Corinfar 10mg long-acting tablets 100
Women's clothing size
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Active substance: nifedipine 10mg.
Excipients: lactose monohydrate, potato starch, microcrystalline cellulose, povidone K25, magnesium stearate.
Composition of the film shell: hypromellose, macrogol 6000, macrogol 35000, quinoline yellow dye (E104), titanium dioxide (E171), talc.
Selective slow calcium channel blocker (BMCC), a derivative of 1,4-dihydropyridine. It has an antianginal and hypotensive effect. Reduces the current of extracellular Ca 2+ inside cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries; in high doses inhibits the release of Ca 2+ from intracellular depot.
In therapeutic doses, normalizes transmembrane current Ca 2+ , impaired in a number of pathological conditions, primarily in arterial hypertension. Does not affect the tone of the veins. Enhances coronary blood flow, improves blood supply to myocardial ischemic zones without the development of the phenomenon of "theft", activates the functioning of collaterals.
By expanding the peripheral arteries, it reduces OPSS, myocardial tone, afterload and myocardial oxygen demand. Practically does not affect the sinoatrial node and AV-node, has weak antiarrhythmic activity.
Increases renal blood flow, causes moderate natriuresis.
The negative chrono-, dromo- and inotropic effect is overridden by reflex activation of the sympathoadrenal system and an increase in heart rate in response to peripheral vasodilation.
The time of onset of the clinical effect is 20 minutes and its duration is 4-6 hours.
At long-term use (2-3 months) develops tolerance to the action of the drug.
Indications for use
- chronic stable angina (angina pectoris);
- Prinzmetal's angina (variant angina);
- arterial hypertension.
- arterial hypotension (systolic blood pressure below 90 mm Hg);
- cardiogenic shock, collapse;
- chronic heart failure in the stage of decompensation;
- pronounced aortic stenosis;
- unstable angina;
- acute myocardial infarction (first 4 weeks);
- joint use with rifampicin;
- I trimester of pregnancy;
- lactation (breastfeeding);
- Increased sensitivity to nifedipine and other derivatives of 1,4-dihydropyridine or to other components of the drug.
With caution: mitral valve stenosis, hypertrophic obstructive cardiomyopathy, severe bradycardia or tachycardia, SSSU, malignant arterial hypertension, hypovolemia, severe cerebral circulation disorders, myocardial infarction with left ventricular failure, gastrointestinal obstruction, renal and hepatic insufficiency, hemodialysis (due to the risk of arterial hypotension), II and III trimesters of pregnancy, children and adolescents under 18 years of age (efficacy and safety have not been established), simultaneous administration of beta-blockers, digoxin.
Use in pregnancy and lactation
The drug is contraindicated in the first trimester of pregnancy and during lactation.
With caution: the drug should be prescribed in the II and III trimesters of pregnancy.
Application in case of impaired liver functionWith caution: liver failure.
Use in renal dysfunctionWith caution: renal failure.
Use in childrenWith caution: age up to 18 years (efficacy and safety have not been established).
During the treatment period, it is necessary to refrain from taking ethanol. It is recommended to stop treatment with the drug gradually.
It should be borne in mind that angina pectoris may occur at the beginning of treatment, especially after the recent abrupt withdrawal of beta-blockers (the latter should be canceled gradually).
The simultaneous appointment of beta-blockers should be carried out in conditions of careful medical supervision, since this can cause an excessive decrease in blood pressure, and in some cases - an aggravation of the symptoms of heart failure.
With severe heart failure, the drug is dosed with a large Caution.
The diagnostic criteria for prescribing the drug for vasospastic angina are: the classic clinical picture, accompanied by an increase in the ST segment, the occurrence of ergonovin-induced angina pectoris or spasm of the coronary arteries, the detection of coronarospasm in angiography or the detection of an angiospastic component without confirmation (for example, at different voltage thresholds or with unstable angina, when ECG data indicate transient angiospasm).
For patients with severe obstructive cardiomyopathy, there is a risk of an increase in the frequency, severity and duration of angina attacks after taking nifedipine; in this case, it is necessary to cancel the drug.
In patients with irreversible renal failure who are on hemodialysis, have high blood pressure and reduced BCC, the drug should be used carefully, because a sharp drop in blood pressure is possible. For patients with impaired liver function close monitoring is established; if necessary, the dose of the drug is reduced and / or other dosage forms of nifedipine are used.
If surgical intervention under anesthesia is necessary, it is necessary to inform the anesthesiologist about the treatment of the patient with nifedipine.
In in vitro fertilization, in some cases, BMCC caused changes in the head of spermatozoa, which can lead to impaired sperm function. In cases in which repeated in vitro fertilization has not occurred for an unclear reason, the use of BMC, including nifedipine, can be considered a possible cause of failure.
During treatment, it is possible to obtain a false-positive result of a direct Coombs reaction and laboratory tests for antinuclear antibodies.
With the spectrophotometric determination of vanillyl-mandelic acid in the urine, nifedipine can be the cause of obtaining a false-inflated result, however, on the results of tests, conducted with the help of HPLC, nifedipine has no effect.
With caution, simultaneous treatment with nifedipine, disopyramide and flecainide should be carried out due to the possible enhancement of the inotropic effect.
Influence on the ability to drive vehicles and control mechanisms
During the period of treatment, patients need to be careful when driving vehicles and engaging in other potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.
Dosage and Administration
Inside after eating, without chewing and drinking enough liquid. The dose of the drug is selected by the doctor individually in accordance with the severity of the disease and the patient's sensitivity to the drug. For patients with concomitant severe cerebrovascular diseases and in elderly patients, the dose of the drug should be reduced.
Simultaneous food intake delays, but does not reduce the absorption of nifedipine from the gastrointestinal tract.
Chronic stable and vasospastic angina
The initial dose is 10 mg (1 tab.) 2-3 times / day. With an insufficiently pronounced clinical effect, the dose of the drug is gradually increased to 2 tab. (20 mg) 1-2 times / day. The maximum daily dose is 40 mg (4 tab./day).
The average daily dose is 10 mg (1 tab.) 2-3 times / day.
With an insufficiently pronounced clinical effect, a gradual increase in the dose of the drug to 20 mg (2 tab.) 2 times / day is possible. The maximum daily dose is 40 mg (4 tab./day).
With a 2-fold appointment, the minimum interval between doses of the drug should be at least 4 hours.
The duration of the course of treatment is determined by the attending physician.
Symptoms: headache, flushing of the skin of the face, prolonged pronounced decrease BLOOD PRESSURE, inhibition of sinus node function, bradycardia / tachycardia, bradyarrhythmia. In severe poisoning - loss of consciousness, coma.
Treatment: symptomatic therapy. In severe poisoning (collapse, depression of the sinus node), the stomach is washed (if necessary, the small intestine), activated charcoal is prescribed. The antidote is calcium preparations, shown intravenously the introduction of 10% calcium chloride or calcium gluconate, followed by a transfer to a long-term infusion. With a pronounced decrease in blood pressure, a slow intravenous administration of dopamine, dobutamine, adrenaline or norepinephrine is indicated. It is recommended to monitor the content of glucose (insulin release may decrease) and electrolytes in the blood (K + Sa 2+ ). With the development of heart failure - intravenous administration of strophanthin. In case of conduction disorders - atropine, isoprenaline or artificial pacemaker. Hemodialysis is not effective, plasmapheresis is recommended.
From the cardiovascular system: tachycardia, palpitations, arrhythmias, peripheral edema (ankles, feet, legs), manifestations of excessive vasodilation (asymptomatic decrease in blood pressure, development or aggravation of heart failure, "hot flashes" of blood to the skin of the face, flushing of the skin of the face, a feeling of heat), a pronounced decrease in blood pressure (rarely), syncope. In some patients, especially at the beginning of treatment or with an increase in the dose, there may be attacks of angina pectoris and in isolated cases - the development of myocardial infarction, which requires discontinuation of the drug.
From the nervous system: headache, dizziness, general weakness, increased fatigue, drowsiness. With prolonged use of the drug in high doses - paresthesia of the limbs, tremor, extrapyramidal (parkinsonian) disorders (ataxia, "mask-shaped" face, shuffling gait, tremor of the hands and fingers, difficulty swallowing), depression.
From the digestive system: dyspepsia (nausea, diarrhea or constipation), dry mouth, flatulence, increased appetite; rarely - gum hyperplasia, completely disappearing after discontinuation of the drug; with prolonged use - impaired liver function (intrahepatic cholestasis, increased activity of hepatic transaminases).
From the musculoskeletal system: arthritis, myalgia, swelling of the joints, cramps of the upper and lower extremities.
Allergic reactions: rarely - skin itching, urticaria, exanthemas, autoimmune hepatitis, exfoliative dermatitis, photodermatitis, anaphylactic reactions.
From the hematopoietic system: anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.
From the urinary system: an increase in daily diuresis, deterioration of kidney function (in patients with renal insufficiency).
Other: rarely - visual impairment (including transient blindness with maximum concentration of nifedipine in the blood plasma), gynecomastia (in elderly patients, completely disappearing after discontinuation of the drug), galactorrhea, hyperglycemia, pulmonary edema, bronchospasm, weight gain.
The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 ° C.
Shelf life - 5 years.
- Dosage form
- long-acting tablets
- 10 mg
- Number of tablets
- INN Russian
- Russian title