Adalat is 30 Bayer treating hypertension, preventing chronic stable angina (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Nifedipine
Ingredient Coronary artery disease, high blood pressure, angina

Ingredient

Composition information	Content
Nifedipine	30mg

Uses

indications

Adalat La 30 drugs are indicated in the following cases:

Treatment of hypertension all levels.

Used alone or in combination with a beta blockers to prevent chronic stable angina. Calcium antagonists reduce the calcium ion flow through the membrane into the cell through slow calcium channel. Nifedipine specially acts on the heart muscle and smooth muscle cells of coronary arteries and peripheral blood vessels.

The main effect of nifedipine is the artery smooth muscle relaxation including coronary and peripheral circulation.

Adalat La tablets are formulated to be able to achieve a nifedipine control that is sufficient to achieve clinical use efficiency at a daily dosage daily.

Dynamic pharmacokinetics

Adalat La tablets are produced to provide nifedipine at an approximation ratio within 24 hours. Nifedipine is released from the tablet begins at the speed from the zero level through the absorption-absorbing process that is controlled through the membrane.

Absorption: After drinking, Nifedipine is absorbed almost completely. Nifedipine's whole body is released immediately (Nifedipine capsules) is 45 - 56% due to the first metabolic effect. Birth in the stable state of Adalat La tablets is about 68 - 86% compared to Nifedipine capsules. Food slightly changes the initial absorption level but does not affect the level of use of the drug.

Distribution: There are about 95% nifedipine is connected to plasma proteins (albumin). Partial distribution time after intravenous infusion is determined as 5 to 6 minutes.

Metabolism: After oral, nifedipine is metabolized in the intestinal and liver wall, mainly through oxidation. These metabolites do not have academic activity. Nifedipine is out of the kidneys mainly in the form of metabolites and has about 5-15% from the bile in the feces, the non -metabolic nifedipine is found in very small amounts (less than 0.19%) in the urine.

Elimination: The final sale time is from 1.7 to 3.4 hours in conventional forms (Nifedipine capsules) of Adalat La's last waste sale time does not show a significant parameter because the drug concentration in plasma is maintained during the release from the tablet and absorption. After releasing and absorbing the final dose, the concentration of drugs in the final plasma will eventually decrease with the semi -discharged time as for the conventional processing form.

Before taking Adalat is 30 Bayer treating hypertension, preventing chronic stable angina (3 blisters x 10 tablets)

How to use

Take oral use.

The drug is taken in whole with a cup of water, regardless of the meal. Take medication should be about 24 hours apart, that is, drink at the same time every day, should drink in the morning.

Adalat La tablets must be taken whole tablets, do not bite, chew or break the pill in any case.

Dosage

initial dose recommended in mild to moderate hypertension is a 20 mg tablet once a day. For severe hypertension, the initial dose recommends is a 30 mg tablet once a day. If necessary, the dose can be increased to a maximum of 90 mg once daily depending on the requirements for each patient.

For the prevention of angina, the initial dose recommends is a 30 mg tablet once a day. The dose may increase depending on the requirements for each patient to a maximum of 90 mg once a day. Patients with hypertension control or symptoms of angina with Adalat capsules or Adalat Retard can switch to adalat LA safely. The effect of preventing angina was maintained when the patient was transferred from other antagonistic drugs such as Diltiazem or Verapamil to Adalat La. Patients who move from other calcium antagonists to Adalat La should start treatment with the initial recommended dose of 30 mg of adalat la once a day. It may then start adjusting higher dose to ensure clinical efficiency.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

In the case of severe nifedipine poisoning, there are the following symptoms: perception disorders that can lead to coma, hypotension, fast/slow arrhythmia, hyperglycemia, metabolic acidosis, decreased oxygen, heart shock with pulmonary edema.

Treatment

In treatment, the leading measure is to eliminate active ingredients and recover the stable condition of the cardiovascular system.

After the stomach appointment, if necessary, the small intestine douche.

In case of Nifedipine poisoning, it is necessary to eliminate as much medicine as possible, including in the small intestine, to avoid the absorption of active ingredients.

Dialysis does not work, because Nifedipine is not appraised, but can be replaced by plasma (connected to high plasma proteins, relatively low distribution integral).

Slow arrhythmia can treat symptoms based on beta sympathetic medications, in case of severe life threats can place temporary pacemaker.

Consequences of cardiac shock and arterial dilatation can be treated with calcium (10 - 20 ml of 10% calcium gluconate solution with slow and repeated intravenously if necessary). As a result, blood calcium concentration may reach a high level of limit or slight increase. If the blood pressure is not lifted by calcium, additional sympathetic substances can be used like dopamine or noradrenalin. The dosage of the above drugs depends on the achieved efficiency.

Be careful when infusing due to the risk of circulating overload.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using adalat is 30 you may experience unwanted effects (ADR).

Common, ADR> 1/100

Nervous system disorders: headache

Immune system disorders: Allergic reactions, allergic/angioedema. circuit: Hypotension, fainting. Tired.

Rare, ADR

The immune system disorders: rashes, urticaria, erythema. Erectile erectile.

Unknown frequency

Blood disorders and lymphatic systems: granulocytes, leukopenia.

Respiratory disorders, chest and mediastinum: Difficulty breathing. ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Adalat is 60 contraindicated in the following cases:

Hypersensitivity to nifedipine or any excipients of the drug. Lap. Patients with bags with Kock (tricks to open ileum after colorectal surgery). Nifedipine is not used in combination with rifampicin because it may not achieve effective nifedipine levels in plasma due to enzyme induction.

Be cautious when using

should be cautious when using the drug for patients with hypotension because there is a risk of reducing blood pressure and must be careful for very low blood pressure (severe hypotension with systolic blood pressure lower than 90 mmHg).

Adalat La can be used in combination with beta blockers and other hypertension medications, but it should be paid attention to the ability to effectively lead to posture reduction. Adalat La may not prevent the response effects after stopping other hypertension treatment.

Be careful to use Adalat La in patients with poor heart reserves. Sometimes it is possible to see the heart failure becomes worsening when using nifedipine.

may need to adjust blood sugar control for patients with diabetes using adalat la.

In patients with hypertrophy of malignant hypertension and a decrease in blood volume may occur significantly.

Because the outer membrane of the adalat is not digested, it is possible to see the whole pills in the toilet or in the patient's stool. Therefore, be careful when using adalat for patients because of the possible congestion symptoms. The phenomenon of stomach foreign objects can occur in very rare cases and may need surgical intervention.

Symptoms of congestion have been described in individual cases without gastrointestinal disorders.

In patients with mild, moderate or severe liver function damage, need to monitor carefully, and may reduce the dose.

Nifedipin is metabolized through the Cytochrome P450 3A4 system, drugs that are inhibited or induced this enzyme system can thus change the initial metabolism or clearance of nifedipine.

When used with these drugs, blood pressure monitor and if necessary, nifedipine dose reduction must be considered.

The maximum increase of a day of 120 mg of nifedipine can lead to an increase in 2 mmol sodium absorption daily. Therefore, it is advisable to consider controlling the amount of sodium into the patient's body.

The ability to drive and operate machinery

The reaction to the drug varies depending on the patient, which can reduce the ability to drive or operate machinery. This occurs especially when starting treatment, changing drugs and when drinking alcohol.

Pregnancy

should not use nifedipine during pregnancy unless the clinical condition of a woman needs to be treated with nifedipine.

The period of breastfeeding

nifedipine is secreted into breast milk. Nifedipine concentration in breast milk is equivalent to the mother's serum concentration. For instant release forms, it is proposed to delay breastfeeding or milking for 3-4 hours after taking the drug to reduce the contact with Nifedipine for children.

Drug interaction

nifedipine is metabolized through the cytochrome P 450 3A4 system in both intestinal and liver mucosa. Therefore, drugs that have the effect or inhibition or induction of this enzyme system can change the first transformation step in the liver (after oral oral or nifedipine clearance.

When used simultaneously with cytochrome P450 3A4 induction substances, nifedipine's clinical response should be monitored and if it is necessary to consider increasing the dose of Nifedipine. If nifedipine increases during use combined with both drugs, when stopping treatment with the other drug, it is necessary to consider reducing the dose of nifedipine.

Nifedipine may increase the effect of lowering blood pressure when using other medications for hypertension such as diuretics, beta blockers, enzyme inhibitors, angiotensin receptor blockers 1 (AT1), other calcium channel blockers, α-adrenergic blockers, PDE5 inhibitors, and α-Methyldopa.

When using nifedipine simultaneously with β blockers, the patient must be carefully monitored because the hypotension is quite serious. In some separate cases, it may worsen heart failure. Therefore, patients need to be careful to check the symptoms of digoxin overdose and, if necessary, glycosid should be reduced when taking into account the plasma digoxin levels. When nifedipine is used simultaneously with quinidine, it is found that on each case separately, the quinidine concentration decreases or after stopping nifedipine treatment, the quinidine concentration increases significantly. Therefore, it is necessary to monitor Quinidine concentration or dose adjustment if used in combination or stop using nifedipine. Nifedipine dose should be closely monitored, if needed.

tacrolimus is metabolized through the cytochrome P450 3A4 system. Recent data claimed that nifedipine may be reduced when used simultaneously with Tacrolimus in each separate case. When used in combination with both of the above drugs, serum tacrolimus concentration should be monitored and nifedipine dose reduced when needed.

Storage

The active ingredient contained in adalat is sensitive to the protective light to avoid the light inside and outside the packaging. Do not leave the medicine in moisture and must take immediately after removing the drug from the blister. No storage at temperatures above 30 ° C.

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