Cordaflex 20mg Egis Pharma prevents angina, hypertension (6 blisters x 10 tablets)

Nifedipine active ingredient, a calcium channel dilated agent belongs to the dihydropyridine group, has anti -chest pain and lowering blood pressure. The drug prevents calcium ions from passing through the membrane to enter the smooth muscle cells of the artery and into purple muscle cells, reducing the release of internal cell calcium, so the drugs relax the peripheral arteries and coronary arteries.

The effects on the heart muscle are negligible at the treatment dose.

By relaxing arteries, Nifedipine reduces peripheral resistance, and thus reduces the heart's attack, reduces oxygen demand and reduces the post -load.

Nifedipine relaxes both normal coronary arteries and atherosclerotic arteries, so the heart protection drugs against coronary spasms and improving the eagerness of myocardial ischemia. In people with normal blood pressure, Nifedipine does not work or works very little on the blood pressure.

Coronary dilation and inhibiting their contractions will improve the supply of oxygen for the heart muscle.

pharmacokinetics

nifedipine is almost absorbed completely from the digestive tract. Absolute bioavailability changes in the range of 40 to 70%. Nifedipine is under the first surpass (40 - 60%).

After taking a 20 mg slow -released film tablet, the concentration of effective plasma treatment is achieved within 1 hour. The concentration of stable drugs in the blood for about 1.5 to 6 hours, then gradually decreases from the hour 30 - 36 onwards.

94 - 97% Nifedipine is attached to plasma proteins (albumin).

The active ingredient can pass through the placenta and are discharged into breast milk, less than 5% of the drug put into the body can pass through the blood -brain barrier.

Nifedipine is mainly converted into 3 non -pharmacological metabolites, and about 60-80% of the drug inserted into the body is discharged in urine in this form. The remaining drug is discharged through bile and feces.

Austring pain may occur at the beginning of treatment or in patients with a history of angina, with frequency, time and severity may increase.

In hypertension or coronary artery disease, if the sudden stoppine stops stop, it can cause hypertension or myocardial ischemia (effect).

Notify the doctor with unwanted effects when using the drug.

Precautions when used

Special prudence when taking medication for patients with severe hypotension (systolic blood pressure below 90 mmHg) or when there is congested heart failure. The anti -hypertension effect of the drug will increase when there is a decrease in blood flow.

Nifedipine is needed to be closely monitored with Nifedipine with beta blockers because it may have a significant reduction in blood pressure: even heart failure may occur in some cases.

No need to change the dose of nifedipine when kidney diseases. The effect of the drug can increase when there is a decrease in the lung pressure and when there is a decrease in blood flow after being fertilized, so the dose should be lower.

Need to be careful especially when taking drugs for patients with liver diseases.

Needs to reduce the dose when there is increased vein and cirrhosis.

When starting with nifedipine treatment or when increasing the dose may occur, it is rare for chest pain (angina due to paradoxical ischemia) right after taking the medication. Stop drug if there is a cause and effect between chest pain and medication.

Patients with diabetes should be closely monitored when using nifedipine.

Avoid using alcoholic drinks while taking the drug.

Slow Cordaflex 20 mg film tablets contain lactose.

Do not take this drug for patients with rare genetic problems that do not tolerate galactose, have lactase lactase deficiency or have impossible glucose - galactose.

The ability to drive and operate machinery

Do not drive or operate machinery at the beginning of the treatment, for a period of determination for each case one. After that, this limit or prohibition must be determined for each patient.

Pregnancy and lactation

Prelise clinical studies show that nifedipine causes teratogenic, poisonous embryo and fetal at doses much higher than the dosage to treat humans.

Nifedipine can pass through the placenta and be discharged into breast milk.

Contraindicated using nifedipine in the first 3 months of pregnancy. The use of drugs during pregnancy must be limited for the middle and the last three months of pregnancy and for cases where the use of other drugs is not appropriate.

Nifedipine high doses will inhibit the labor, so the drug is effective to relax the uterus when the term has not been threatened.

Do not use nifedipine when breastfeeding, or stop breastfeeding during medication.

In some cases of in vitro fertilization, it has noticed that nifedipine and other calcium channel blockers of the same group have caused reversible biochemical changes in the head of the sperm. Therefore, the function of sperm can be damaged when using these drugs, which can gradually reach a continuous failure when in vitro fertilization.

Drug interaction

Interact with other drugs and other types of interactions:

Must be carefully coordinated with Cordaflex with:

Do not share nifedipine with rifampicin because then the blood will not achieve the concentration of nifedipine effectively, caused by rifampicin.

When used with drugs for hypertension (ACE inhibitors, diuretics, etc.), nitrate, psychotropic effects and magnesium -containing drugs, can have anti -hypertension effects:

Used with beta blockers, although the effect of anti -hypertension and chest pain is generally good, but because it is likely to decrease in blood pressure, lower blood pressure and heart failure, the coordination needs to be especially cautious.

Used with prazosine can cause serious lower blood pressure.

Used with digoxin can gradually increase the concentration of digoxin in plasma.

Used with theophylline may increase theophylline level in plasma.

Particularly cautious when used with quinidine because of plasma quinidine concentrations can decrease while using nifedipine and then increasing when stopping nifedipine: combining these two drugs can gradually reach the evil arrhythmia (the QT interval in the center of pouring in a pathology).

Grapefruit, erythromycin, azole fungal drug (fluconazol, iTraconazole, ketoconazole) some antibiotics of Fluoroquinolone group (Norfloxacine, Ciprofloxacine) Oral contraceptive drugs containing Gestagen and HIV -protease inhibitors of HIV (such as Indisa Ritonavir) can inhibit the metabolism of nifedipine and increase the effects of nifedipine. Similarly, using nifedipine with cimetidine will increase the concentration of drugs in plasma and thus increase the effects of nifedipine, but if they share nifedipine with ranitidine, it does not significantly increase the concentration of nifedipine in plasma:

rifampicin and phenytoin - by causing enzyme induction - will significantly reduce nifedipine levels in plasma; It is also not excluded with the same interaction with Barbiturate and Carbamazepine;

Cyclosporine is also the substrate of CYP3A4 enzyme, so using these two drugs can extend the time of both.

Nifedipine reduces Vincistine's excretion, thus increasing the side effects of this drug. Must consider reducing the dose of vincristine.

Sharing cisapride with nifedipine may increase nifedipine levels in plasma. In this chief must monitor blood pressure and if needed, Nifedipine is reduced.

Shared Quinuprristine/Dalfopristine with nifedipine may increase nifedipine levels in plasma. In this case, blood pressure must be followed and if necessary, Nifedipine dose must be reduced.