Nifedipine is a drug that reduces systolic pressure. It is used for many types of violation of arterial blood supply to organs. It is effective in the acute course of angina attacks, pathologies of coronary blood flow, coronary heart disease, arterial hypertension.
So, today we will talk about the drug Nifedipine, about its instructions for use, price, reviews and analogues.
Features of the drug
Nifedipine is a synthetic medicine that is produced to inhibit the work of calcium channels. According to the chemical composition, Nifedipine is produced from the precursor of the pyridine group dehydrogenated at positions 1 and 4. The powder is in the form of yellow crystals, hardly soluble in water and alcohol.
About the features of the drug Nifedipine in more detail will tell the following video:
Composition
The chemical composition of 1 tablet distinguish the main substance - the derivative of 1,4 dihydropyridine and additional substances for better assimilation of Nifedipine:
- milk sugar;
- magnesium stearic;
- gelatin food;
- cellulose in microcrystals;
- wheat starch;
- titanium dioxide and silicon dioxide in a colloidal state, talc and other shell substances.
Dosage forms
Nifedipine is produced in several dosage forms:
- tablets Nifedipine with 10 and 20 mg of active principle substance, most commonly familiar to consumers;
- solution for drip infusions, 1 ml of which contains 0.01 mg of Nifedipine;
- solution in ampoules of 2 ml capacity for direct cardiac administration.
Also Israeli pharmacies offer Nifedipine gel( ointment, emulsion) as a cure for hemorrhoids.
For prevention and treatment of cardiovascular diseases, our readers advise the drug "NORMALIFE".This is a natural remedy that affects the cause of the disease, completely preventing the risk of getting a heart attack or stroke. NORMALIFE has no contraindications and begins to act within a few hours after its use. The effectiveness and safety of the drug has been repeatedly proven by clinical studies and long-term therapeutic experience.
The opinion of doctors. .. & gt; & gt;
In the city pharmacies, the minimum price for a medicine is 36 rubles, the highest cost is marked by a border of 47 rubles. Online pharmacies offer to buy Nifedipine for 27 rubles.
The mechanism of action of Nifedipine is discussed below.
Pharmacological action of
- By blocking calcium channels, Nifedipine limits the supply of calcium ions to the striated tissue of the heart chambers and myocytes of the smooth muscles of the coronary and peripheral arteries. Increasing the dosage of Nifedipine blocks the release of calcium ions from the cellular structures into the bloodstream. Temporarily reduces the number of active calcium channels, without monitoring the temporary blocking mechanism and subsequent reactivation.
- Has a desynchronized effect on the rhythm of excitations and contractions, blocking the action of calmodulin of anginal origin and troponins - cardial. It leads to normal pathological process of enhanced transport of calcium ions by means of the membrane potential that occurs when systolic pressure increases. The selective effect on blockade of calcium channels is expressed in ignoring the closure of canals in venous myocytes.
- Increases the rate of circulation in the coronary arteries, restores blood circulation in the hearths affected by ischemic disease. Restoration of blood circulation is due to the opening of additional branches of the coronary arteries without infringement of blood circulation in the rest of the vascular bed.
- The decrease in the resistance of arterial vessels is due to vasodilation. The consequence of this process is the prolongation of the diastole of the ventricle, the decrease in the oxygen demand of myocytes of the heart and the general tone of the striated muscle of the heart.
- The pronounced effect on the functioning of the drivers of rhythm of the first and second order does not produce, therefore the rhythm of the reduction of the heart divisions remains unchanged. Increases the excretion of urine by the kidneys. The vasodilation of the vessels is covered by the compensation of the sympathoadrenal system, expressed in an increase in the frequency of cardiac contractions.
Pharmacodynamics
- With oral administration of Nifedipine, the clinical effect is achieved after 20 minutes, intravenous infusion allows to achieve the therapeutic effect of the drug after 5-7 minutes.
- With direct administration to the heart, the clinical effect is noted within 3-5 seconds after the administration of Nifedipine. Do not exceed the dose of more than 40 mg per day.
Pharmacokinetics
When Nifedipine is used, there is a high ability to absorb its intestinal villi into the bloodstream( more than 92%).When administered orally together with food, bioavailability exceeds 60%.Nifedipine, used on an empty stomach, is 40% bioavailability.
After suction into the venous bed, a "check" and treatment through the portal vein of the liver passes. It is available to brain cells, milk alveoli and embryonic cytostructures when passing through the blood-brain, hematomolar and hematoplacental barriers. Half-decay and disintegration of the drug is observed in the liver. The final products of the metabolism of Nifedipine are excreted through the urinary system( four-fifths of products) and through bile( a fifth of metabolites).The half-life is from 4 to 17 hours.
Indications
- angiotrophoneurosis with peripheral impairment of blood flow in terminal arterioles;
- hypertension( as an independent agent or in combination with other antihypertensive drugs);
- Prinzmetal angina;
- spasm of the arteries of the eyeball and inner ear;
- chronic heart failure;
- persistent chronic angina.
For children and adolescents, the drug is contraindicated. It is important to know about the indications for the use of Nifedipine in pregnancy: you should take it with caution, especially in the last 3 months of bearing the fetus. To reduce the increased tone of the uterus in the period of gestation, there are safer analogs of calcium antagonists.
On how to take Nifedipine, we will tell you further.
Instruction for use
- Nifedipine tablets are taken orally during meals, preferably liquid. It is permissible to swallow the tablets together with water.
- If the doctor does not have a large dosage, then more than 2 tablets per day for 20 mg of self-acceptance is prohibited.
- The maximum daily dose of Nifedipine should not exceed 80 mg( four tablets per day) if the 40 mg dose is not effective enough.
Systemic circulatory disorders of the brain and liver failure limit the use of Nifedipine. A smaller dosage should be given to the elderly and elderly patients, especially in combination with other angiotensives. The period of application should be within the competence of the attending physician.
Contraindications
Restriction, acute use in a small dose or complete contraindication Nifedipine has for patients suffering from:
- hypotension;
- with malignant hypertension;
- diabetes mellitus;
- severe form of heart failure;
- individual intolerance to the components of the drug;
- by hypervolemia;
- acute period of myocardial infarction;
- by hepatic and renal insufficiency;
- pathologies of cerebral circulation in severe form;
- tachycardia;
- aortic and mitral stenoses;
- disruption of the functioning of the sinus-atrial node.
Side effects of Nifedipine
- In a number of patients using Nifedipine, there were sharp drops in systolic pressure, lethargy, reddening of the facial skin, pain and twisting in the head, swelling of the extremities, hot flashes.
- Prolonged use of the drug resulted in increased blood levels of liver transaminases, nausea, dyspeptic digestive disorders( constipation or diarrhea).
- It is not excluded in some patients the manifestation of skin allergic reactions, myalgia, exacerbations of arthritis. There is a decrease in the concentration of glucose in the blood, increased urination, gingival hyperplasia.
- When analyzing the blood smear there is a decrease in the number of all blood cells, thrombocytopenic purpura.
Special instructions
Discontinuation of the drug can not be done abruptly. The treatment regimen assumes a slow dose reduction over time. Reception of drinks containing ethyl alcohol is prohibited for the duration of treatment. Labor activities associated with increased attention and concentration, should be limited for the time being.
Reviews
According to a survey of doctors in 2015, 36% of family doctors, 33% of therapists, and 18% of cardiologists noted positive dynamics in treatment. This contingent of doctors regularly use Nifedipine in the clinical treatment of their patients.
Patients leave a positive comment on this drug, noting in the beginning of the application the presence of side effects. When continuing treatment with Nifedipine, side effects recede.
Analogs
To date, 63 analogues of Nifedipina are used. Among the most popular are Cordipine, Cordaflex, Adalat, Myogard, Nifedikor, Ronian, Fenamon, etc.