Kordipin

Kordipin – derivative dihydropyridine, a blocker of calcium channels with anti-anginal and anti-hypertensive action.

Form of release and structure

Dosage form – tablets, film coated (on 10 pieces in strips, 5 strips in a pack cardboard).

Active ingredient: nifedipine, in 1 tablet – 10 mg.

Additional components: starch prezhelatinizirovanny, sodium lauryl sulfate, povidone, talc, lactoses monohydrate, silicon dioxide colloid anhydrous, starch corn.

Structure of a cover: macrogoal, titanium dioxide, talc, copolymer of methacrylic acid, dye quinolinic yellow (E104).

Indications to use

• Arterial hypertension and stopping of hypertensive crises;
• Stable stenocardia and Printsmetal's stenocardia (stopping of attacks and their prevention);
• Raynaud's disease.

Contraindications

Absolute:

• Arterial hypotension (systolic pressure is lower than 90 mm hg);
• Kollaptoidny states;
• Cardiogenic shock;
• Unstable stenocardia;
• The expressed heart failure;
• Arterial hypotension;
• Stenosis of aortal vessels of heavy degree;
• Acute myocardial infarction (first week of the acute period);
• Heavy myocardial insufficiency;
• Liver failure;
• Porphyria;
• Hypovolemia;
• Syndrome of the broken absorption of a glucose/galactose, galactosemia, deficit of lactose;
• Age up to 18 years;
• Hypersensitivity to drug components.

Relative:

• Stenosis of the mitral valve;
• The expressed bradycardia;
• The expressed disturbances of cerebral blood circulation;
• Impassability of digestive tract;
• Subaortic stenosis with a myocardium hypertrophy;
• Sick sinus syndrome;
• Myocardial infarction with the accompanying insufficiency of a left ventricle;
• Tachycardia;
• Malignant arterial hypertension;
• Renal failure;
• Hemodialysis;
• Diabetes mellitus;
• Simultaneous use of beta adrenoblockers, digoksinsoderzhashchy means;
• Pregnancy.

Route of administration and dosage

Kordipin it is necessary to accept inside, swallowing of tablets entirely and washing down with enough liquid. If there is a need for bystry development of effect, the tablet can be chewed.

The dosing mode in each case is defined by the doctor individually.

The initial daily dose usually makes 30 mg (on 1 tablet 3 times a day). The supporting daily dose – 30-40 mg (on 1 tablet 3-4 times a day). At insufficiency of effect increase in a dose up to 60-80 mg a day is possible, in separate hard cases the daily dose is raised to 90-120 mg, with division of a dose into 3-4 receptions.

For stopping of an attack of stenocardia and hypertensive crisis appoint 2-3 tablets sublingual.

Side effects

• Nervous system: вертиго, headache, sleep disorders, increased fatigue, paresthesias;
• Cardiovascular system: thorax pain, orthostatic hypotension, disturbances of a cordial rhythm (asystolia, bradycardia, tachycardia), exacerbation of coronary heart disease;
• Allergic reactions: urticaria, itch, rash;
• Digestive tract: hyperplasia of gums, lock/diarrhea, heartburn, nausea, intra hepatic cholestasia, increase in activity of hepatic transaminases, disturbance of work of a liver;
• Bodies of a hemopoiesis: thrombocytopenia, aplastic anemia, leukopenia, agranulocytosis;
• Urinary system: increase in amount of urine, renal failure;
• Musculoskeletal system: muscular weakness, mialgiya, tremor, muscular spasms;
• Sense bodys: deterioration in sight;
• Others: peripheral hypostases, inflows, hyperemia of integuments, gynecomastia.

Special instructions

In an initiation of treatment Kordipin, especially in case of a combination with beta adrenoblockers, development of hypotension is possible.

Special observation at the beginning of therapy is required to people of advanced age, and also patients with pulmonary hypertensia, unstable stenocardia, a hypertrophic cardiomyopathy, a heavy abnormal liver function, a diabetes mellitus.

At patients with heavy coronary insufficiency owing to reflex tachycardia weighting of ischemia of a myocardium is possible (it is shown by increase of painful attacks).

In need of carrying out the inhalation test with metasincaline for assessment of hyperreactivity of bronchial tubes Kordipin it is necessary to cancel.

Drug can exert impact on results of some laboratory indicators, including on indicators of an alkaline phosphatase, lactate dehydrogenase, alaninaminotranspherase and aspartate aminotransferase. These changes are not always followed by clinical manifestations, however emergence of symptoms of jaundice or a cholestasia is in certain cases possible.

It is necessary to stop treatment by nifedipine gradually since sharp cancellation, especially after long therapy, can lead to development of a withdrawal.

At some patients, especially at the beginning of Kordipin's use, side effects from a nervous system therefore at the initial stages of therapy it is recommended to refrain from management of vehicles and performance of potentially dangerous types of works are possible. Further extent of restrictions is defined individually.

During treatment by drug it is necessary to refrain from the use of alcoholic drinks as alcohol in combination with nifedipine can cause dangerous hypotonia.

Medicinal interaction

• Other anti-hypertensive drugs and diuretics: synergistic action of these means, perhaps considerable lowering of arterial pressure is noted;
• Beta adrenoblockers: hypotensive action and anti-anginal effect is exponentiated, tachycardia of reflex character is stopped;
• Tricyclic antidepressants, ranitidine, Cimetidinum, derivatives of a fenotiazin: hypotensive effect of nifedipine is exponentiated;
• Calcium drugs, rifampicin: the effect of nifedipine decreases;
• Digoxin, carbamazepine, Phenytoinum, theophylline: their serumal concentration increases;
• Quinidine: its concentration in blood decreases;
• Ethanol and etanolsoderzhashchy drugs: hypotensive action amplifies;
• Organic nitrates (nitroglycerine, isosorbide): the anti-anginal effect and hypotensive action is exponentiated (it is recommended to avoid such combination because of risk of development of the expressed hypotension);
• Flukonazol, phenobarbital: plasma concentration of nifedipine decreases;
• Fluoxetine: side effects of nifedipine amplify;
• Cimetidinum: plasma concentration of nifedipine increases and, as a result, its effects amplify;
• Anticholinergic drugs: the attention worsens and memory at gerontological patients is broken;
• Salts mania: the risk of development of a myasthenia increases;
• Diltiazem: development of the expressed hypotension is possible;
• Fentanyl: in addition reduces the arterial pressure (in need of carrying out anesthesia using fentanyl Kordipin it is necessary to cancel in 36 hours).

During treatment it is recommended to refrain from the use of grapefruit juice as it can strengthen effect of drug.

Terms and storage conditions

To store in the unavailable to children, protected from light, dry place at a temperature up to 25 ºС.

Period of validity – 3 years.