosage is 40 mg.

Note. It is advisable to take the tablets at regular intervals.

Ointment

Nifedipine ointment is applied to cleansed skin of the perianal area. thin layer. To ensure that the product is absorbed faster, you can rub it in, but lightly, making massaging movements. After the manipulation, you need to lie down for at least a quarter of an hour so that the gel has time to take effect.

If the medicine does not lead to the development of side effects, then after a day it can be used rectally. To do this, a small amount of ointment needs to be inserted into the anal hole. This should be done once first.

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 you should 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.

Is Nifedipine suitable for pregnant and lactating women?

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

It is advisable to prescribe the medicine 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 period, since in any case, the benefits of the drug for the expectant mother should exceed the potential risks to the fetus.

But first, Nifedipine is prescribed in a minimum dose - 10 mg (1 tablet) 4 times a day. The dosage can be doubled if there is no expected therapeutic effect. In case of urgent need, the amount of the drug taken per day can be increased to 60 mg (6 tablets).

Drink the product 20-30 minutes before meals, with a sufficient amount of still water. The duration of treatment is determined for each patient individually. It is not always possible to achieve an adequate therapeutic response from a pregnant woman’s body to the treatment, so its course can be prolonged by the attending physician.

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

Nifedipine for breastfeeding

Nifedipine tablets are contraindicated for nursing mothers, since their components can penetrate into breast milk. If the use of the drug cannot be avoided, lactation must be stopped during treatment.

Nifedipine ointment can be used both during gestation and during breastfeeding.

Possible side effects

The use of Nifedipine in tablet form may cause side effects such as:

Long-term use of the medicine may have Negative influence and to work of cardio-vascular system. So, medicine can cause hypotension, asystole, bradycardia or tachycardia, angina pectoris. Can sometimes be disturbing side effects from the gastrointestinal tract: nausea, diarrhea, heartburn attacks.

.

To change the drug, you must consult a general practitioner, family doctor or cardiologist.

Nifedipine is a drug that lowers systolic blood pressure. It is used for many types of disorders of the arterial blood supply to organs. Effective when acute course, pathologies coronary blood flow, .

So, today we will talk about the drug Nifedipine, its instructions for use, price, reviews and analogues.

Features of the drug

Nifedipine is a synthetic drug produced to inhibit calcium channels. By chemical composition Nifedipine is produced from a precursor of the pyridine group, dehydrogenated at positions 1 and 4. The powder is in the form of yellow crystals, sparingly soluble in water and alcohol.

The mass of the Nifedipine molecule C 17 H 18 N 2 O 6 is 346.3 g/mol.

The following video will tell you in more detail about the features of the drug Nifedipine:

Compound

According to the chemical composition of 1 tablet, there is a main substance - a derivative of 1,4 dihydropyridine and additional substances for better absorption of Nifedipine:

• milk sugar;
• magnesium stearic;
• food gelatin;
• cellulose in microcrystals;
• wheat starch;
• colloidal titanium and silicon dioxides, talc and other shell substances.

Dosage forms

Nifedipine is produced in several dosage forms:

• Nifedipine tablets with 10 and 20 mg of the active main substance, most often familiar to consumers;
• solution for drip infusion, 1 ml of which contains 0.01 mg of Nifedipine;
• solution in 2 ml ampoules for direct cardiac administration.

Israeli pharmacies also offer Nifedipine gel (ointment, emulsion) as a cure for hemorrhoids.

In city pharmacies, the minimum price for a medicine is 36 rubles, the highest high price marked with a milestone of 47 rubles. Online pharmacies offer to buy Nifedipine for 27 rubles.

The mechanism of action of Nifedipine is discussed below.

pharmachologic effect

• By blocking calcium channels, Nifedipine limits the flow of calcium ions into the striped fabric heart chambers and myocytes smooth muscles coronary and peripheral arteries. Increasing the dosage of Nifedipine blocks the release of calcium ions from cellular structures into the bloodstream. Temporarily reduces the number of active calcium channels without controlling the temporary mechanism of blocking and subsequent reactivation.
• It has a desynchronized effect on the rhythm of excitations and contractions, blocking the actions of calmodulin of angional origin and troponins of cardiac origin. Leads to normal pathological process enhanced transport of calcium ions through membrane potential, which occurs when systolic pressure. Selective action to block calcium channels is expressed in ignoring the closure of channels in venous myocytes.
• Increases the speed of blood circulation in the coronary arteries, restores blood circulation in areas of the heart affected by coronary artery disease. Restoration of blood circulation occurs due to the opening of additional branches coronary arteries without restricting blood circulation in the rest of the vascular bed.
• Reduced resistance arterial vessels occurs due to vasodilation. The consequence of this process is the prolongation of ventricular diastole, a decrease in the oxygen demand of cardiac myocytes and the general tone of the striated muscle of the heart.
• It does not produce a pronounced effect on the functioning of first- and second-order pacemakers, so the rhythmicity of contraction of the heart remains unchanged. Increases urine excretion by the kidneys. Vasodilation of blood vessels is overlapped by compensation of the sympathoadrenal system, expressed in an increase in heart rate.

Pharmacodynamics

• At oral administration Nifedipine clinical effect is achieved after 20 minutes, intravenous infusion allows you to achieve the therapeutic effect of the drug after 5-7 minutes.
• At direct introduction in the heart, the clinical effect is observed within 3-5 seconds after administration of Nifedipine. The dose should not exceed 40 mg per day.

For a long time daily use Nifedipine has an “accustoming” effect on tissues that occurs after 60-90 days. Therapeutic effect from Nifedipine lasts for up to 24 hours.

Pharmacokinetics

When using Nifedipine, there is a high ability to be absorbed by the intestinal villi into the bloodstream (more than 92%). When taken orally with food, bioavailability exceeds 60%. Nifedipine taken on an empty stomach has 40% bioavailability.

After absorption into the venous bed, it undergoes “checking” and treatment through the portal vein of the liver. Accessible to brain cells, milk alveoli and embryonic cytostructures when passing through the blood-brain, blood-mammary and hematoplacental barriers. Half-life and breakdown of the drug is observed in the liver. Final products metabolism Nifedipine is excreted through the urinary system (four-fifths of the products) and through bile (one-fifth of the metabolites). The half-life ranges from 4 to 17 hours.

Indications

• angiotrophoneurosis with peripheral disorders blood flow in the terminal arterioles;
• (as an independent remedy or in combination with other antihypertensive drugs);
• arterial spasm eyeball and inner ear;
• persistent chronic angina.

The drug is contraindicated for children and adolescents. It is important to know about the indications for use of Nifedipine during pregnancy: it should be taken with caution, especially in the last 3 months of gestation. To reduce increased tone the uterus during the period of gestation exists more safe analogues calcium antagonists.

We will tell you further about how to take Nifedipine.

Instructions for use

• Nifedipine tablets are taken orally during meals, preferably liquid. It is acceptable to swallow the tablets with water.
• If the doctor does not prescribe a larger dosage, then taking more than 2 tablets per day of 20 mg on your own is prohibited.
• The maximum daily dose of Nifedipine should not exceed 80 mg (four tablets per day), if a dose of 40 mg is ineffective.

Systemic cerebral circulatory disorders and liver failure limit the use of Nifedipine. A lower dosage should be prescribed to elderly and geriatric patients, especially in combination with other angiotensive agents. The duration of use of the drug should be within the competence of the attending physician.;

Side effects of Nifedipine

• A number of patients using the drug Nifedipine experienced sharp drops in systolic pressure, lethargy, redness of the facial skin, pain and dizziness in the head, swelling of the end parts of the extremities, and a flush of heat.
• Long-term use of the drug led to increased blood levels of liver transaminases, nausea, and dyspeptic digestive disorders (constipation or diarrhea).
• Skin manifestations cannot be excluded in some patients. allergic reactions, myalgia, exacerbations of arthritis. There is a decrease in blood glucose concentration, increased urination, and gum hyperplasia.
• When analyzing a blood smear, a decrease in the number of all blood elements, thrombocytopenic purpura, is observed.

special instructions

Stopping the drug should not be done abruptly. The treatment regimen involves slowly reducing the dose over time. Drinking drinks containing ethyl alcohol is prohibited during treatment. Labor activity associated with increased attention and concentration should be limited for a while.