This medicine is a selective blocker (inhibitor) of “slow” calcium channels, chemically refers to dihydropyridine derivatives. It inhibits the movement of Ca2 from the intercellular space into cardiomyocytes and smooth muscle stands, peripheral and cardiac arteries; in large doses, inhibits the release of Ca2 from intracellular depots.
In therapeutic doses, it normalizes the intercellular exchange of Ca2, which can be disturbed in a number of pathological conditions (arterial hypertension and others). It does not affect the tone of the veins. Increases coronary blood flow, enhances blood supply to ischemic areas of the myocardium without the development of the “robbery” syndrome, stimulates the work of collaterals.
The time of the onset of the clinical effect is short to 20 minutes, the duration of the effect is 5-6 hours.
In the intestines, up to 90% of the drug is absorbed. Bioavailability is about 60%. Eating increases bioavailability. 95% of the drug binds to plasma proteins. The maximum concentration of nifedipine in the blood when taken orally in two tablets (20 mg of nifedipine) occurs after 2-3 hours. It is completely transformed in the liver.
It is excreted by the kidneys in the form of an inert metabolite (70%), with bile (30%). The half-life is about 3-5 hours.
Renal failure, hemodialysis, change the pharmacokinetics of Corinfar. In people with liver disease, clearance decreases and the half-life is prolonged. With long-term use (more than two months), tolerance to the drug may develop.
Instructions for use and dose
The medicine is taken orally. To improve the bioavailability of the tablets, they must be drunk after meals, not crushed, so as not to damage the protective shell, and washed down with water. It is advisable to take the drug at the same time daily. The dosage, frequency of administration and duration of the treatment course is determined by the doctor. In the instructions for use, standard doses are indicated.
Instructions for use Corinfar Retard and Corinfar explains how to take this medicine. Tablets are used orally after meals, without biting and drinking plenty of water. Simultaneous administration with food inhibits the adsorption of the active substance from the intestine. Usually, drugs are taken in the morning and in the evening, however, it is worth remembering that Corinfar UNO 40 mg can be used only once a day.
The dose and frequency of administration of the drug is selected individually by the attending physician, taking into account the severity of the disease and other clinical aspects.
With vasospastic angina and angina pectoris: 1 tablet of Corinfar Retard or Corinfar (depending on severity and individual sensitivity) 2 times a day. With a mild effect, the dose of the drug is slowly increased to two tablets 2 times a day.
Essential hypertension: 1 tab. Corinfar Retard or Corinfar (depending on severity and individual sensitivity) 2 times a day. With a mild effect, the dose of the drug is slowly increased to two tablets 2 times a day.
With a double administration of the drug per day, the interval between doses should be an average of 12 hours. Corinfar UNO is taken the same time of day with an interval of 24 hours, preferably before lunch, 1 tablet (40 mg) once a day.
Side effects and overdose
Side effect of Corinfar retard is in the form of heart rhythm disturbance, impaired heart function, hot flashes. Some patients have dizziness, malaise, apathy, soreness of the head, decreased performance. There are changes on the part of digestion: nausea, indigestion, impaired peristalsis, dry oral mucosa.
Less common is muscle soreness, inflammation of the pancreas, visual impairment, changes in blood parameters, and increased body weight (mainly in elderly patients). If you suspect an adverse reaction, the drug is canceled, you need to seek help from a doctor for symptomatic therapy.
Adverse reactions after taking Corinfar rarely appear. Most often, they occur in people with hypersensitivity to nifedipine.
- violation of the heart rate, swelling of the lower extremities;
- a sharp decrease in pressure indicators;
- fever, redness of the skin;
- fatigue, migraine, dizziness;
- the sensitivity of the fingers may deteriorate for a while, sometimes the coordination of movements is disturbed, the gait becomes uneven, there are problems with swallowing food;
- nausea, hypersensitivity of the oral mucosa, bloating;
- anemia, allergic reactions.
With prolonged treatment, depression, muscle and joint pain, visual impairment, weight loss can occur.
With all the recommendations of the doctor, cases of overdose do not occur. With the independent administration of a large dose of the drug, a coma can occur, the pressure decreases below the minimum acceptable values, hypoxia develops. If signs of poisoning appear, it is necessary to induce vomiting, rinse the stomach, take activated charcoal and calcium-based preparations, and call an ambulance.
The following effects of interaction with the following drugs should be taken into account:
- with tricyclic antidepressants, antihypertensive agents, vasodilators – increased hypotensive effect;
- with beta-blockers – a pronounced decrease in blood pressure;
- with diltiazem – suppression of the metabolism of nifedipine;
- with quinidine – a sharp decrease in the concentration of quinidine in the blood, after the abolition of nifedipine – a sharp increase in the content of quinidine in the blood;
- with digoxin, theophylline – an increase in theophylline and digoxin in the blood (there is a chance of signs of an overdose of digoxin);
- with quinupristine, dalphopistin, cimetidine – an increase in the concentration of nifedipine in the blood;
- with rifampicin – acceleration of the metabolism of nifedipine;
- with cephalosporins, tacrolimus – an increase in the concentration of the latter in the blood;
- with phenytoin – attenuation of the effects of nifedipine;
- with drugs that inhibit the cytochrome P450 system (macrolides, fluoxetine, nefazodone, protease inhibitors, antifungal agents) and valproic acid – an increase in the content of nifedipine in the blood;
- with carbamazepine, phenobarbital – a decrease in the content of nifedipine in the blood.
Corinfar retard has several adverse drug interactions. When taking medication with antihypertensive drugs together, there is an increased amplification of the therapeutic effect. Antidepressants have a similar increased effect. When combining the drug with nitrates, a change in the work of the heart occurs, the heart rate changes.
When combined with beta-blockers, a sharp decrease in blood pressure is observed, which leads to a deterioration in the patient’s condition. Cimetidine increases the pharmacological effect on the body of the drug. The drug is unfavorably combined with quinidine, they change the therapeutic effects of each other.
In pregnancy (and lactation)
The use of Corinfar retard during pregnancy and lactation is impossible. The drug component easily penetrates the uteroplacental barrier, penetrates into breast milk. There is no reliable data on the exact effect of the active substance on the fetus, therefore it is better for women to avoid taking the medicine during this period.
The drug has a teratogenic effect, as evidenced by animal tests.
1st trimester of pregnancy is a strict contraindication for taking the drug, and in 2-3 trimesters and during breastfeeding, it is necessary to use the drug with great care.
Method and features of the application
The drug is available in the form of tablets. The dosage of admission is individual. The average dosage is twenty milligrams twice a day. After which the doctor for some time observes the therapeutic effect of the drug. With its inefficiency, the dose rises to optimal in therapy. The interval between the use of the medication is from four hours, but no less.
If the medicine is taken twice a day, then the tablets are consumed after twelve hours (morning, evening). The first pill is taken after breakfast. Food has an effect on the medicine, so it is better to take the drug after completing a meal. The tablet is taken with water in sufficient quantities.
The drug is incompatible with alcohol.
During the treatment of diseases, alcohol is not consumed. At this time, alcoholic beverages are completely excluded from the diet. Ethanol violates the pharmacological properties of the drug, changes the bioavailability and has a negative effect on the liver and kidneys.
Estrogen-containing drugs neutralize the hypotensive effect.
The combination of Corinfar Retard medication with antidepressants, nitrates, diuretics and other antihypertensive drugs enhances its hypotensive effect. Concomitant use with “Rifampicin” accelerates the metabolism of nifedipine, therefore, it is impossible to combine these drugs. Reduce the effectiveness of the drug NSAIDs, sympathomimetics, estrogens.
Use the drug with caution, not neglecting certain instructions.
- Increasing the dose, as well as stopping the therapy, is necessary gradually. It should be borne in mind that angina may appear at the beginning of therapy. The greatest likelihood of its occurrence is provoked by the abolition of beta-blockers used before. The simultaneous appointment of the latter should be carried out under the strict supervision of a doctor, so that in the event of an excessive decrease in blood pressure and manifestations of heart failure, the doctor can immediately take appropriate measures.
- During the use of the drug, ethanol, including those contained in medicinal tinctures, should be discarded.
- With an increase in angina attacks, their intensification in patients with severe isolated myocardial damage, the drug should be discontinued.
- If a surgery is to be performed under general anesthesia, the anesthesiologist should be informed that Corinfar is being taken.
- In patients with irreversible k >
Reviews about Corinfar Retard and Corinfar, as well as reviews at Corinfar UNO are very controversial. Along with reports of the excellent effect of using the drug at high pressure, there are reviews indicating the absence of a therapeutic effect in arterial hypertension, from which Corinfar tablets should help.
Patients’ opinions about the drug are mixed. Negative (in most cases) is due to a large number of side effects, positive – due to the low cost of the drug.
Some patients complain that they did not know about getting used to the drug. When the medicine did not work after use, the patients increased the dose, after which they became much worse. Consumers also complain about the use of other drugs in parallel with Corinfar. You never know what the action will be, it is easier to replace or completely cancel the calcium blocker.
Those who took Corinfar Retard tablets claim that they are better than their Russian counterparts, although experts disagree with this. Patients note that the Indian drug practically does not cause unpleasant manifestations.
Everyone who suffered from high blood pressure responds positively about the medication. The remedy begins to act quickly, and the effect is long. If you take a pill in the morning, then before lunch you can forget about the torment.
The price of Corinfar Retard in Russia is 157 rubles per pack of 50 tablets, the same amount of regular Corinfar will cost 71 rubles. And the price of Corinfar UNO is approximately equal to 340 rubles for 50 tablets of the drug.
In Ukraine, the average prices of Corinfar, Corinfar Retard and Corinfar UNO in the amount of 50 tablets are 25, 84 and 103 hryvnias, respectively.
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