Corinfarum

Corinfarum – the selection blocker of calcium channels with anti-anginal and hypotensive action.

Form of release and structure

Dosage form – tablets of the prolonged action, film coated: a round biconvex form with slanted edges, the homogeneous structure of a kernel and a film cover have yellow color (on 10 pieces in blisters, in a cardboard pack 3 blisters; on 50 or 100 pieces in glass brown bottles, in a cardboard pack 1 bottle).

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

Auxiliary components: potato starch, lactoses monohydrate, cellulose microcrystallic, magnesium stearate, K25 povidone.

Structure of a film cover: macrogoal 6000, gipromelloza, macrogoal 35 000, titanium dioxide (E171), dye quinolinic yellow (E104), talc.

Indications to use

Use of Corinfarum is shown for treatment of cardiovascular diseases:

• Arterial hypertension;
• Chronic stable stenocardia or angina of exertion;
• Alternative stenocardia (Printsmetal's stenocardia).

Contraindications

• Chronic heart failure in a decompensation stage;
• Arterial hypotension (with a systolic arterial pressure (AP) below 90 mm of a mercury column);
• The expressed aortal stenosis;
• Cardiogenic shock, collapse;
• Unstable stenocardia;
• Concomitant use with rifampicin;
• Acute myocardial infarction (first 4 weeks);
• I trimester of the period of pregnancy;
• Breastfeeding;
• Hypersensitivity to components of drug and other derivatives 1,4 dihydropyridines.

With care it is recommended to appoint drug sick at the hypertrophic subaortic stenosis, a stenosis of the mitral valve expressed to tachycardia or bradycardia, malignant arterial hypertension, the sick sinus syndrome (SSS), a hypovolemia, a myocardial infarction with a left ventricular failure, heavy disturbances of cerebral circulation, impassability of the digestive tract (DT), a liver and renal failure, a hemodialysis, a combination to beta adrenoblockers and digoxin and also in II and III trimesters of pregnancy; aged up to 18 years.

Route of administration and dosage

Pill is taken inside, without chewing, after food, washing down with a small amount of liquid. The concomitant use of food does not reduce absorption of nifedipine from a GIT, but detains him.

The doctor appoints a dose of drug and the period of treatment on the basis of clinical indications, taking into account disease severity and individual sensitivity of the patient to drug.

The recommended dosing:

• Arterial (essential) hypertension: an initial dose – on 1 tablet 2-3 times a day, for achievement of the expressed clinical effect a dose it is possible to increase gradually to the maximum daily – 2 tablets 2 times a day;
• Chronic vasospastic and stable stenocardia: an initial dose – 1 tablet 2-3 times a day, for achievement of the expressed therapeutic effect gradually raise a single dose to 2 tablets with frequency rate of reception 1-2 times a day. The daily dose should not exceed 4 tablets.

At frequency rate of reception 2 times a day it is necessary to observe a break between receptions not less than 4 hours.

At purpose of Corinfarum patients with the accompanying expressed cerebrovascular pathologies and to patients of advanced age should reduce a dose.

Side effects

• From system of a hemopoiesis: leukopenia, anemia, thrombocytopenia, agranulocytosis, Werlhof's disease;
• From cardiovascular system: heartbeat, tachycardia, arrhythmias, manifestations of an excessive vazodilatation (a lowering of arterial pressure (asymptomatic), aggravation or development of heart failure, feeling of heat, a dermahemia of the person, rushes of blood to face skin), peripheral hypostases (feet, anklebones, shins), a syncope; seldom – the expressed decrease in the ABP; in isolated cases – stenocardia attacks, development of a myocardial infarction (is more often in an initiation of treatment or at increase in a dose);
• From the alimentary system: dryness in a mouth, dyspepsia (nausea, a lock or diarrhea), increase in appetite, a meteorism; seldom – a passing hyperplasia of gums; at prolonged use – abnormal liver functions in the form of an intra hepatic cholestasia, increase in activity of liver enzymes;
• From a nervous system: general weakness, headache, drowsiness, dizziness, increased fatigue; at prolonged use in high doses – a tremor, paresthesias of extremities, parkinsonichesky (extrapyramidal) disturbances (the complicated swallowing, a mask-like face, the ataxy shuffling gait, a tremor of fingers of hands and brushes), a depression;
• From a musculoskeletal system: mialgiya, arthritis, spasms of the lower and upper extremities, puffiness of joints;
• From an urinary system: at a renal failure – deterioration in function of kidneys, increase in a daily urine;
• Allergic reactions: seldom – a photodermatosis, a skin itch, a dieback, urticaria, exfoliative dermatitis, autoimmune hepatitis, anaphylactic reactions;
• Others: seldom – a galactorrhoea, a bronchospasm, a fluid lungs, a hyperglycemia, increase in body weight, a vision disorder, including a tranzitorny blindness against the background of the maximum concentration in a nifedipine blood plasma; patients of advanced age have a gynecomastia (disappearing after the termination of administration of drug).

Special instructions

It is impossible to take alcoholic drinks during treatment.

Drug withdrawal needs to be carried out by a gradual dose decline.

It is necessary to consider that at the beginning of use of Corinfarum, especially against the background of sharp recent cancellation of beta adrenoblockers, stenocardia can develop.

Combined use with beta adrenoblockers can cause strong decrease in the ABP, and sometimes and an aggravation of symptoms of heart failure therefore it is recommended to be accompanied with careful observation of the doctor.

Patients with heavy heart failure should appoint a drug dose carefully.

Patients with a severe form of a subaortic stenosis against the background of nifedipine reception are subject to risk of increase in frequency, duration of attacks and weight of display of stenocardia, in this case there can be a question of drug withdrawal.

Under careful regular control, and if necessary and with a nifedipine dose decline, it is necessary to carry out treatment of patients with an impaired renal function. Because of big risk of sharp falling of the ABP with care it is necessary to use drug at the patients with the high ABP and reduced volume of the circulating blood against the background of the accompanying irreversible renal failure who are on a hemodialysis.

At vasospastic stenocardia it is necessary to be guided by the main criteria for purpose of Corinfarum: classical clinic of a disease with increase in a segment of ST, emergence of a spasm of coronary arteries or the ergonovin-induced stenocardia, detection at an angiography of a coronary spasm or an angiospastic component without confirmation.

Before surgical intervention using the general anesthesia it is necessary to inform the anesthesiologist on administration of drug.

In some cases drug can become the reason of changes in a head part of spermatozoa (possibly disturbance of functions of spermatozoa, it is necessary to consider at extracorporal fertilization).

When conducting laboratory tests on identification of antinuclear antibodies and forward reaction of Koombs against the background of nifedipine reception, receiving a false positive take is possible.

The nifedipine combination with Disopyramidum and flekainamidy therefore in need of this combination treatment is recommended to be carried out with care can lead to strengthening of an inotropic effect.

Against the background of administration of drug spektrofotometrichesky definition in urine of content of vanililmindalny acid yields the overestimated result.

During drug use by the patient it is recommended to be careful at control of vehicles and mechanisms, and also at occupations those types of activity which performance requires special attention and high speed of psychomotor reactions.

Medicinal interaction

Purpose of drug together with rifampicin as it accelerates nifedipine metabolism process is not recommended.

Hypotensive effect of nifedipine can strengthen a concomitant use of other hypotensive drugs, tricyclic antidepressants, Cimetidinum, nitrates, diuretics, inhalation anesthetics, alpha adrenoblockers (Prazozinum).

Drug is capable to strengthen a negative inotropic effect of Amiodaronum and quinidine and to reduce the level of concentration of quinidine in a blood plasma.

At simultaneous use of Corinfarum:

• Nitrates – strengthen tachycardia;
• Diltiazem, grapefruit juice – suppresses nifedipine metabolism in an organism;
• Theophylline, digoxin, cephalosporins – increase the level of the concentration in a blood plasma;
• Non-steroidal anti-inflammatory drugs (NPVS) (against the background of suppression in kidneys of synthesis of prostaglandins and delays of liquid and ions of sodium in an organism), sympathomimetics, are oestrogenic – reduce hypotensive effect of drug;
• The quinidine, procaineamide and other drugs extending QT interval, – cause considerable lengthening of an interval of QT;
• Drugs of lithium can increase toxic action (nausea, a sonitus, vomiting, diarrhea, a tremor, an ataxy);
• Antiviral drugs (including индинавир, ампренавир, нелфинавир, саквинавир, ритонавир), macroleads, antifungal means of group of azoles (флуконазол, кетоконазол or итраконазол), valproic acid – cause increase in level of concentration of drug in a blood plasma;
• Carbamazepine and phenobarbital can reduce the content of nifedipine in a blood plasma.

At a combination with indirect anticoagulants (derivatives of an indandion and coumarin, anticonvulsant, quinine, NPVS, Sulfinpyrazonum, salicylates) and other means with high extent of linkng with proteins of plasma, action of Corinfarum can cause increase in level of their contents in a blood plasma.

In need of co-administration the dose of Vincristinum should be lowered as this combination can lead to strengthening of side effects.

Terms and storage conditions

To store in the place protected from light at a temperature up to 25 °C. To protect from children.

Period of validity – 5 years.