Comparison with other drugs for lowering blood pressure. Use in children

Selective calcium channel blocker, 1,4-dihydropyridine derivative. Has antianginal and hypotensive effects. Reduces the flow of extracellular calcium into cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries, and in high doses inhibits the release of calcium from intracellular stores. Reduces the number of functioning calcium channels without affecting the time of their activation, inactivation and recovery. It uncouples the processes of excitation and contraction in the myocardium (mediated by tropomyosin and troponin) and in vascular smooth muscles (mediated by calmodulin). In therapeutic doses, it normalizes the transmembrane current of calcium ions, which is disturbed in a number of pathological conditions, primarily in arterial hypertension. Does not affect the tone of the veins. Strengthens coronary blood flow, improves blood supply to ischemic areas of the myocardium without developing the “steal” phenomenon, and activates the functioning of collaterals. By dilating peripheral arteries, it reduces peripheral vascular resistance, myocardial tone, and afterload. It has almost no effect on the sinoatrial and AV nodes and has weak antiarrhythmic activity. Increases renal blood flow, causes moderate natriuresis. The negative chrono-, dromo- and inotropic effects are overlapped by reflex activation of the sympathoadrenal system in response to peripheral vasodilation.

The time for the onset of the clinical effect is 30 minutes, its duration is 12-24 hours. With long-term use (2-3 months), tolerance to the action of the drug develops.

Pharmacokinetics

Suction

After taking the drug orally, nifedipine is highly absorbed from the gastrointestinal tract (more than 90%). Bioavailability is 40-60% and increases when taken simultaneously with food. The modified release tablet dosage form provides gradual release of the active substance into the systemic circulation. C max in blood plasma is reached after 2.3-7.7 hours and is 17-41.4 ng/ml.

Distribution

Penetrates through the BBB and placental barrier, excreted in breast milk. Binding to blood plasma proteins is 90%. There is no cumulative effect.

Metabolism and excretion

Subject to the “first pass” effect through the liver. Completely metabolized in the liver. Excreted by the kidneys in the form of inactive metabolites (70-80% of the dose taken). 20% - with bile.

Pharmacokinetics in special clinical situations

In patients with hepatic impairment, total clearance is reduced and the half-life is increased.

Indications

- stable angina (angina pectoris);

- variant angina (Prinzmetal's angina);

- arterial hypertension.

Instructions for use / dosage

The tablets are taken whole in the morning with meals, without chewing and with a sufficient amount of liquid.

The drug should be discontinued gradually.

Side effect

From the cardiovascular system: hot flashes, flushing of the facial skin, feeling of heat, tachycardia, arrhythmia, peripheral edema (ankles, feet, legs), excessive decrease in blood pressure, syncope, heart failure; In some patients, especially at the beginning of treatment, angina attacks may occur, which requires discontinuation of the drug. Isolated cases of myocardial infarction have been described.

From the central nervous system and peripheral nervous system: headache, dizziness, general weakness, increased fatigue, drowsiness, paresthesia. With long-term use in high doses - extrapyramidal (parkinsonian) disorders (ataxia, mask-like face, shuffling gait, stiffness in the movements of the arms and legs, tremor of the hands and fingers, difficulty swallowing), depression.

From the digestive system: dry mouth, increased appetite, dyspepsia (nausea, diarrhea or constipation), gum hyperplasia (completely disappearing after discontinuation of the drug). With long-term use, liver function disorders are possible (intrahepatic cholestasis, increased activity of liver enzymes).

From the musculoskeletal system: arthritis, myalgia; rarely - arthralgia, swelling of the joints.

From the hematopoietic system: anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.

From the urinary system: increased daily diuresis, deterioration of renal function (in patients with renal failure).

Allergic reactions: itching, urticaria, exanthema, exfoliative dermatitis, photodermatitis, autoimmune hepatitis, acute allergic generalized reactions - swelling of the mucous membranes, laryngeal edema, bronchospasm (up to the development of shortness of breath, threatening the patient's life).

Others: visual impairment (including transient blindness when the maximum concentration of nifedipine in plasma is reached), gynecomastia (in elderly patients, completely disappearing after discontinuation of the drug), galactorrhea, hyperglycemia, pulmonary edema, weight gain.

Contraindications

- cardiogenic shock;

- acute period of myocardial infarction (during the first 4 weeks);

- unstable angina;

- severe aortic stenosis;

— severe arterial hypotension (systolic blood pressure below 90 mm Hg);

- simultaneous administration of rifampicin;

- pregnancy;

- lactation (breastfeeding);

- age under 18 years (efficacy and safety have not been established);

- hypersensitivity to nifedipine and other 1,4-dihydropyridine derivatives.

WITH caution the drug is used for severe mitral valve stenosis, hypertrophic obstructive cardiomyopathy, severe bradycardia or tachycardia, SSSU, for chronic heart failure, for mild or moderate arterial hypotension, for severe cerebrovascular accidents, gastrointestinal obstruction, renal and liver failure (especially in patients undergoing on hemodialysis, due to the high risk of excessive and unpredictable decrease in blood pressure), in the elderly.

Use during pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

Use for liver dysfunction

WITH caution The drug is used for liver failure.

Use for renal impairment

WITH caution the drug is used for renal failure (especially in patients on hemodialysis, due to the high risk of excessive and unpredictable decrease in blood pressure).

special instructions

The patient should be warned about the need to take the drug regularly, regardless of how they feel.

In patients on hemodialysis with high blood pressure and irreversible renal dysfunction and with a reduced total blood volume, the drug should be used with caution, because a sharp drop in blood pressure is possible.

If liver function is impaired, patients require careful monitoring and, if necessary, a dose reduction or the use of other dosage forms of nifedipine.

In case of severe heart failure, the dose of nifedipine should be selected carefully.

The simultaneous administration of beta-blockers must be carried out under conditions of careful medical supervision, since this may cause an excessive decrease in blood pressure, and in some cases, aggravation of heart failure.

During treatment, positive results are possible with direct Coombs test and laboratory tests for antinuclear antibodies.

It should be borne in mind that angina pectoris may occur at the beginning of treatment, especially after recent abrupt withdrawal of beta-blockers (the latter should be withdrawn gradually).

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 ergonovine-induced angina or coronary artery spasm, the detection of coronary spasm during angiography or the identification of an angiospastic component without confirmation (for example, with a different voltage threshold or with unstable angina, when ECG data indicate transient vasospasm).

Caution should be used when co-administering disopyramide and flecainamide due to a possible increase in inotropic effect.

If the patient requires surgery under general anesthesia, it is necessary to inform the anesthesiologist about the nature of the therapy being performed.

Caution should be exercised in elderly patients due to the high likelihood of age-related renal dysfunction.

You should not drink alcohol during therapy.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

Symptoms: headache, facial skin flushing, prolonged pronounced decrease in blood pressure, depression of the sinus node, bradycardia and/or tachycardia, bradyarrhythmia; in case of severe overdose - loss of consciousness, coma.

Treatment: gastric and small intestinal lavage. The antidote is calcium preparations; intravenous administration of a 10% solution of calcium chloride or calcium gluconate, followed by long-term infusion, is indicated. With a pronounced decrease in blood pressure, slow intravenous administration of dopamine, dobutamine, epinephrine (adrenaline) or norepinephrine (norepinephrine). For conduction disorders - atropine, isoprenaline or an artificial pacemaker. It is recommended to monitor blood glucose (insulin release may decrease) and electrolytes (potassium, calcium). Hemodialysis is not effective.

Drug interactions

The hypotensive effect of nifedipine is enhanced by simultaneous use with other antihypertensive drugs, nitrates, cimetidine (to a lesser extent with ranitidine), inhalation anesthesia agents, and diuretics.

It should be taken into account that calcium channel blockers may enhance the negative inotropic effect of amiodarone and quinidine.

When used together, nifedipine causes a decrease in the concentration of quinidine in the blood plasma; after discontinuation of nifedipine, a sharp increase in the concentration of quinidine may occur.

With simultaneous use, nifedipine increases the concentration of digoxin and theophylline in the blood plasma (the use of such a combination requires monitoring of the clinical effectiveness and the content of digoxin and theophylline in the blood plasma).

Inducers of microsomal liver enzymes (including rifampicin) reduce the concentration of nifedipine.

When combined with nifedipine and nitrates, tachycardia increases.

The hypotensive effect of nifedipine is reduced when used simultaneously with sympathomimetics, NSAIDs, estrogens, and calcium supplements.

Nifedipine can displace drugs characterized by a high degree of binding from protein binding (including indirect anticoagulants - coumarin and indanedione derivatives, anticonvulsants, NSAIDs, quinine, salicylates, sulfinpyrazone), as a result of which their concentration in the blood plasma may increase.

When used together, nifedipine inhibits the metabolism of prazosin and other alpha-blockers, as a result of which the hypotensive effect may be enhanced.

Nifedipine inhibits the elimination of vincristine from the body and may cause increased side effects of vincristine (if necessary, reduce the dose of vincristine).

When used together, lithium drugs can increase toxic effects (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

With the simultaneous administration of cephalosporins (for example, cefixime) and nifedipine, the bioavailability of the cephalosporin increases by 70%.

Procaine, quinidine, and other drugs known to prolong the QT interval enhance the negative inotropic effect and increase the risk of significant prolongation of the QT interval.

Diltiazem suppresses the metabolism of nifedipine in the body (the use of this combination requires careful monitoring and, if necessary, a reduction in the dose of nifedipine).

Grapefruit juice inhibits the metabolism of nifedipine in the body, and therefore its use with nifedipine is contraindicated.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored in a place protected from light, out of reach of children, at a temperature not exceeding 30°C. Shelf life - 3 years.

Contents [Show]

In this article you can read the instructions for use of the drug Corinfar. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Corinfar in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Corinfar in the presence of existing structural analogues. Use for the treatment of arterial hypertension and blood pressure reduction in adults, children, as well as during pregnancy and lactation. Interaction of the drug with alcohol.

Corinfar- selective blocker of “slow” calcium channels (SBCC), a derivative of 1,4-dihydropyridine. Has antianginal and hypotensive effects. Reduces the flow of extracellular Ca into cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries; in high doses inhibits the release of Ca from intracellular stores. In therapeutic doses, it normalizes the transmembrane Ca current, which is disturbed in a number of pathological conditions, primarily in arterial hypertension. Does not affect the tone of the veins. Strengthens coronary blood flow, improves blood supply to ischemic areas of the myocardium without developing the “steal” phenomenon, and activates the functioning of collaterals.

By dilating peripheral arteries, it reduces total peripheral vascular resistance, myocardial tone, afterload and myocardial oxygen demand. It has virtually no effect on the sinoatrial and atrioventricular nodes and has weak antiarrhythmic activity. Increases renal blood flow, causes moderate natriuresis.

The negative chrono-, dromo- and inotropic effects are overlapped by reflex activation of the sympathoadrenal system and an increase in heart rate in response to peripheral vasodilation.

The onset of the clinical effect is 20 minutes and its duration is 4-6 hours.

Compound

Nifedipine + excipients.

Pharmacokinetics

Absorption is high (more than 90%). Bioavailability - 50-70%. Eating increases bioavailability. Penetrates through the blood-brain and placental barriers and is excreted in breast milk. Communication with blood plasma proteins (albumin) - 95%. Completely metabolized in the liver.

It is excreted by the kidneys in the form of an inactive metabolite (60-80% of the dose taken), 20% with bile. There is no cumulative effect. Chronic renal failure, hemodialysis and peritoneal dialysis do not affect pharmacokinetics.

Indications

• chronic stable angina (angina pectoris);
• Prinzmetal's angina (variant angina);
• arterial hypertension.

Release forms

Extended-release film-coated tablets 40 mg Corinfar UNO.

Extended-release film-coated tablets 20 mg Corinfar retard.

Instructions for use and dosage

Take orally after eating, without chewing and with a sufficient amount of 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 should be reduced.

Simultaneous food intake delays, but does not reduce, the absorption of the active substance from the gastrointestinal tract.

Chronic stable and vasospastic angina

Essential hypertension

The average daily dose is 10 mg (1 tablet) 2-3 times a day.

If the clinical effect is not sufficiently pronounced, it is possible to gradually increase the dose of the drug to 20 mg (2 tablets) 2 times a day. The maximum daily dose is 40 mg (4 tablets per day).

The duration of treatment is determined by the attending physician.

Side effect

• tachycardia;
• heartbeat;
• arrhythmias;
• peripheral edema (ankles, feet, legs);
• manifestations of excessive vasodilation (asymptomatic decrease in blood pressure, development or worsening of heart failure, “flushes” of blood to the facial skin, hyperemia of the egg skin, feeling of heat);
• pronounced decrease in blood pressure (rare);
• syncope;
• headache;
• dizziness;
• general weakness;
• increased fatigue;
• drowsiness;
• paresthesia of the limbs;
• tremor;
• extrapyramidal (parkinsonian) disorders (ataxia, “mask-like” face, shuffling gait, tremor of the hands and fingers, difficulty swallowing);
• depression;
• dyspepsia (nausea, diarrhea or constipation);
• dry mouth;
• flatulence;
• increased appetite;
• arthritis;
• myalgia;
• swelling of the joints;
• spasms of the upper and lower extremities;
• skin itching;
• hives;
• exanthema;
• autoimmune hepatitis;
• exfoliative dermatitis;
• photodermatitis;
• anaphylactic reactions;
• anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis;
• increase in daily diuresis;
• deterioration of kidney function (in patients with renal failure);
• visual impairment (including transient blindness at the maximum concentration of nifedipine in the blood plasma);
• gynecomastia (in elderly patients, completely disappearing after withdrawal);
• galactorrhea;
• pulmonary edema;
• bronchospasm;
• increase in body weight.

Contraindications

• arterial hypotension (systolic blood pressure below 90 mm Hg);
• cardiogenic shock, collapse;
• chronic heart failure in the stage of decompensation;
• severe aortic stenosis;
• unstable angina;
• acute myocardial infarction (first 4 weeks);
• combined use with rifampicin;
• pregnancy (1st trimester);
• lactation period;
• hypersensitivity to nifedipine and other 1,4-dihydropyridine derivatives or other components of the drug.

Use during pregnancy and breastfeeding

Contraindication: pregnancy (1st trimester); lactation period. With caution: pregnancy (2nd and 3rd trimesters).

Use in children

With caution in children under 18 years of age (efficacy and safety have not been established).

special instructions

During the treatment period, you must refrain from taking ethanol (alcohol). 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 recent abrupt withdrawal of beta-blockers (the latter should be withdrawn gradually).

The simultaneous administration of beta-blockers must be carried out under conditions of careful medical supervision, as this may cause an excessive decrease in blood pressure, and in some cases, aggravation of symptoms of heart failure.

In case of severe heart failure, the drug is dosed with great caution.

Diagnostic criteria for prescribing the drug for vasospastic angina are: a classic clinical picture, accompanied by an increase in the ST segment, the occurrence of ergonovine-induced angina or coronary artery spasm, detection of coronary spasm during angiography or identification of an angiospastic component without confirmation (for example, with a different voltage threshold or with unstable angina, when electrocardiogram data indicate transient vasospasm).

For patients with severe obstructive cardiomyopathy, there is a risk of increased frequency, severity and duration of angina attacks after taking nifedipine; in this case, discontinuation of the drug is necessary.

In patients with irreversible renal failure on hemodialysis, high blood pressure and a reduced total blood volume, the drug should be used with caution, as a sharp drop in blood pressure is possible. Patients with impaired liver function are closely monitored; if necessary, reduce the dose of the drug and/or use other dosage forms of nifedipine.

If surgical intervention under general anesthesia is necessary, it is necessary to inform the anesthesiologist about the patient's treatment with nifedipine.

During in vitro fertilization, in some cases, BMCC caused changes in the head part of the sperm, which can lead to dysfunction of the sperm. In cases in which repeated in vitro fertilization has not been carried out for an unclear reason, the use of BMCC, including nifedipine, can be considered a possible reason for failure.

During treatment, it is possible to obtain a false-positive result from the direct Coombs test and laboratory tests for antinuclear antibodies.

In the spectrophotometric determination of vanillyl-mandelic acid in urine, nifedipine may cause a falsely elevated result, however, nifedipine does not affect the results of tests performed using HPLC.

Caution should be exercised during simultaneous treatment with nifedipine, disopyramide and flecainamide due to a possible increase in inotropic effect.

Impact on the ability to drive a car and other mechanisms

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Drug interactions

With the simultaneous use of other antihypertensive drugs, as well as tricyclic antidepressants, nitrates, cimetidine, inhalational anesthetics, diuretics, the hypotensive effect of nifedipine may be enhanced.

BMCCs may further enhance the negative inotropic effects of antiarrhythmic drugs such as amiodarone and quinidine.

When combining Corinfar with nitrates, tachycardia increases.

Diltiazem inhibits the metabolism of nifedipine in the body, which may require a reduction in the dose of nifedipine when these drugs are prescribed simultaneously.

Reduces the concentration of quinidine in blood plasma.

Increases the concentration of digoxin and theophylline in the blood plasma.

Rifampicin accelerates the metabolism of nifedipine; co-administration is not recommended.

When administered concomitantly with cephalosporins (for example, cefixime), the concentration of cephalosporins in the blood may increase.

Sympathomimetics, non-steroidal anti-inflammatory drugs (NSAIDs) (suppression of prostaglandin synthesis in the kidneys and retention of sodium ions and fluid in the body), estrogens (fluid retention in the body) reduce the hypotensive effect.

Corinfar can displace drugs with a high degree of binding from protein binding (including indirect anticoagulants - coumarin and indanedione derivatives, anticonvulsants, NSAIDs, quinine, salicylates, sulfinpyrazone), as a result of which their concentration in the blood plasma may increase.

Nifedipine inhibits the metabolism of prazosin and other alpha-blockers, which may lead to increased hypotensive effects.

If necessary, the dose of vincristine is reduced, because Nifedipine inhibits its elimination from the body, which may cause increased side effects.

Lithium preparations may enhance toxic effects (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

When procainamide, quinidine and other drugs known to prolong the QT interval are co-administered, the risk of significant prolongation of the QT interval increases.

Grapefruit juice inhibits the metabolism of nifedipine in the body and is therefore contraindicated during treatment with nifedipine.

Nifedipine is metabolized by the CYP3A isoenzyme, and therefore the simultaneous use of drugs that inhibit this system can lead to interaction between this drug and nifedipine: for example, macrolides, antiviral drugs (for example, amprenavir, indinavir, nelfinavir, ritonavir or saquinavir), antifungal drugs of the group azoles (ketoconazole, itraconazole or fluconazole) cause an increase in the concentration of nifedipine in the blood plasma.

Taking into account the experience with the use of BMCC nimodipine, similar interactions with nifedipine cannot be excluded: carbamazepine, phenobarbital can cause a decrease in the concentration of nifedipine in the blood plasma, and valproic acid can cause an increase in the concentration of nifedipine in the blood plasma.

Analogues of the drug Corinfar

• Adalat;
• Vero Nifedipine;
• Calcigard retard;
• Cordafen;
• Cordaflex;
• Cordipin;
• Cordipin retard;
• Corinfar retard;
• Corinfar UNO;
• Nicardia;
• Nicardia SD retard;
• Nifadil;
• Nifebene;
• Nifehexal;
• Nifedex;
• Nifedicap;
• Nifedicor;
• Nifedipine;
• Nifedipine FPO;
• Nifecard;
• Nifecard HL;
• Nifelat;
• Nifesan;
• Osmo Adalat;
• Sanfidipin;
• Sponif 10;
• Phenigidine.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps and look at the available analogues for the therapeutic effect.

Corinfar belongs to the category of selective calcium channel blockers and is a derivative of the substance 1,4-dihydropyridine.

This drug has a hypotensive and antianginal effect and does not affect the tone of the veins. The mechanism of its action is to reduce the entry of extracellular calcium into cardiomyocytes and smooth muscle cells of peripheral and coronary arteries.

In this article we will look at why doctors prescribe Corinfar, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Corinfar can be read in the comments.

Composition and release form

There are tablets Corinfar (10 mg), Corinfar Retard (20 mg) and Corinfar Uno (40 mg).

• One tablet of Corinfar contains the active ingredient nifedipine (10 mg) and auxiliary components - lactose monohydrate, macrogol 35000, magnesium stearate, potato starch, talc, povidone, hypromelose, MCC, titanium dioxide, dye E104.
• One Corinfar Retard tablet contains 20 mg of nifedipine, and Corinfar Uno contains 40 mg of nifedipine.

Clinical and pharmacological group: calcium channel blocker.

Indications for use

Corinfar is usually prescribed to lower blood pressure and reduce pain symptoms due to angina pectoris. Indications for its use are:

• arterial hypertension;
• stable chronic angina;
• Prinzmetal's angina.

The effect of the drug begins approximately 20 minutes after ingestion and lasts from four to six hours.

pharmachologic effect

Corinfar is a drug from the group of calcium channel blockers, which has a pronounced antianginal and hypotensive effect. The composition includes the active substance nifedipine, a synthetic derivative of dihydropyridine.

The mechanism of action of the drug is associated with its ability to slow down the penetration of calcium ions into the cells of the smooth muscle layer of blood vessels and the heart through slow L-type calcium channels. Due to a decrease in the concentration of calcium ions in the cells of the myocardium and the smooth muscle layer of blood vessels, the contractile activity of the cells of the vascular wall decreases, and the peripheral and coronary vessels expand.

Instructions for use

According to the instructions for use, Corinfar tablets are taken orally, without chewing, after meals, with a small amount of liquid. Simultaneous food intake does not reduce the absorption of nifedipine from the gastrointestinal tract, but delays it.
The doctor prescribes the dose of the drug and the period of treatment based on clinical indications, taking into account the severity of the disease and the patient’s individual sensitivity to the drug.

Chronic stable and vasospastic angina:

• Initial dose - 10 mg (1 tablet) 2-3 times/day. If the clinical effect is not sufficiently pronounced, the dose of the drug is gradually increased to 2 tablets. (20 mg) 1-2 times/day. The maximum daily dose is 40 mg (4 tablets/day).

Essential hypertension:

• The average daily dose is 10 mg (1 tablet) 2-3 times a day. If the clinical effect is not sufficiently pronounced, it is possible to gradually increase the dose of the drug to 20 mg (2 tablets) 2 times a day. The maximum daily dose is 40 mg (4 tablets/day).

When prescribed twice, the minimum interval between doses of the drug should be at least 4 hours.

When prescribing Corinfar to patients with concomitant severe cerebrovascular pathologies and elderly patients, the dose should be reduced.

Contraindications

The drug should not be used in the following cases:

• collapse, cardiogenic shock;
• unstable angina;
• severe aortic stenosis;
• pregnancy in the first trimester;
• breast-feeding;
• simultaneous use with rifampicin;
• chronic heart failure (CHF) in the stage of decompensation;
• acute myocardial infarction (during the first 4 weeks);
• arterial hypotension (systolic pressure below 90 mmHg);
• hypersensitivity to the components of the drug and other 1,4-dihydropyridine derivatives.

The drug should be taken with caution if the patient has:

• mitral valve stenosis;
• severe tachycardia or bradycardia;
• arterial malignant hypertension;
• severe forms of cerebrovascular accident;
• myocardial infarction, especially with left ventricular failure;
• intestinal obstruction;
• renal and liver failure;
• pregnancy in the second and third trimesters;
• age under 18 years (reliable information about effectiveness and safety is not provided);
• combined use with beta-blockers, digoxin.

When taking tablets, you must be careful when driving, as the drug can affect the speed of the psychomotor reaction.

Side effects

The drug may have the following negative effects:

• swelling of the joints, arthritis, limb cramps, myalgia;
• anemia, thrombocytopenia, leukopenia and other disorders of the hematopoietic system;
• palpitations, tachycardia, swelling of the lower extremities, arrhythmia and other cardiovascular problems;
• dizziness, headache, drowsiness, general weakness and fatigue, other disorders of the central nervous system;
• nausea, constipation, flatulence, increased appetite, dry mouth, sometimes liver function worsens;
• in case of renal failure, kidney function may deteriorate;
• sometimes an allergic reaction in the form of dermatitis, skin itching, urticaria.

After using Corinfar in increased quantities, headaches, facial flushing are observed, blood pressure decreases, tachycardia or bradycardia, and bradyarrhythmia occur. Severe poisoning provokes loss of consciousness or coma.

Analogues of Corinfar

Structural analogues of the active substance:

• Adalat;
• Vero Nifedipine;
• Calcigard retard;
• Cordafen;
• Cordaflex;
• Cordipin;
• Nicardia;
• Nicardia SD retard;
• Nifadil;
• Nifebene;
• Nifehexal;
• Nifedex;
• Nifedicap;
• Nifedicor;
• Nifedipine;
• Nifedipine FPO;
• Nifecard;
• Nifecard HL;
• Nifelat;
• Nifesan;
• Osmo Adalat;
• Sanfidipin;
• Sponif 10;
• Phenigidine.

Attention: the use of analogues must be agreed with the attending physician.

Price

The average price of CORINTHAR, tablets in pharmacies (Moscow) is 100 rubles.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Corinfar is a selective calcium channel blocker. The instructions for use explain at what pressure these tablets can be taken. Cardiovascular medicine is prescribed for the treatment of arterial hypertension and reduction of high blood pressure. The drug has a pronounced antianginal and hypotensive effect.

Release forms and composition

Produce:

1. Extended-release film-coated tablets 10 mg.
2. Extended-release film-coated tablets 20 mg “Corinfar retard”.
3. Extended-release film-coated tablets 40 mg "Corinfar UNO".

One Corinfar tablet includes:

nifedipine - 10 mg;

excipients: lactose monohydrate - 15.8 mg, potato starch - 15.7 mg, microcrystalline cellulose - 15.5 mg, povidone K25 - 2.7 mg, magnesium stearate - 0.3 mg.

One tablet of Corinfar Retard contains:

nifedipine - 20 mg;

excipients: lactose monohydrate - 31.6 mg, potato starch - 31.4 mg, microcrystalline cellulose - 31 mg, povidone K25 - 5.4 mg, magnesium stearate - 0.6 mg.

One tablet of Corinfar UNO includes:

nifedipine - 40 mg;

excipients - lactose monohydrate - 30 mg, microcrystalline cellulose - 48.5 mg, cellulose - 10 mg, hypromellose 4000 cP - 20 mg, magnesium stearate - 1.5 mg, colloidal silicon dioxide - 0.75 mg.

Pharmacological properties

The active substance, nifedipine, is a synthetic derivative of dihydropinidine and belongs to the group of calcium channel blockers. The mechanism of action of the drug "Corinfar", the instructions for use confirm this, is due to the ability of nifedipine to block slow L-type calcium channels, slowing down the penetration of calcium ions into the smooth muscle layer of the heart and blood vessels.

Due to a decrease in the concentration of calcium ions in the myocardium, the contractile activity of the cells of the vascular walls and the expansion of coronary and peripheral vessels decrease. "Corinfar" increases coronary blood flow, activates the work of collaterals, improves blood supply to the myocardium in ischemic areas.

The use of the drug reduces peripheral vascular resistance due to the expansion of peripheral arteries, increases myocardial tone, while simultaneously reducing its need for oxygen. The therapeutic effect of taking the drug occurs within 20 minutes and lasts for 12 hours.

The use of Corinfar for a long time, more than 3 months, causes the body to tolerate its action. In patients with renal failure, the half-life of the drug is prolonged.

Corinfar tablets: what does the medicine help with?

Indications for the use of Corinfar Retard and UNO are the same - the choice of drug is made by the attending physician depending on the severity of the disease and individual sensitivity. Tablets are prescribed if the patient has:

• Chronic angina pectoris.
• Arterial hypertension.
• Vasospastic angina (Prinzmetal's angina).

The drug "Corinfar": instructions for use

Your doctor will explain at what pressure to take the medicine. As a rule, it is prescribed for high blood pressure (160 and above) to reduce it. The tablets are taken orally after meals, without chewing and with a sufficient amount of liquid. The dose of the drug is selected by a specialist 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 should be reduced. Simultaneous food intake delays, but does not reduce, the absorption of the active substance from the gastrointestinal tract.

• Essential hypertension.

The average daily dose is 10 mg (1 tablet) 2-3 times a day. If the clinical effect is not sufficiently pronounced, it is possible to gradually increase the dose of the drug to 20 mg (2 tablets) 2 times a day. The maximum daily dose is 40 mg (4 tablets per day). When prescribed twice, 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.

• Chronic stable and vasospastic angina.

The initial dose is 10 mg (1 tablet) 2-3 times a day. If the clinical effect is not sufficiently pronounced, the dose of the drug is gradually increased to 2 tablets (20 mg) 1-2 times a day. The maximum daily dose is 40 mg (4 tablets per day).

Contraindications

• Unstable angina.
• Breast-feeding.
• Arterial hypotension (with systolic blood pressure (BP) below 90 mmHg).
• I trimester of pregnancy.
• Severe aortic stenosis.
• Hypersensitivity to the components of the drug "Corinfar", from which the tablets can cause side effects, and other 1,4-dihydropyridine derivatives.
• Chronic heart failure in the stage of decompensation.
• Simultaneous use with rifampicin.
• Cardiogenic shock, collapse.
• Acute myocardial infarction (first 4 weeks).

It is recommended to prescribe the drug with caution to patients with hypertrophic obstructive cardiomyopathy, mitral valve stenosis, severe tachycardia or bradycardia, malignant arterial hypertension, sick sinus syndrome (SSNS), hypovolemia, myocardial infarction with left ventricular failure, severe cerebrovascular accidents, gastrointestinal obstruction (gastrointestinal tract), liver and kidney failure, hemodialysis, combination with beta-blockers and digoxin, as well as in the II and III trimesters of pregnancy; under the age of 18.

Side effects

According to the instructions, the use of Corinfar can cause the following side effects:

• irritability, headaches, drowsiness, dizziness, sleep disturbances, paresthesia, tremor, myalgia, fatigue;
• increased angina attacks, reflex tachycardia, sharp drop in blood pressure;
• discomfort in the stomach, nausea, stool disturbances, vomiting;
• transient gum hyperplasia, swelling of the extremities;
• various allergic reactions, from skin hyperemia to angioedema;
• thrombocytopenic purpura, thrombocytopenia, leukopenia, anemia.

Long-term use of the drug in large dosages can provoke the development of such negative consequences as gynecomastia in men, hyperglycemia in patients with diabetes, and the development of myocardial infarction. Abrupt cessation of treatment can cause ischemia and arterial hypertension, so discontinuation of the drug must be carried out gradually.

Analogues of the drug "Corinfar"

Complete analogues for the active element:

1. Calcigard retard.
2. Nicardia.
3. Nifecard.
4. Cordaflex.
5. Sponif 10.
6. Nifehexal.
7. Sanfidipin.
8. "Corinfar" retard.
9. Nifebene.
10. Nifedicap.
11. Nifelat.
12. Phenigidine.
13. Nifesan.
14. Vero Nifedipin.
15. Osmo Adalat.
16. Nifedicor.
17. Cordipin retard.
18. "Corinfar" UNO.
19. Nifadil.
20. Nifedex.
21. Cordafen.
22. Nifedipine.
23. Cordipin.
24. Adalat.

Price and terms of sale

The average price of Corinfar in pharmacies (Moscow) is 78 rubles for 50 tablets of 10 mg. In Minsk only analogues are sold. The price of “Corinfar Uno” in Kyiv reaches 211 hryvnia, in Kazakhstan - 2070 hryvnia. In Russia, the drug is available without a prescription.

Release form

Modified-release, film-coated tablets.

1 tablet contains nifedipine 40 mg;
excipients (core): MCC; cellulose; lactose; hypromellose 4000 mPa.s; magnesium stearate; silicon oxide colloidal anhydride shell: hypromellose 15 mPa.s; macrogol 6000; macrogol 400; iron oxide red (E172); titanium dioxide (E171); talc

Package

pharmachologic effect

Selective blocker of “slow” calcium channels, a 1,4-dihydropyridine derivative. It has an antianginal and hypotensive effect.

Indications

Stable angina (angina pectoris), vasospastic angina (Prinzmetal angina), arterial hypertension.

Contraindications

Hypersensitivity to nifedipine and other 1,4-dihydropyridine derivatives, arterial hypotension (with blood pressure below 90 mm Hg), cardiogenic shock, severe aortic stenosis, unstable angina, acute myocardial infarction (within the first 4 weeks), simultaneous use rifampicin, pregnancy, breastfeeding; age under 18 years (efficacy and safety have not been established).
Use with caution in patients with severe mitral valve stenosis, hypertrophic obstructive cardiomyopathy, severe bradycardia or tachycardia, sick sinus syndrome, heart failure, mild or moderate arterial hypertension, severe cerebrovascular accidents, myocardial infarction with left ventricular failure, gastrointestinal obstruction, renal and hepatic insufficiency , patients on hemodialysis (due to the risk of arterial hypotension) are elderly.

Directions for use and doses

Orally, in the morning during meals, without chewing and with a sufficient amount of liquid.
1 tablet Corinfar® UNO (40 mg nifedipine) 1 time per day.

Side effects

From the cardiovascular system: tachycardia, arrhythmia, peripheral edema (ankles, feet, legs), excessive decrease in blood pressure, flushing of the face, feeling of heat, syncope, heart failure (more often - an increase in signs of an existing one).
In patients with high blood pressure (hypertension) or coronary heart disease, after suddenly stopping the drug, a “withdrawal phenomenon” may develop, expressed by a sharp increase in blood pressure (hypertensive crisis) or a decrease in blood supply to the heart muscle (myocardial ischemia).
From the nervous system: headache, dizziness, general weakness, increased fatigue, drowsiness.
From the digestive system: dyspepsia (nausea, diarrhea or constipation), dry mouth, increased appetite.
Allergic reactions: itching, urticaria, exanthema, exfoliative dermatitis, photodermatitis, autoimmune hepatitis, acute allergic generalized reactions (for example, swelling of the mucous membranes, larynx, spasm of the bronchial muscles up to the development of shortness of breath, threatening the patient's life).
From the hematopoietic organs: anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.
From the urinary system: increased daily diuresis, deterioration of renal function (in patients with renal failure).
Other: visual impairment (including transient blindness - at the maximum concentration of nifedipine in plasma), gynecomastia (in elderly patients, completely disappearing after discontinuation of the drug), galactorrhea, hyperglycemia, pulmonary edema, weight gain.

special instructions

The patient should be warned about the need to take the drug regularly, regardless of how they feel.
In patients on hemodialysis with high blood pressure and irreversible renal dysfunction and with a reduced total blood volume, the drug should be used with caution, because a sharp drop in blood pressure is possible.
If liver function is impaired, patients require careful monitoring and, if necessary, a dose reduction or the use of other dosage forms of nifedipine.
In case of severe heart failure, the dose of nifedipine should be selected carefully.
The simultaneous administration of beta-blockers must be carried out under conditions of careful medical supervision, since this may cause an excessive decrease in blood pressure, and in some cases, aggravation of heart failure.
During treatment, positive results are possible with direct Coombs test and laboratory tests for antinuclear antibodies.
It should be borne in mind that angina pectoris may occur at the beginning of treatment, especially after recent abrupt withdrawal of beta-blockers (the latter should be withdrawn gradually).
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 ergonovine-induced angina or coronary artery spasm, the detection of coronary spasm during angiography or the identification of an angiospastic component without confirmation (for example, with a different voltage threshold or with unstable angina, when ECG data indicate transient vasospasm).
Caution should be used when co-administering disopyramide and flecainamide due to a possible increase in inotropic effect.
If the patient requires surgery under general anesthesia, it is necessary to inform the anesthesiologist about the nature of the therapy being performed.
Caution should be exercised in elderly patients due to the high likelihood of age-related renal dysfunction.
You should not drink alcohol during therapy.
Impact on the ability to drive vehicles and operate machinery
During the treatment period, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Drug interactions

The hypotensive effect of nifedipine is enhanced by the simultaneous use of other antihypertensive drugs, nitrates, cimetidine (to a lesser extent, ranitidine), inhalational anesthetics, and diuretics.
Certain drugs from the CCB group can further enhance the negative inotropic effect (lowering the force of heart contractions) of antiarrhythmic drugs such as amiodarone and quinidine.
Nifedipine causes a decrease in the concentration of quinidine in the blood plasma; after discontinuation of nifedipine, the concentration of quinidine may sharply increase.
Increases the concentration of digoxin and theophylline in the blood plasma, and therefore the clinical effect and the content of digoxin and theophylline in the blood plasma should be monitored.
Inducers of microsomal liver enzymes (rifampicin, etc.) reduce the concentration of nifedipine.
In combination with nitrates, tachycardia increases.
The hypotensive effect is reduced by sympathomimetics, NSAIDs, estrogens, and calcium supplements.
Nifedipine can displace drugs characterized by a high degree of binding from protein binding (including indirect anticoagulants, coumarin and indanedione derivatives, anticonvulsants, quinine, NSAIDs, including salicylates, sulfinpyrazone), as a result of which their concentration may increase in blood plasma.
Suppresses the metabolism of prazosin and other alpha-blockers, as a result of which the hypotensive effect may be enhanced.
Nifedipine inhibits the elimination of vincristine from the body and may cause increased side effects of vincristine (if necessary, reduce the dose of vincristine).
Lithium preparations can increase toxic effects (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).
With the simultaneous administration of cephalosporins (for example, cefixime) and nifedipine in probands, the bioavailability of cephalosporin increased by 70%.
Procaine, quinidine, and other drugs known to prolong the QT interval enhance the negative inotropic effect and increase the risk of significant prolongation of the QT interval.
Diltiazem suppresses the metabolism of nifedipine in the body (when used together, careful monitoring is necessary); if necessary, reduce the dose of nifedipine.
Grapefruit juice suppresses the metabolism of nifedipine in the body, and therefore its use with nifedipine is contraindicated.

AWD Pharma, GmbH & Co.KG (Germany)

Active substance:

ATX code:

Cardiovascular system (C) > Calcium channel blockers (C08) > Selective calcium channel blockers with a predominant effect on blood vessels (C08C) > Dihydropyridine derivatives (C08CA) > Nifedipine (C08CA05)

Clinical and pharmacological group:

Calcium channel blocker

Release form, composition and packaging

The drug is available with a prescription tablet. retard 40 mg: 20, 50 or 100 pcs.
Reg. No.: RK-LS-5No. 007637 dated 06/25/2003 - Canceled
Retard tablets are red-brown, round, biconvex, odorless.

1 tab.
nifedipine 40 mg
Excipients: microcrystalline cellulose, lactose, hypromellose 4000 mPa.s, magnesium stearate, colloidal anhydride silicon oxide.

Shell composition: hypromellose 15 mPa.s, macrogol 6000, macrogol 400, red iron oxide (E172), titanium dioxide (E171), talc.

10 pieces. - blisters (2) - cardboard packs.
10 pieces. - blisters (5) - cardboard packs.
10 pieces. - blisters (10) - cardboard packs.

Description of the active components of the drug CORINPHAR UNO 40. The scientific information provided is general and cannot be used to make a decision about the possibility of using a particular drug.

pharmachologic effect

Selective class II calcium channel blocker, dihydropyridine derivative. Inhibits the flow of calcium into cardiomyocytes and vascular smooth muscle cells. Has antianginal and hypotensive effects. Reduces the tone of vascular smooth muscles. Dilates coronary and peripheral arteries, reduces peripheral vascular resistance, blood pressure and slightly reduces myocardial contractility, reduces afterload and myocardial oxygen demand. Improves coronary blood flow. It has virtually no antiarrhythmic activity. Does not inhibit myocardial conductivity.

Pharmacokinetics

When taken orally, it is quickly absorbed from the gastrointestinal tract. It is metabolized during the “first pass” through the liver. Protein binding is 92-98%. Metabolized in the liver to form inactive metabolites. T1/2 - about 2 hours. Excreted mainly by the kidneys in the form of metabolites and in trace amounts unchanged; 20% is excreted through the intestines in the form of metabolites.

Indications for use

Prevention of angina attacks (including vasospastic angina), in some cases - relief of angina attacks; arterial hypertension, hypertensive crises; Raynaud's disease.

Dosage regimen

Individual. For oral administration, the initial dose is 10 mg 3-4 times a day. If necessary, the dose is gradually increased to 20 mg 3-4 times a day. In special cases (variant angina, severe arterial hypertension), for a short time the dose can be increased to 30 mg 3-4 times a day. To relieve a hypertensive crisis, as well as an attack of angina, 10-20 mg (rarely 30 mg) can be used sublingually.

IV to relieve an attack of angina or hypertensive crisis - 5 mg for 4-8 hours.

Intracoronary to relieve acute spasms of the coronary arteries, a bolus of 100-200 mcg is administered. For stenosis of large coronary vessels, the initial dose is 50-100 mcg.

Maximum daily doses: when taken orally - 120 mg, when administered intravenously - 30 mg.

Side effect

From the cardiovascular system: hyperemia of the skin, sensation of warmth, tachycardia, arterial hypotension, peripheral edema; rarely - bradycardia, ventricular tachycardia, asystole, increased attacks of angina.

From the digestive system: nausea, heartburn, diarrhea; rarely - deterioration of liver function; in isolated cases - gum hyperplasia. With long-term use in high doses, dyspeptic symptoms, increased activity of liver transaminases, and intrahepatic cholestasis are possible.

From the central nervous system and peripheral nervous system: headache. With long-term use in high doses, paresthesia, muscle pain, tremors, mild visual disturbances, and sleep disturbances are possible.

From the hematopoietic system: in isolated cases - leukopenia, thrombocytopenia.

From the urinary system: increased daily diuresis. With long-term use in high doses, renal dysfunction is possible.

From the endocrine system: in isolated cases - gynecomastia.

Allergic reactions: skin rash.

Local reactions: with intravenous administration, a burning sensation at the injection site is possible.

Within 1 minute after intracoronary administration, the negative inotropic effect of nifedipine, an increase in heart rate, and arterial hypotension may occur; these symptoms gradually disappear after 5-15 minutes.

Contraindications for use

Arterial hypotension (systolic blood pressure below 90 mm Hg), collapse, cardiogenic shock, severe heart failure, severe aortic stenosis; hypersensitivity to nifedipine.

Use during pregnancy and breastfeeding

Adequate and strictly controlled studies of the safety of nifedipine during pregnancy have not been conducted. The use of nifedipine during pregnancy is not recommended.

Since nifedipine is excreted in breast milk, its use should be avoided during lactation or breastfeeding should be discontinued during treatment.

Experimental studies revealed the embryotoxic, fetotoxic and teratogenic effects of nifedipine.

Use for liver dysfunction

In case of liver dysfunction, Nifedipine should be used only in a clinical setting under the strict supervision of a physician. In patients with impaired liver function, high doses of nifedipine should be avoided.

Use for renal impairment

In case of impaired renal function, Nifedipine should be used only in a clinical setting under the strict supervision of a physician. In patients with impaired renal function, high doses of nifedipine should be avoided.

Use in elderly patients

Elderly patients are more likely to have decreased cerebral blood flow due to acute peripheral vasodilation.

special instructions

Nifedipine should be used only in a clinical setting under the strict supervision of a physician for acute myocardial infarction, severe cerebrovascular accidents, diabetes mellitus, liver and kidney dysfunction, malignant arterial hypertension and hypovolemia, as well as in patients on hemodialysis. In patients with impaired liver and/or kidney function, the use of nifedipine in high doses should be avoided. Elderly patients are more likely to have decreased cerebral blood flow due to acute peripheral vasodilation.

When taken orally, nifedipine can be chewed to accelerate the effect.

If chest pain occurs during treatment, nifedipine should be discontinued. Nifedipine should be discontinued gradually, since withdrawal syndrome may develop if it is suddenly stopped (especially after long-term treatment).

When administered intracoronarily in the presence of stenosis of two vessels, nifedipine cannot be administered into the third open vessel due to the danger of a pronounced negative inotropic effect.

During the course of treatment, avoid drinking alcohol due to the risk of excessive reduction in blood pressure.

Impact on the ability to drive vehicles and operate machinery

At the beginning of treatment, you should avoid driving vehicles and other potentially dangerous activities that require rapid psychomotor reactions. In the process of further treatment, the degree of restrictions is determined depending on the individual tolerance of nifedipine.

Drug interactions

When used simultaneously with antihypertensive drugs, diuretics, phenothiazine derivatives, the antihypertensive effect of nifedipine is enhanced.

When used simultaneously with anticholinergic drugs, memory and attention problems may occur in elderly patients.

When used simultaneously with beta-blockers, severe arterial hypotension may develop; in some cases - the development of heart failure.

When used simultaneously with nitrates, the antianginal effect of nifedipine is enhanced.

When used simultaneously with calcium preparations, the effectiveness of nifedipine decreases due to an antagonistic interaction caused by an increase in the concentration of calcium ions in the extracellular fluid.

Cases of the development of muscle weakness have been described when used simultaneously with magnesium salts.

When used simultaneously with digoxin, it is possible to slow down the excretion of digoxin from the body and, consequently, increase its concentration in the blood plasma.

When used simultaneously with diltiazem, the antihypertensive effect is enhanced.

When used simultaneously with theophylline, changes in the concentration of theophylline in the blood plasma are possible.

Rifampin induces the activity of liver enzymes, accelerating the metabolism of nifedipine, which leads to a decrease in its effectiveness.

When used simultaneously with phenobarbital, phenytoin, carbamazepine, the concentration of nifedipine in the blood plasma decreases.

There are reports of an increase in the concentration of nifedipine in the blood plasma and an increase in its AUC when used simultaneously with fluconazole and itraconazole.

When used simultaneously with fluoxetine, the side effects of nifedipine may increase.

In some cases, when used simultaneously with quinidine, a decrease in the concentration of quinidine in the blood plasma is possible, and when nifedipine is discontinued, a significant increase in the concentration of quinidine is possible, which is accompanied by a prolongation of the QT interval on the ECG.

Cimetidine and, to a lesser extent, ranitidine, increase the concentration of nifedipine in the blood plasma and, thus, enhance its antihypertensive effect.

Ethanol may enhance the effect of nifedipine (excessive hypotension), which causes dizziness and other undesirable reactions.

- 10 mg;

Shell composition: titanium dioxide - 0.77 mg, macrogol 6000 - 0.48 mg, quinoline yellow dye - 0.27 mg, talc- 0.38 mg, hypromellose - 2.88 mg, macrogol 35000- 0.22 mg.

One tablet Corinthara Retard includes:

• nifedipine - 20 mg;
• excipients: lactose monohydrate - 31.6 mg, potato starch - 31.4 mg, microcrystalline cellulose - 31 mg, K25 povidone - 5.4 mg, magnesium stearate - 0.6 mg.

Shell composition: titanium dioxide - 1.377 mg, hypromellose - 5.188 mg, quinoline yellow dye - 0.143 mg, talc - 1.038 mg, macrogoal 6000 - 0.861 mg, macrogoal 35000 - 0.393 mg.

One tablet Corinthara UNO includes:

• nifedipine - 40 mg;
• excipients - lactose monohydrate - 30 mg, microcrystalline cellulose - 48.5 mg, cellulose - 10 mg, hypromellose 4000 sR - 20 mg, magnesium stearate - 1.5 mg, colloidal silicon dioxide - 0.75 mg.

Shell composition: titanium dioxide - 2 mg, macrogol 6000 - 0.07 mg, hypromellose - 2 mg, iron oxide red - 0.9 mg, macrogol 400 - 1.1 mg, talc - 1 mg.

Release form

Corinfar And Corinfar Retard are extended-release tablets, which are coated with a straw color, biconvex, round, with a beveled edge; on the section there is a homogeneous yellow substance.

10 such tablets Corinthara or Corinthara Retard in blisters, three blisters in a cardboard box. Or 50 of these tablets Corinthara or Corinthara Retard in a dark glass bottle, one such bottle in a cardboard box. Corinfar is also available separately in a quantity of 100 tablets in a dark glass bottle and a cardboard box.

Corinfar UNO- extended-release tablets, dark red coated, biconvex, round. 10 such tablets in a blister; 5, 2 or 10 such blisters in a paper pack.

pharmachologic effect

The drug has hypotensive And antianginal .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

This medicine is a selective blocker (inhibitor)" slow» calcium channels, chemically classified as derivatives dihydropyridine . Inhibits the movement of Ca2+ from the intercellular space into cardiomyocytes and smooth muscle cells, peripheral and cardiac arteries; in large doses inhibits the release of Ca2+ from intracellular stores.

In therapeutic doses, it normalizes intercellular Ca2+ exchange, which can be disrupted in a number of pathological conditions (and others). Does not affect the tone of veins. Increases coronary blood flow, enhances blood supply to ischemic areas myocardium without developing the “steal” syndrome, it stimulates the work of collaterals. Dilates peripheral arteries, reduces total peripheral vascular resistance, myocardial tone, and the heart's need for oxygen. Does not affect atrioventricular And sinoatrial nodes , has a small antiarrhythmic action. The drug also activates renal blood flow.

The time for the clinical effect to appear is about 20 minutes, the duration of the effect is 5-6 hours.

Pharmacokinetics

Up to 90% of the drug is absorbed in the intestines. Bioavailability is about 60%. Eating food increases bioavailability. 95% of the drug binds to plasma proteins. Maximum concentration nifedipine in the blood of ingestion of two tablets (20 mg of nifedipine) occurs within 2–3 hours. Completely converted in the liver.

Excreted by the kidneys in the form of an inert metabolite (70%), with bile (30%). The half-life is approximately 3-5 hours.

Renal failure and conduction do not change the pharmacokinetics of Corinfar. In persons with liver disease, clearance is reduced and the half-life is prolonged. With long-term use (more than two months), tolerance to the drug may develop.

Indications for use of Corinfar

Indications for use Corinthara Retard (Corinthara) and indications for use Corinthara UNO are the same - the choice of drug is made by the attending physician depending on the severity of the disease and individual sensitivity.

• Vasospastic angina (Prinzmetal's angina ).
• Chronic tension.

Contraindications

• Allergy to nifedipine and any other derivatives dihydropyridine or components of the drug.
• Low pressure (systolic pressure less than 90 mmHg).
• Unstable.
• Cardiogenic shock .
• Chronicdecompensated cardiac failure , heavy aortic stenosis .
• The first four weeks.
• The first 13 weeks of pregnancy.
• Period.
• Reception.

The drug should be used with caution when mitral valve stenosis , heavy tachycardia or bradycardia , malignant , syndrome sinus node weakness , hypovolemia , pronounced violations cerebral circulation , with insufficiency of left ventricular function, intestinal obstruction , liver and kidney failure, (possible development of arterial hypotension), 14-40 weeks of pregnancy, age less than 18 years, co-administration, beta blockers .

Side effects

• From the circulatory system: tachycardia , peripheral edema, excessive vasodilation (decrease in blood pressure, worsening heart failure, facial flushing, feeling of heat), severe decrease in blood pressure, fainting. A small number of patients may experience seizures at the start of therapy or after increasing the dose, and in very rare cases -.
• From the nervous system: dizziness, headache, weakness, fatigue, drowsiness. With long-term treatment with the drug in large doses - tremors, extrapyramidal disorders (mask-like face, ataxia, gait changes), .
• From the digestive system: dry mouth, flatulence , increased appetite. Less common is gum hyperplasia, which disappears after cessation of treatment. Long-term use may cause liver damage ( cholestasis, increased activity of liver enzymes).
• From the musculoskeletal system: myalgia , joint swelling, limb cramps.
• Hypersensitivity reactions: rarely -, autoimmune hepatitis , .
• From the hematopoietic system: leukopenia , anemia , thrombocytopenia , agranulocytosis .
• From the excretory system: increase diuresis , impaired renal function (in persons with kidney failure).
• Other: rarely - visual impairment, temporary gynecomastia , hyperglycemia, galactorrhea, bronchospasm, increase in body weight.

Instructions for use of Corinfar

Instructions for use Corinthara Retard And Corinthara explains how to take this medicine. The tablets are used orally after meals, without chewing and with sufficient volume of water. Concomitant use with food inhibits adsorption active substance from the intestines. Usually the drugs are taken in the morning and evening, but it is worth remembering that Corinfar UNO 40 mg can only be used once a day.

The dose and frequency of administration of the drug is selected by the attending physician individually, taking into account the severity of the disease and other clinical aspects.

At vasospastic angina And voltage : 1 tablet each Corinthara Retard or Corinthara

Essential hypertension : 1 table each. Corinthara Retard or Corinthara(depending on the severity and individual sensitivity) 2 times a day. If the effect is weak, the dose of the drug is slowly increased to two tablets 2 times a day.

When prescribing the drug twice a day, the interval between doses should be an average of 12 hours. Corinfar UNO taken at the same time of day with an interval of 24 hours, preferably before lunch, 1 tablet (40 mg) once a day.

Overdose

Symptoms: facial flushing, headache, bradycardia/ , strong long-term decrease in blood pressure, suppression sinus node . In severe cases - fainting.

Therapy: symptomatic. As a rule, gastric lavage is performed and used. The antidote will be calcium preparations - intravenous 10% solution calcium chloride or . With a strong decrease in blood pressure, slow intravenous administration is recommended. , norepinephrine or . If heart failure occurs, it is administered intravenously. During development - isoprenaline , .

Hemodialysis in case of overdose is ineffective, it is recommended plasmapheresis .

Interaction

The following effects from interactions with the following drugs should be taken into account:

• With tricyclic antidepressants, antihypertensives, vasodilators - increased hypotensive effect;
• With beta blockers - pronounced decrease in blood pressure;
• c - suppression of metabolism;
• With quinidine – sharp decrease in concentration quinidine in the blood, after withdrawal nifedipine - sharp rise in content quinidine in blood;
• With carbamazepine , phenobarbital — reduction in content nifedipine in blood.

Terms of sale

In Ukraine, the drug can only be purchased with a prescription; in Russia, the drug is on the over-the-counter list.

Storage conditions

Store at temperatures up to 30 degrees in original packaging. Keep away from children.

Best before date

special instructions

• It is necessary to discontinue drug therapy gradually.
• At the beginning of treatment, it may occur, especially if there has been a recent abrupt withdrawal beta blockers (they also need to be withdrawn gradually).
• For severe heart failure Corinfar should be dosed with caution.
• In persons with severe obstructive cardiomyopathy there is a risk of increased frequency, severity and duration of attacks angina pectoris after use nifedipine ; in this case, the drug is discontinued.
• In persons with severe renal failure , which are on hemodialysis , have high blood pressure and reduced circulating blood volume, the drug is recommended to be used with caution, as there is a risk of a sharp drop in blood pressure.
• If surgery is planned using general anesthesia, it is necessary to inform the anesthesiologist about the appointment. nifedipine .
• The drug affects the ability to drive vehicles. You must be careful when driving.