Corinfar - instructions for use, analogs, testimonials and release forms (10 mg tablets, 40 mg UO, 20 mg retard) drug for the treatment of hypertension and pressure reduction in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Corinth. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Corinfar in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Corinfar in the presence of existing structural analogues. Use to treat hypertension and reduce blood pressure in adults, children, as well as during pregnancy and lactation. Interaction of the drug with alcohol.

Corinth - selective blocker of "slow" calcium channels (BCCC), 1,4-dihydropyridine derivative. Has antianginal and hypotensive effect. Reduces the current of extracellular Ca inside cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries; in high doses, inhibits the release of Ca from the intracellular depot. In therapeutic doses normalizes the transmembrane current of Ca, disturbed in a number of pathological conditions, especially in hypertension. Does not affect the tone of the veins. Strengthens the coronary blood flow, improves the blood supply of the ischemic zones of the myocardium without the development of the phenomenon of "stealing", activates the functioning of collaterals.

Expanding the peripheral arteries, reduces the overall peripheral vascular resistance, myocardial tone, postnagruzku and the need for myocardium in oxygen. Virtually does not affect the sinoatrial and atrioventricular nodes, has a weak antiarrhythmic activity. It enhances kidney blood flow, causes a moderate natriuresis.

Negative chrono-, dromo- and inotropic action is blocked 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.

Composition

Nifedipine + excipients.

Pharmacokinetics

Absorption is high (more than 90%). Bioavailability is 50-70%. Eating increases bioavailability. Penetrates through blood-brain and placental barriers, excreted in breast milk. The connection with blood plasma proteins (albumins) is 95%. It is completely metabolized in the liver.

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

Indications

• chronic stable angina (stress angina);
• angina of prinzmetal (variant angina);
• arterial hypertension.

Forms of release

The tablets of the prolonged action, covered with a cover of 10 mg.

Tablets of the prolonged action, covered with a cover of 40 mg Corinfar OOE.

Tablets of prolonged action, coated with 20 mg Corinfar retard.

Instructions for use and dosage

Inside after eating, without chewing and washing down 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 sensitivity of the patient to the drug. For patients with concomitant severe cerebrovascular disease and in elderly patients, the dose should be reduced.

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

Recommended dosing regimen for adults:

Chronic stable and vasospastic angina

The initial dose is 10 mg (1 tablet) 2-3 times a day. With an insufficiently pronounced clinical effect, the dose of the drug is gradually increased to 2 tablets (20 mg) 1-2 times per day. The maximum daily dose is 40 mg (4 tablets per day).

Essential hypertension

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

With an insufficiently pronounced clinical effect, it is possible to gradually increase the dose to 20 mg (2 tablets) 2 times a day. The maximum daily dose is 40 mg (4 tablets per day).

At 2-fold appointment, the minimum interval between doses of the drug should be at least 4 hours.

The duration of treatment is determined by the attending physician.

Side effect

• tachycardia;
• palpitation;
• arrhythmias;
• peripheral edema (ankles, feet, tibia);
• manifestations of excessive vasodilation (asymptomatic decrease in blood pressure, development or exacerbation of heart failure, "tides" of blood to the skin of the face, hyperemia of the skin of the egg, a feeling of heat);
• marked decrease in blood pressure (rarely);
• syncope;
• headache;
• dizziness;
• general weakness;
• increased fatigue;
• drowsiness;
• paresthesia of the limbs;
• tremor;
• extrapyramidal (parkinsonian) disorders (ataxia, "masklike" face, shuffling gait, tremor of hands and fingers, difficulty swallowing);
• depression;
• dyspepsia (nausea, diarrhea, or constipation);
• dry mouth;
• flatulence;
• increased appetite;
• arthritis;
• myalgia;
• swelling of the joints;
• convulsions of the upper and lower extremities;
• itching;
• hives;
• exanthema;
• autoimmune hepatitis;
• exfoliative dermatitis;
• photodermatitis;
• anaphylactic reactions;
• anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis;
• an increase in daily diuresis;
• impairment of renal function (in patients with renal insufficiency);
• visual impairment (including transient blindness with 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);
• joint use with rifampicin;
• pregnancy (1 trimester);
• lactation period;
• increased sensitivity to nifedipine and other derivatives of 1,4-dihydropyridine or to other components of the drug.

Application in pregnancy and lactation

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

Use in children

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

special instructions

During the treatment it is necessary to refrain from taking ethanol (alcohol). Discontinue drug treatment is recommended gradually.

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

Simultaneous administration of beta-blockers should be carried out in conditions of careful medical control, as this can lead to an excessive decrease in blood pressure, and in some cases, to worsening of symptoms of heart failure.

With severe heart failure, the drug is dosed with great care.

Diagnostic criteria for prescribing with vasospastic angina are: a classic clinical picture accompanied by an increase in the ST segment, the emergence of ergonovirus-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, with a different voltage threshold or unstable angina, when the data of the electrocardiogram indicate a transient angiospasm).

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, it is necessary to cancel the drug.

In patients with irreversible renal failure who are on hemodialysis, who have high blood pressure and reduced total blood, the drug should be used cautiously, since it is possible a sharp drop in blood pressure. For patients with impaired liver function, careful monitoring is established; if necessary, the dose of the drug is reduced and / or used by other dosage forms of nifedipine.

If surgical intervention is required under general anesthesia, the anesthetist should be informed of the patient's treatment with nifedipine.

In case of in vitro fertilization, in some cases BCCC caused changes in the head part of spermatozoa, which can lead to a disruption of the functions of spermatozoa. In cases in which repeated in vitro fertilization has not been performed for an unclear reason, the use of BCCC, including nifedipine, can be considered a possible cause of failure.

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

In the spectrophotometric determination of vanillyl-mandelic acid in urine, Nifedipine may be the cause of a false-overestimated result, however, the results of HPLC tests show no effect on nifedipine.

With caution, simultaneous treatment with nifedipine, disopyramide and flecainamide should be carried out due to a possible increase in inotropic effect.

Influence on ability to drive 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.

BCCI can further enhance the negative inotropic effect of antiarrhythmics such as Amiodarone and quinidine.

When combining Corinphar with nitrates, tachycardia increases.

Diltiazem inhibits the metabolism of nifedipine in the body, which may require the simultaneous administration of these drugs to reduce the dose of nifedipine.

Reduces the concentration of quinidine in the blood plasma.

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

Rifampicin accelerates the metabolism of nifedipine, joint use is not recommended.

At simultaneous appointment with cephalosporins (for example, cefixime) the concentration of cephalosporins in the blood can increase.

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

Corinfar can displace from the bond with proteins preparations with a high degree of binding (including indirect anticoagulants - coumarin and indanedione derivatives, anticonvulsants, NSAIDs, quinines, salicylates, sulfinpyrazone), so that their concentration in the blood plasma can increase.

Nifedipine inhibits the metabolism of prazosin and other alpha-adrenoblockers, which can lead to an increase in the hypotensive effect.

If necessary, the dose of vincristine is reduced, becauseNifedipine inhibits its removal from the body, which can cause increased side effects.

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

With the simultaneous administration of procainamide, quinidine and other drugs that cause prolongation of the QT interval, the risk of a significant prolongation of the QT interval increases.

Grapefruit juice inhibits the metabolism of nifedipine in the body, so it is contraindicated during treatment with nifedipine.

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

Taking into account the experience of using BIMC nimodipine, it is impossible to exclude similar interactions with nifedipine: carbamazepine, Phenobarbital may cause a decrease in the concentration of nifedipine in blood plasma,and valproic acid - an increase in the concentration of nifedipine in blood plasma.

Analogues of Corinfar

Structural analogs for the active substance:

• Adalate;
• Vero Nifedipine;
• Calzigard retard;
• Kordafen;
• Cordaflex;
• Cordipine;
• Cordipine retard;
• Corinfar retard;
• Corinfar OOE;
• Nicardy;
• Nykardija SD retard;
• Nyfadil;
• Nifébyen;
• Nifhexal;
• Nifedex;
• Nifedikap;
• Nifedikor;
• Nifedipine;
• Nifedipine FPO;
• Nifecard;
• Nifecard HL;
• Nifelate;
• Nifesan;
• Osmo Adalat;
• Sanfidipine;
• Sponify 10;
• Phenigidine.

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