Calcium channel blocker Corinfar - a rapid decrease in pressure. Corinfar

Corinfar is a popular antihypertensive agent, quickly helps to reduce high blood pressure and keeps it normal when taken regularly. Since it has a number of contraindications, it should be prescribed only by a qualified specialist - a therapist or a cardiologist. How it works and in what cases it is used, let's take a closer look.

Corinfar directly affects the activity of the heart, reducing the frequency of its rhythm. This medicine is an antagonist of calcium ions and due to this reduces the contractile activity of the walls of blood vessels. As a result, peripheral pressure decreases, and with constant intake it stabilizes.

Form and estimated price

The drug is produced only in the form of yellowish or yellow-green tablets. Packed in plates, in packing of 50 or 100 pieces.

In addition to Corinfar, such forms of medicine are produced that differ in the amount of active substance:

Nifedilin Corinfar - 10 mg.
Corinfar Retard - 20 mg.
Corinfar Uno - 40 mg.

According to the number of tablets in the package, the price also varies - from 78 to 106 rubles.

Components and mechanism of action

The active component of this medicinal product is nifedipine. Additional ingredients: magnesium carbonate, microcellulose, macrogol, starch, povidone, lactose, polyethylene glycol and others.

At what pressure should the medication be used? The drug and its forms are effective at pressures above 150/100 mm Hg. Art. With constant intake, the heart rate and heart function stabilize.

The drug is an active blocker of calcium channels, due to which it does not allow ions to seep into the smooth muscles of blood vessels and the heart. Due to the decrease in the amount of calcium, the tension of the vascular walls decreases, the gap between them expands. As a result, more blood flows to the heart.

With an increase in blood flow in the coronary vessels, oxygen supply to the myocardium in ischemic areas improves. The tone of the tissues of the organ increases and the need for oxygen decreases. Medications provide antihypertensive effect, which lasts for a day.

Properties

The drug is prescribed in mono-and complex therapy and is intended for:

normalization and stabilization of pressure;
elimination of vein thrombosis;
normalization of heart rate;
cupping pain in chest and head;
sleep improvement.

Stabilizes high blood pressure relieves stress on the heart without compromising blood circulation. Effective for stopping palpitations, arterial hypertension, various types of angina pectoris.

The therapeutic effect even at the minimum dose lasts for 6 hours. Maximum effect achieved 2.5 hours after consumption. It does not possess accumulative properties even at high dosages. But with constant use, for more than three months, the body becomes tolerant to Corinfar.

Indications and contraindications

What does this drug help? Cardiologists prescribe it for:

chronic angina;
arterial hypertension;
Prinzmetal's angina.

The tool is not prescribed for:

severe aortic stenosis;
unstable form of angina pectoris;
acute course of myocardial infarction;
cardiogenic shock;
GV and during the period of bearing a child.

Front surgical intervention the drug is stopped 2 days before the planned operation. Experts do not recommend drinking alcohol-containing drinks during treatment with Corinfar, as this leads to a violation heart rate. And also it is impossible to simultaneously use drugs from the group of adrenergic blockers (, Anaprilin).

Rules for taking and dosing

Instructions for use clearly defines how and when to use the medication. If not special conditions, Corinfar is prescribed at a dose of 10 or 20 mg up to two times a day. Take the drug after meals at regular intervals with water. Daily dosage cannot exceed 80 mg per day.

An approximate scheme for the use of the drug is presented in the table.

Possible side effects

With the constant use of the drug, the following side effects are likely:

Due to increased exposure, the drug is not compatible with the following medicines:

antidepressants;
beta blockers;
Rimfapicin.

During breastfeeding, the medicine is found in milk, which can significantly reduce the heart rate of the baby.

Analogues

There are several drugs that are similar in mechanism of action and composition, among them:

Adalat.
Sponif.
Sanfidipin.

Feedback from doctors and patients

Reviews of cardiologists are positive:

Ivanets A.P., cardiologist:“The prescription of the drug significantly improves the well-being of patients with complaints of high blood pressure and heart rhythm disturbances. Per a short time taking medication in patients with a decrease in heart rate and blood pressure. Side effects extremely rare. There are few contraindications.

Here's what the patients themselves say:

Tarasova Olga, 49 years old:"After the flu began frequent heartbeats. The doctors did an electrocardiogram and found malfunctions in the work of the heart, prescribed to use Corinfar. Three weeks later, I feel much healthier. There were no more attacks of cardiac arrhythmias.”

Anna Nikitichna, 57 years old:“My diagnosis is chronic angina pectoris. For a long time I have been drinking Corinfar 1 tablet 2 times a day. I feel good thanks to this medicine. There are no seizures."

Dmitry, 66 years old: “Six months ago, he survived a microstroke. The doctors prescribed Corinfar for me. At first, I didn't feel very well. But when choosing a dosage, everything stabilized. The heart no longer hurts, the headaches are gone.

Tamara Mikhailovna, 61 years old:"V Lately I noticed that homework is difficult for me. Often tormented by headaches, palpitations, pressure increased. Corinfar was prescribed in the clinic. He helped to cope with the pressure in a short time. "

Zoya, 52 years old: “I used to be hypotensive. But lately, the pressure has been gradually increasing. No matter what medication I tried. The doctor just shrugged. I went to the district clinic and there I was prescribed Corinfar. Now I feel great. The pressure has stabilized. Very good drug and another advantage is that it is cheap.”

Now you all know about this drug. We hope this article will help you choose the right medicine for pressure. Good health to you.

Hypertension and ischemic diseases of the heart muscle are very common cause hospitalization of patients in a hospital for long-term treatment. For the prevention of seizures have been developed medical preparations, which are able to stop the symptoms of a crisis, remove pain and prevent the development of complications. One of the most effective groups for long-term therapy, calcium channel blockers are considered. Corinfar is a bright representative of this line of products, which has been on the market for a long time and is very popular among specialists in the field of cardiology.

Therapeutic action

The therapeutic effect is associated with the action of the components of the drug. The first link it affects is the amount of mechanical work performed by the heart muscle. Decreased heart rate, falling peripheral resistance vessels. This reduces the need for cardiomyocytes in oxygen molecules.

Corinfar - synthetic drug related to calcium ion channel blockers

Vasodilation coronary vessels significantly improves the trophism of the heart muscle, reduces the manifestations of atherosclerotic lesions of their walls. Decrease effect blood pressure develops as a result of a decrease in the tone of the muscle layer of the vascular wall, which leads to a partial deposition of the total volume of circulating blood in the tissues and parenchymal organs such as the liver and spleen.

There is also an increase in the rate of excretion of sodium from the body along with urine. This additionally reduces the amount of fluid in the vascular bed, reduces the afterload on the heart, reduces the amount of effusion in the natural cavities of the body, and helps in preventing the occurrence of pulmonary edema.

In addition to affecting the tone of the veins and arteries, Corinfar has an effect on the juxtaglomerular apparatus of the kidneys, which also affects the level of blood pressure. This effect is related to the expansion renal vessels, leveling hypoxia, which reflexively inhibits the release of angiotensin (an enzyme that increases blood pressure).

"Nifedipine", which is part of the drug, has the ability to prevent platelets from sticking together, resulting in the prevention of thrombosis. In general, the drug has antianginal, antiplatelet, diuretic and hypotensive effects.

Pharmacokinetics

When taken orally, the drug is rapidly absorbed into upper divisions gastrointestinal tract. The sublingual route of administration of the active substance is also possible, which ensures faster penetration into the bloodstream in emergency conditions.

Corinfar - common medicinal product which is currently in use

After absorption through the gastrointestinal mucosa, binding to plasma protein molecules occurs. The maximum concentration of the components of the drug in the blood is observed thirty to fifty minutes after administration.

Bioavailability is about seventy percent. The duration of the rendered therapeutic effect observed for six hours. In this regard, for round-the-clock action, it is necessary to take three to four tablets throughout the day. There are various types of "Corinfar", which have a longer half-life, which can reach a day, which reduces its dosage and frequency of administration over one day.

After cupping emergency, active substance metabolized in hepatocytes by oxidation. Bound inactive molecules are formed, which are excreted through the distal digestive tube and kidney. Such a metabolism implies a refusal to take Corinfar in case of pathologies of the renal or hepatic tissue.

The use of the drug "Corinfar" at high pressure

The drug is very effective in stopping attacks of arterial hypertension, with various types angina and in the event of renal or intestinal colic. It has to do with the mechanism of action.

Corinfar from pressure has antianginal and hypotensive effects

Influence on the pathogenetic mechanism - spasm of the muscular wall of the ureters, intestines or vessel by inhibiting the development of the action potential of cells. As a result, the myofibril is simply not able to generate an impulse that leads to the development of a spastic process and relaxes. This makes it disappear pain syndrome, pressure normalizes and blood supply to the affected organ or system improves.

Indications

hypertension of varying severity;
hypertensive crisis;
Availability coronary disease hearts;
Prinzmetal's angina;
development of angina pectoris;
prevention of thrombosis;
intestinal, renal or hepatic colic;
increased sympathetic tone nervous system.

Dosage and Applications

Exists various forms drug, each of them has certain recommendations for admission. Directly "Corinfar" must be applied two to three times a day, one tablet, depending on the dose prescribed by the doctor.

Tablets are taken after meals and washed down with plenty of water.

You need to drink the medicine strictly after eating (for prevention possible complications from the side digestive system) with a small amount of water. The duration of one course of therapy is determined only by a specialist, controlling the performance of laboratory tests.

"Corinfar Retard" is used two tablets twice a day after twelve hours. "Corinfar Uno" is prescribed one pill once a day after meals. Maximum daily dose nifedipine in this case is no more than eighty milligrams.

Side effects:

the appearance of nausea / repeated vomiting without relief;
heaviness in the right hypochondrium;
drug-induced hepatitis;
increased levels of hepatic transaminases in the blood serum;
collapse;
increased angina pectoris;
tachycardia
peripheral edema;
the appearance of urticarial rash;
paresthesia;
convulsions of the upper and lower extremities;
headache and dizziness
thrombocytopenia;
decrease in the number of white blood cells.

From the nervous system: the body as a whole weakens, acute headache, accompanied by dizziness

Contraindications:

the presence of an allergy to the components of the drug;
diagnosed cardiogenic shock of various nature;
established massive heart attack heart muscle (first 4 weeks);
an attack of unstable angina;
under eighteen years of age;
I trimester of pregnancy;
lactation;
liver or kidney failure;
stenosis of the aortic mouth;
hypotensive conditions;
hemodialysis;
chronic insufficiency of the heart muscle.

Interaction

It is undesirable to take during treatment with antidepressants, there is an effect of a significant increase in the effect of the drug. Contraindicated in combination with beta-blockers (digoxin) and other drugs that reduce the frequency of contractions of the heart muscle. It should also not be used with rimfapicin.

Overdose of "Corinfar"

In case of taking too large a dose of the active substance, the occurrence of hypotension, dizziness, loss of consciousness is observed. Absence urgent action may lead to coma and respiratory arrest.

Increased doses disrupt the heart rhythm (it can either become faster or slower), develop arterial hypotension, increase blood sugar

The drug is potent agent, which must be taken in a strictly prescribed dose under the supervision of the attending physician. As emergency therapy, gastric lavage, infusions saline solutions and use of forced diuresis.

To prevent possible complications and adverse reactions from the digestive system, the tablet is not recommended to be crushed, chewed or sucked. It is necessary to take the drug after a meal, drinking a whole tablet with the required amount of water. Also shown complete failure from drinking alcohol during treatment, as there are no data on clinical research about the harmlessness of such a combination.

Treatment can only be carried out under the supervision of a specialist who monitors the condition internal organs patient and indicators of the blood coagulation system. It is important to observe the dose and frequency of administration indicated by the doctor in order to avoid the development of complications and overdose phenomena.

Preparations synonyms and analogues:

"Adalat";
"Cordiipin";
"Nifexal";
"Nifelat";
"Fenigidin".

Conclusion

"Corinfar" is effective remedy to prevent the occurrence of hypertensive crises, as well as thrombosis. This drug can only be prescribed by a specialist who is able to establish the correct final diagnosis, based on modern methods diagnostics, as well as to detect the presence of possible contraindications. Adequate cost and high efficiency are the reasons positive feedback by consumers. It must be remembered that Corinfar only relieves an attack, but does not completely cure it.

High blood pressure, ischemia of the heart muscle are today quite common diseases that require a serious approach to treatment. Most popular means to solve such problems is the drug Corinfar. In the material below, you can read the instructions for the use of Corinfar, at what pressure it is advisable to prescribe it.

The drug is produced with different dosage. In accordance with it, the names of the means also differ. The drug with the lowest content of the active ingredient (10 milligrams) is called Corinfar. An agent with 20 milligrams of the active ingredient already has the Retard prefix. The drug with the highest concentration active ingredient(40 milligrams) is called Corinfar Uno.

The tool is made in tablet form, in the shell yellow color. In addition to the active component - nifedipine, the content of which is determined by the dosage, the tablets contain:

lactose;
starch;
microcrystalline cellulose;
povidone;
magnesium stearate.

The mechanism of influence on pressure, increases or decreases

The active component of the drug reduces the level of blood pressure and favors the reduction of cardiac stress.

When using the drug, there is also a drop in the load on the myocardium and on the vascular walls.

At high level pressure and rapid pulse in patients taking the drug, there is a normalization of these indicators due to a drop in the number and strength of heart contractions.

Also, the drug has the following effects on patients with high blood pressure:

improves coronary blood flow;
contributes to the normalization of the health of the branches of blood vessels;
hypotensive effect;
in the part of the myocardium with poor blood flow, a significant improvement is observed.

Indications for use and dosage

Indications for the appointment of Corinfar are the following diseases:

chronic angina;
arterial hypertension;
Prinzmetal's angina.

The dosage of the drug is determined in each case individually and depends on the course of the disease, the patient's pressure level, drug tolerance, the presence of contraindications and other factors.

Instructions for use are prescribed by a doctor, consider general recommendations.

The drug should be taken only after meals. Tablets must be swallowed without chewing and drinking plenty of water.

On the acute stage hypertensive crisis 1 or 2 tablets should be put under the tongue until completely resorbed. This method of using the drug contributes to the speedy entry of the active substance into the blood and the beginning of the impact on the body.

Angina of a chronic nature of a vasospastic type involves the use of 1 tablet with a dosage of 10 milligrams. Corinfar should be taken at least 3 times a day. Without therapeutic effect it is permissible to increase the dosage by 2 times, but not more than 4 tablets per day.
With hypertension of the essential type, the patient is recommended to take 3 times a day, 1 tablet per day. In the absence of a therapeutic result, an increase to 2 tablets per 1 dose is permissible. But it is not recommended to take more than 4 pieces during the day. The interval between the use of funds should be at least 4 hours.

Corinfar Uno is prescribed 1 tablet after breakfast. The highest dosage of Corinfar Uno can reach 80 milligrams throughout the day.

The duration of the therapeutic course is determined in each case individually by the attending physician.

If the patient has a diagnosis of severe liver failure, the dosage should be adjusted.

Features of taking medication by children and pregnant women

Pregnant women can take the drug if the pregnancy is complicated by chronic hypertension or toxicosis on later dates pregnancy.

To avoid risk premature birth it is not recommended to prescribe Corinfar before the 18th week of pregnancy. The experience of prescribing the drug to pregnant women shows that the vast majority of patients tolerate the drug well. Experts do not note any complications.

Duration treatment course cannot exceed 14 days. All this time, you should continuously monitor the condition of the pregnant woman.

During lactation, the use of Corinfar is contraindicated, since the active ingredient will be excreted along with milk. Therefore, if there are indications for use, it should be discontinued. breastfeeding baby.

Application by children

The effectiveness and safety of the use of the drug Corinfar by children has not been established, therefore it is worth taking it in childhood only if necessary and under the strict supervision of a doctor.

Side effects and contraindications

Side effects on the body can be expressed as follows:

the occurrence of nausea or severe, unrelieved vomiting;
hepatitis due to medication;
pulling feeling from right side under the ribs;
increased levels of hepatic transaminases in the blood serum;
exacerbation of angina pectoris;
collapse;
tachycardia;
the formation of a rash of the urticarial type;
the occurrence of peripheral edema;
cramps in the limbs;
paresthesia;
thrombocytopenia;
dizziness, headaches;
a drop in the number of white blood cells.

Among the contraindications for the use of Corinfar, the following can be distinguished:

individual intolerance to the components of the drug;
cardiogenic shock of various origins;
recurring episodes of unstable angina;
4 weeks after suffering a myocardial infarction of an extensive nature;
the first 8 weeks of pregnancy;
breast-feeding;
stenosis of the aortic mouth;
renal, hepatic insufficiency;
hemodialysis;
hypotension;
chronic heart failure.

What can replace

Corinfar can be replaced with drugs such as Osmo-Adalat, Kordipin, Calcigard, Adalat. Each of these drugs is based on the same active ingredient - nifedipine, so the effect on the patient's body with these drugs is the same. Pharmacological products differ only in price and manufacturer.

If the patient has intolerance to nifedipine, then the medicine can be replaced the following drugs: Concor, Co-Diovan, Captopril, Amprilan. These funds are also designed to lower the level of pressure, but the active ingredient is another substance.

Calcium antagonist of the 1,4-dihydropyridine group. It blocks the transmembrane entry of calcium ions through selective voltage-dependent "slow" L-channels into the smooth muscle cells of arterial vessels and cardiomyocytes. Nifedipine, like all dihydropyridine calcium antagonists, has a pronounced selectivity for vascular smooth muscle compared to the myocardium. The main hemodynamic effect of the drug is systemic peripheral vasodilation, leading to a decrease in systemic peripheral vascular resistance, which determines its antihypertensive effect. The antianginal effect of nifedipine is associated with a decrease in cardiac afterload and a decrease in myocardial oxygen demand due to systemic vasodilation. In addition, the drug has a direct vasodilating effect on coronary arteries heart, preventing the development of angiospasm. The action of nifedipine is due to the improvement of diastolic relaxation of the left ventricle (normalization of diastolic filling).
Other effects include minor diuretic action blocking effect on platelet aggregation.
According to studies, long-term use of the drug inhibits the development of atherosclerotic changes in the vessels.
After oral intake on an empty stomach, the active substance nifedipine is rapidly and almost completely (90-100%) absorbed from the gastrointestinal tract. With sublingual application, the effect of nifedipine begins to appear after 5-15 minutes, and when taken orally - after 10-30 minutes. The maximum effect appears 30-90 minutes after ingestion and lasts for 4-6 hours. In the form of a retard, the drug has an effect for more than 8 hours. After a single dose of 2 Corinfar tablets (20 mg), the therapeutic concentration in the blood (10 ng / ml) reached after 30 minutes, the maximum concentration in blood plasma (75 ng / ml) is determined after 1.6 hours, after which a gradual decrease is noted. After a single dose of 1 tablet of Corinfar Retard (20 mg), the therapeutic level of the drug in the blood plasma is reached after 60 minutes, the maximum concentration - after 2.4 hours; stable equilibrium concentration (from 20 to 60 ng / ml) persists for 6 hours. 10 hours after the use of Corinfar Retard, an active concentration of 13 ng / ml remains in the blood plasma, which gradually decreases to 2 ng / ml within 24 hours .
The absolute bioavailability of nifedipine is 50-70%. They note a high effect of the first passage through the liver, which causes significant fluctuations in the concentration active substance in the blood of some patients. About 95% of the drug binds to plasma proteins. Time to reach maximum concentration in plasma for a prolonged form of the drug is 4-6 hours, the duration of action is up to 24 hours.
In the liver, nifedipine is almost completely metabolized, primarily due to oxidative and hydrolytic processes, the resulting metabolites do not have pharmacological activity. In humans, 3 active metabolites of nifedipine are identified.
In the form of metabolites, nifedipine is excreted from the body mainly through the kidneys (60-80%), the remaining metabolites - with feces, less than 0.1% of the active substance is found in the urine.
The half-life is 5-11 hours. Accumulation of the drug in the body during long-term treatment therapeutic doses are not described. With reduced liver function, an increase in the half-life of the active substance and a decrease in total plasma clearance are noted, in such cases a dose reduction is required.
In a small amount, nifedipine crosses the BBB, probably through the placental barrier, and also penetrates into breast milk.
With hemodialysis, it is practically not excreted from the blood plasma; it can be removed by plasmapheresis.

Indications for the use of Corinfar

ischemic heart disease stable angina stress, vasospastic angina (variant angina, Prinzmetal's angina), essential hypertension (arterial hypertension).

The use of the drug Corinfar

Corinfar - 1-2 tablets (10-20 mg) 2-3 times a day, the maximum daily dose is 80 mg, Corinfar Retard - 1-2 tablets 2 times a day. Tablets are taken without chewing after meals, drinking enough liquids. The recommended interval between doses is 12 hours and should not be less than 4 hours. Treatment should be carried out for a long time. In patients with liver failure dose reduction may be necessary.
Corinfar Uno 40 tablets are taken orally 1 tablet 1 time in the morning during meals without chewing, drinking plenty of liquid (for example, a glass of water). The maximum daily dose of the drug is 2 tablets (80 mg) 1 time per day. The duration of treatment is determined by the course of the disease.

Contraindications to the use of Corinfar

cardiogenic shock, hypersensitivity to nifedipine or other dihydropyridines, acute period myocardial infarction, unstable angina, pronounced stenosis of the aortic orifice, the period of pregnancy and lactation.

Side effects of Corinfar

Most often, at the beginning of treatment, transient headache, vasomotor reactions (hyperemia of the skin of the face and trunk with a feeling of heat) are possible, less often - reflex tachycardia, increased angina attacks, swelling of the legs, paresthesia, dizziness, fatigue, arterial hypotension; rarely - nausea, a feeling of fullness in the stomach, diarrhea, pruritus, urticaria, exanthema, in isolated cases - exfoliative dermatitis, gynecomastia (mainly in elderly men with prolonged use of the drug, disappears after its withdrawal), changes in blood composition (anemia, thrombocytopenia, leukopenia), thrombocytopenic purpura, hyperglycemia (especially in patients with diabetes), myocardial infarction, in isolated cases when using the drug in high doses - myalgia, tremor, transient visual disturbances; in isolated cases with prolonged use - reversible gingival hyperplasia, intrahepatic cholestasis, transient increase in serum transaminases, hepatitis.

Special instructions for the use of the drug Corinfar

With caution, the drug is used for severe arterial hypotension (systolic blood pressure below 90 mm Hg), with decompensated heart failure, hypovolemia, in the elderly (over 60 years of age). The drug is not recommended for children.
With the sudden cessation of treatment with nifedipine, a withdrawal syndrome may develop.
In patients with kidney failure and patients on hemodialysis, taking the drug may be accompanied by a deterioration in the condition.
In patients taking the drug, the reaction rate and the ability to concentrate may decrease. This is especially pronounced at the beginning of treatment, with an increase in the dose of the drug and with the simultaneous use of alcohol.

Corinfar drug interactions

The effect of the drug is enhanced with the simultaneous appointment of other antihypertensive drugs, tricyclic antidepressants, nitrates, cimetidine and ranitidine; when combined with β-adrenergic receptor blockers, there is a risk of increased arterial hypotension, in some cases, the occurrence or strengthening of signs of circulatory failure; when combined with quinidine, the level of the latter in the blood plasma decreases. Nifedipine increases the concentration of digoxin and theophylline in the blood plasma with simultaneous use.

Overdose of Corinfar, symptoms and treatment

Manifested by vasomotor reactions and headache, sharp decline Blood pressure up to collapse, coma, tachycardia or bradycardia, hyperglycemia, tissue hypoxia. In case of poisoning, it is necessary to wash the stomach, appoint orally Activated carbon. Depending on the severity of the patient's condition, 10% is prescribed solution of calcium chloride or calcium gluconate, first in / in a jet, and then by long-term infusion.

Storage conditions of the drug Corinfar

In a place protected from light.

List of pharmacies where you can buy Corinfar:

Saint Petersburg

corinfar

International non-proprietary name

Nifedipine

Dosage form

Long-release film-coated tablets

Compound

One tablet contains

active substance - nifedipine 10 mg,

Excipients:lactose monohydrate, potato starch, microcrystalline cellulose, polyvidone K 25, magnesium stearate, methylhydroxypropyl cellulose, macrogol 6000, macrogol 35000, quinoline yellow dye (E 104), titanium dioxide (E 171), talc

Description

Tablets of a round form, with a biconvex surface, covered with a cover of yellow color.

Pharmacotherapeutic group

Blockers of "slow" calcium channels. Blockers of "slow" calcium channels are selective. dihydropyridine derivatives. Nifedipine.

ATX code C08CA05

Pharmacological properties

Pharmacokinetics

After oral administration on an empty stomach, the active substance nifedipine is rapidly and almost completely absorbed from the gastrointestinal tract. Nifedipine undergoes active metabolism during the first passage through the liver. The bioavailability of Corinfar is 50 - 70%.

The maximum plasma or serum concentrations when Corinfar is used as a solution are reached after about 15 minutes, when used in the form of other dosage forms without prolonged release of the active substance - after 15-75 minutes. Approximately 95% of nifedipine administered to the body binds to plasma proteins (albumins). In the liver, nifedipine is almost completely metabolized, primarily due to oxidative and hydrolytic processes. The resulting metabolites do not have pharmacodynamic activity. In the form of metabolites, nifedipine is excreted from the body mainly through the kidneys. At the same time, the main metabolite is M-1, it accounts for 60-80% of the dose of nifedipine taken. Remaining quantity medicinal substance excreted in the form of metabolites along with feces. Only traces of the active substance in unchanged form are found in the urine (less than 0.1%). The half-life is 2-5 hours. The accumulation of the drug in the body during long-term treatment with therapeutic doses has not been described. With reduced liver function, there is a clear prolongation of the half-life of the active substance and a decrease in total plasma clearance.

Pharmacodynamics

Corinfar is a representative of calcium antagonists of the group of derivatives 1,4-dihydropyridine.Calcium antagonists in a highly specific form react withvoltage-gated calcium channels and block the flow of ionscalcium through calcium channels typeLin a cell. Downgrade in progress calcium concentration inside the cells and thereby inhibition of intracellulartransmission of impulses.Corinfar primarily affects the smooth muscle cells of the coronary arteries andperipheral vessels. The consequence of this is the expansion of the coronary and peripheral arterial vessels. When used in therapeutic doses Corinfarpractically no direct effect on the myocardium. Corinfar reduces the muscle tone of the coronary vessels, as a resultwhich causes their expansion and increases coronary blood flow. In connection with the expansion of arterial vessels, Corinfar simultaneously reduces peripheral vascular resistance. At the start of treatmentreflexively increase the heart ratecontractions and cardiac output. This boost is not enoughstrongly expressed in order to compensate for vasodilation. As a resultthis lowers blood pressure.With long-term treatment with Corinfar, increased minute volume back to baseline. Particularly sharp drop blood pressure during treatment with Corinfarobserved in patients with arterial hypertension.

Indications for use

stable angina (angina pectoris)

Vasospastic angina (Prinzmetal's angina, variant angina)

- essential arterial hypertension

Dosage and administration

Doses of the drug are selected by the doctor individually according to the severity of the disease.and sensitivity of the patient to the drug.

1.Cstable and vasospastic angina

The average daily dose is 20-30 mg, the frequency of administration

multiplicity of appointment

2. Essential hypertension

The average daily dose is 20-30 mg,multiplicity of appointment1 tablet (10 mg) 2-3 times a day.

With insufficient severity of the clinical effect, a gradualincreasing the daily dose of the drug to 40 mg,multiplicity of appointment2 tablets 2 times a day.

The maximum daily dose should not exceed 80 mg,multiplicity of appointment4 tablets 2 times a day.

Corinfar tablets are taken orally after meals, without chewing and drinking enoughamount of liquid.

Simultaneously taken food delays, but does not reduce the absorption of actiona substance from the gastrointestinal tract.

The minimum interval between doses of the drug should be at least 4 hours. With a double prescription of the drug per day, the recommended interval for takingis approximately 12 hours (morning and evening).

As a rule, treatment with Corinfar is carried out for a long time.

The duration of therapy is determined by the attending physician.

If you miss the next single dose, there is no need to use after thatdouble the amount of Corinfar, and continue taking it according to the prescribed scheme.

A single dose of a smaller amount of Corinfar (for example, half dose) does not lead to any consequences.

With long-term use of Corinfar in very low doses, the success of treatment is put under doubt. Sudden interruption of treatment may result in sharp deterioration diseases, therefore therapy, especially carried out at high doses and / or for a long period, is stopped by a gradual decrease in the dose, after prior consultation with the doctor.

Side effects

Criteria for the degree of frequency of detection of adverse reactions:

often (≥1/100 to< 1/10); нечасто (≥ 1/1000 до <1/100); редко (≥1/10000 до < 1/1000), неизвестно.

Often:

Headache, dizziness, malaise;

Edema, dilation of blood vessels;

Infrequently:

Allergic reaction, allergic / angioedema (including laryngeal edema);

Anxiety reactions, sleep disturbances, vertigo, migraine, tremor, paresthesia, dysesthesia, visual disturbances;

Tachycardia, palpitations, hypotension, chills, fainting;

Nasal congestion, nosebleeds;

Gastrointestinal disorders, abdominal pain, nausea, vomiting, dyspepsia, bloating, dry mouth;

Short-term increase in the level of liver enzymes;

arthritis, muscle spasms;

Polyuria, dysuria;

erectile dysfunction

Pain

Rarely:

Itching, urticaria,

Hyperplasia of the gingival mucosa

Unknown:

Agranulocytosis, leukopenia, anaphylactic reactions;

hyperglycemia

Drowsiness

Pain in the eyes

Pain in the region of the heart

Gastroesophageal reflux, vomiting, jaundice

Toxic epidermal necrolysis

Photodermatosis

Arthralgia, myalgia

Contraindications

- cardiogenic shock

Severe aortic stenosis

Unstable angina

Acute period of myocardial infarction (during the first 4 weeks)

during treatment with rifampicin

Hypersensitivity to nifedipine

Pregnancy and lactation

decompensated liver, kidney and heart failure

arterial hypotension (systolic blood pressure below 90 mm Hg)

Children and adolescents up to 18 years of age

Hereditary fructose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption

Drug Interactions

The hypotensive effect of Corinfar may be enhanced with simultaneous useother antihypertensive agents, as well as tricyclic antidepressants.

With the simultaneous use of Corinfar and beta-blockers, patients are carefully monitored, tk. while it maythere is a sharp drop in blood pressure, in addition, there were casesweakening of the heart.

Certain medicines from the calcium channel blocker groupmay further enhance the negative inotropic effect (reducing the strengthcontraction) of such antiarrhythmic drugs (drugs used incardiac arrhythmias), such as amiodarone and quinidine.

In combination therapy with quinidine, it is recommended to control the level the concentration of quinidine in the blood, tk. in some cases, Corinfar causes its decrease or after the abolition of Corinfarus, its sharp increase occurs.

Corinfar can cause an increase in the level of digoxin (a cardiac glycoside) andtheophylline (an anti-asthma drug), so their plasma levels should be monitored.

Cimetidine, and to a lesser extent, ranitidinemay enhance the effect of Corinfar.

special instructions

Under close supervision, Corinfar should be prescribed to patients with impaired liver function.

Use with caution in patients with hypertrophic obstructive cardiomyopathy, severe bradycardia or tachycardia, sick sinus syndrome, heart failure, mild or moderate arterial hypertension, severe cerebrovascular accident, obstruction of the gastrointestinal tract.

In patients with high blood pressure or coronaryheart disease after abrupt discontinuation of the drug may develop"withdrawal phenomenon", expressed by a sharp increase in blood pressure(hypertensive crisis) or decreased blood supply to the heart muscle (ischemiamyocardium), so the drug should be discontinued gradually.

Features of the influence of the drug on the ability to drive transport and perform work that requires accurate movements.

Consideration should be given to the possibility of slowing down psychomotor reactions associated with a decrease in blood pressure.

Overdose

Symptoms: loss of consciousness up to the development of coma, drop in blood pressure,tachycardia or bradycardia, hyperglycemia,metabolic acidosis, hypoxia.

Treatment: excretion of the drug, restoration of a stable state of the cardiovascular system.

First of all, induce vomiting, wash the stomach abundantly, if necessary, thenin combination with lavage of the small intestine. If necessary, plasmapheresis is recommended. With the development of bradycardia, atropine and / or beta-sympathomimetics should be prescribed, with bradycardia that threatens the life of the patient, a pacemaker should be temporarily implanted.

With arterial hypotension, 1-2 g of calcium gluconate is injected intravenously, dopamine (up to 25 μg / kg body weight / min.), Dobutamine - up to 15 μg / kg body weight / min., adrenaline or noradrenaline - up to 2 ml.