Nifedipin T20 Retard Stella tablet backup, treat hypertension (10 blisters x 10 tablets)

Uncommon, 1/1000

Heavy aortic stenosis.

Myocardial infarction within 1 month.

Acute pain in stable angina, unstable angina.

Be cautious when using

After the beginning of treatment, the pain of ischemia appears or the existing pain is severe, need to stop the drug.

Patients with heart failure or left ventricular failure because heart failure may worsen.

Must reduce the dose when liver damage, diabetes.

Nifedipine can inhibit premature labor.

Nifedipine T20 Retard contains lactose. This drug should not be used for patients with genetic problems that have galactose intolerance, total lactase enzyme deficiency or glucose-galactose.

The ability to drive and operate machinery

reactions to the drug vary depending on the individual, can reduce the ability to drive or operate machinery. This effect especially occurs when starting treatment, changing oral medication and while using alcohol.

Pregnancy

Animal studies show that nifedipine is toxic to the fetus and causes teratogenic, commonly bone deformation. Therefore, not for women who are pregnant unless they are really necessary.

The period of breastfeeding

because Nifedipine reaches high concentrations in breast milk, it may be possible to encounter complications for breastfed babies even at normal doses. Therefore, deciding to stop breastfeeding or not taking this medication. Consider the importance of the drug for the mother.

Medicinal interaction

Sympathetic beta blockers: can lower blood pressure, increase angina, congestive heart failure and arrhythmia, especially in patients with cardiac function.

H2 - histamine anti -receptor drugs: simultaneously using nifedipine with cimetidine may increase serum concentration and increase the effects of nifedipine, so it is necessary to reduce the dose when coordinated. However, with ranitidin, there is only little interaction, and Famotidin does not interact with nifedipine.

Fentanyl: Hypotension occurs during surgery in patients with simultaneous use of nifedipine and fentanyl. If in surgery, high doses of fentanyl must be taken at least 36 hours before surgery, if the patient's condition is allowed.

Anti -epileptic drugs: Nifedipine use simultaneously with anti -epileptic drugs such as phenytoin will increase the concentration of phenytoin in plasma, so the effect and toxicity of phenytoin (such as headache, vibration of eyeball, tremor, depression, ...) increases.

Theophylin: Nifedipine reduces the concentration of theophylin in plasma. Use nifedipine along with theophylin to change asthma control.

Quinidine: Nifedipine may significantly reduce the serum concentration of Quinidine in some of these patients, but it does not affect some other patients.

digoxin: Nifedipine increases the serum concentration of Digoxin about 15 - 45% when used simultaneously, so it is necessary to monitor signs of digoxin poisoning and reduce the dose if necessary.

Alpha blockers: Alpha blockers, especially prazosin, can increase the effect of lowering blood pressure caused by nifedipine inhibits the metabolism of prazosin, must be cautious.

Calcium channel blockers: plasma concentrations of both nifedipine and diltiazem increased when used in combination with these two drugs together. This may be because both drugs are metabolized by the same liver enzyme, which reduces the metabolism of each drug.

Anti -platelet aggregation drugs: Anti -plateletic effects increase if combined with nifedipine with aspirin or ticlodipine.

Immunological inhibitors: Cyclosporin reduces the metabolism of nifedipine through competitive inhibitors of cytochrom P450 metabolism.

rifampicin: rifampicin causes cytochrom P450 enzyme in the liver, thus reducing plasma nifedipine levels and increases angina.

Non -steroid anti -inflammatory drugs: Indomethacin and other nonsteroidal anti -inflammatory drugs may be opposed to the anti -hypertension effect of calcium channel blockers through prostaglandin synthesis inhibitors in the kidneys or causing salt and water stasis.

Grapefruit juice cluster: When drinking grapefruit juice with nifedipine will increase the bioavailability of nifedipine. This interaction may be due to some components in grapefruit juice that inhibit the P450 enzyme.

Alcohol: Alcohol increases bioavailability and metabolic inhibition of nifedipine. As a result, the concentration of serum and the effect of nifedipine increases.

Be cautious when using Nifedipine simultaneously with the following drugs: anticoagulic drugs (Coumarin and indandion), anti -convulsions (Hytantoin), quinidine, salicylat, sulfinPyrazon, estrogen, amphotericin b, enzyme inhibitors carbonic anhydrase, corticoid drugs, Kichini waste drugs (such as Kali Kali waste. Bumetanid, ethacrynic acid, Furosemid), sodium phosphate ...