Cordaflex refers to a group of drugs that are blockers of slow calcium channels, is able to have anti-anginal and antihypertensive effects due to the active component - nifedipine.
The main purpose of this medication is to dilate the blood vessels and lower blood pressure. After taking Cordaflex in a prolonged form, the therapeutic effect occurs after 25-35 minutes and lasts for almost a day.
Clinical and pharmacological group
The calcium channel blocker.
Conditions of leave from pharmacies
It is released on prescription.
Price list
How much is Cordaflex? The average price in pharmacies is at the level of100 rubles.
.Form of issue and composition
Cordaflex is available in the following forms:
- Tablets of prolonged action, covered with a film membrane: brownish-violet, slightly shiny or matte, round, biconcave, with weak characteristic odor or odorless, on the fracture - yellow, with a brownish-violet edging (30 or 60 pieces in dark glass jars, in a cardboard bundle 1 bank).
- The tablets covered with a cover: yellow, round, biconcave, slightly shiny or matte, with a weak characteristic smell (100 pieces in bottles of dark glass, in a cardboard bundle 1 bottle).
The active ingredient is nifedipine (10 or 20 mg in 1 tablet).
Auxiliary components:
- Long-acting tablets: lactose monohydrate, croscarmellose sodium, microcrystalline cellulose, magnesium stearate, giprolase, talc, ethyl acrylate and methyl methacrylate copolymer (:).
- Tablets coated with a coating: polyvinyl butyral, talc, lactose monohydrate, hypromellose, magnesium stearate, hydroxypropylcellulose, microcrystalline cellulose, croscarmellose sodium, iron oxide yellow, titanium dioxide.
The composition of the coating of tablets of prolonged action: titanium dioxide, hypromellose, magnesium stearate, red iron oxide dye.
Pharmacological effect
Selective blocker of slow calcium channels, derivative, -dihydropyridine. Has antihypertensive and antianginal action. Nifedipine reduces the current of extracellular calcium ions into the cardiomyocytes and smooth muscle cells of the coronary and peripheral arteries. In therapeutic doses normalizes the transmembrane current of Ca ions, disrupted in a number of pathological conditions, primarily in hypertension.
- Does not affect the tone of the veins. Nifedipine increases renal blood flow, causing a mild sodium naresis. In high doses, it inhibits the release of Ca ions from intracellular depots. Reduces the number of functioning calcium channels, without affecting the time of their activation, inactivation and recovery.
- Reduces spasm and expands coronary and peripheral arterial vessels, reduces overall peripheral resistance, reduces afterload and myocardial oxygen demand. This improves the blood supply of ischemic zones of the myocardium without the development of the syndrome of "stealing and also increases the number of functioning collaterals. Nifedipine has virtually no effect on the sinoatrial and atrioventricular nodes and does not have both pro and antiarrhythmic effects.
After a single administration of Cordaflex in the form of a prolonged-release tablet, the clinical effect develops after 20 minutes, the duration of the clinical effect is 12-24 hours.
Indications for use
Indications for the appointment of Kordafleks are:
- Reynaud's syndrome (in particular, for prolonged exposure tablets).
- Ischemic heart disease - for the prevention of seizures with different forms of angina (including angina of Prinzmetal).
- Arterial hypertension of different genesis, including hypertensive crises (for tablets 10 mg).
Contraindications
The use of Cordaflex is contraindicated against the background of:
- Cardiogenic shock;
- Pronounced aortic or mitral stenosis, idiopathic hypertrophic subaortic stenosis;
- Pronounced arterial hypotension;
- Severe heart failure;
- The acute stage of myocardial infarction;
- Hypersensitivity to the active substance (nifedipine) and auxiliary components.
The medicine is not prescribed to women who are lactating and pregnant in the first trimester, as well as to adolescents and children under the age of 18.
Cordaflex, according to the instructions, is prescribed with caution to the patient who is on hemodialysis (due to high risk of development of severe arterial hypotension with peripheral vasodilation), elderly people, as well as background:
- Malignant arterial hypertension;
- Severe disorders of cerebral circulation;
- Hypertrophic obstructive cardiomyopathy;
- Chronic heart failure;
- Syndrome of weakness of the sinus node;
- Pronounced violations of the liver and kidneys;
- Pronounced tachycardia.
During pregnancy, Kordaflex is possible only in cases when it is impossible to normalize blood pressure with the use of other antihypertensive medications.
Use in pregnancy and lactation
Cordaflex tablets prolonged action is contraindicated for use until the 20th week of pregnancy.
Controlled studies of the use of the drug Cordaflex in pregnant women have not been conducted. According to available clinical data, it is impossible to judge the specific prenatal risk. At the same time, there are data on the increase in the probability of perinatal asphyxia, cesarean section, premature birth and intrauterine growth retardation. It is unclear whether these cases are due to a major illness (arterial hypertension), treatment or a specific effect of nifedipine. The information available is insufficient to exclude the possibility of side effects, which are dangerous for the fetus and the newborn. Therefore, the use of Cordaflex after the 20th week of pregnancy requires a careful individual assessment of the risk-benefit ratio for patient, fetus and / or newborn and can only be considered if other methods of therapy are contraindicated or ineffective.
A careful monitoring of blood pressure in pregnant women should be carried out with the use of Kordaflex while simultaneously with IV administration of magnesium sulfate due to the possibility of excessive reduction in blood pressure, which is dangerous for both the mother and the fetus and / or newborn.
Because nifedipine is excreted in breast milk, you should refrain from prescribing Cordaflex during lactation, or stop breastfeeding during treatment with the drug.
Dosage and route of administration
The instructions for use indicate: Cordaflex is taken internally. Tablets should be swallowed whole, not liquid, squeezed with a small amount of water.
- The recommended initial dose of the drug is 1 tablet. (20 mg) 2 times / day. If necessary, the daily dose can be increased to 2 tab. 2 times / day. The maximum daily dose of nifedipine should not exceed 120 mg. It is recommended to divide the daily dose into 2 doses with 12-hour intervals.
- In patients with impaired renal function, dose adjustment is not required.
- In elderly patients, the metabolism of nifedipine is reduced in the "first pass" through the liver, and the likelihood of worsening cerebral blood flow because of the possible sharp peripheral vasodilation, so at the beginning of the treatment, the dose of Cordaflex is reduced approximately in 2 times.
- In patients with impaired liver function, the drug is used with caution under the control of liver function, with severe violations of liver function, it is necessary to reduce the dose.
The drug should be discontinued gradually, especially after use in high doses.
Side effects
The use of a medication can trigger the following side effects:
- Musculoskeletal system: myalgia; sometimes - arthritis.
- Urinary system: an increase in daily diuresis; sometimes - impairment of kidney function in patients with chronic renal failure.
- The system of hematopoiesis: rarely - leukopenia, thrombocytopenic purpura, thrombocytopenia; sometimes anemia.
- Endocrine system: sometimes - galactorrhea, hyperglycemia, gynecomastia (after the withdrawal of the drug, these manifestations completely disappear), a change in body weight.
- Allergic manifestations: rarely - skin itching, exanthema, urticaria; sometimes - autoimmune hepatitis.
- Central and peripheral nervous system: increased fatigue, headache, sleep disturbances (insomnia or drowsiness), dizziness; in rare cases - impaired vision, mood lability; with prolonged use in high doses - tremor, paresthesia in extremities.
- Digestive system: attacks of nausea, heartburn, constipation, diarrhea; rarely (with prolonged use of Cordaflex) - flatulence, dry mouth, increased activity of liver enzymes, intrahepatic cholestasis; sometimes anorexia, gingivitis, gingival hyperplasia.
- Cardiovascular system: tachycardia, severe arterial hypotension, hyperemia of the facial skin, peripheral edema; rarely - fainting, increased heart failure and angina attacks (withdrawal necessary preparation).
- Other: sensation of heat; sometimes - photodermatitis, weakness, chills, fever, sweating.
Overdose
When taking Cordaflex over the established rate, there may be any symptoms, for example:
- extrasystole (both ventricular and nodular),
- fainting, loss of consciousness,
- bradycardia,
- tachycardia,
- hypotension,
- angina (pain in the chest area),
- collapse,
- headache,
- metabolic ankalosis,
- hyperkalemia,
- pulmonary edema, provoked by cardiogenic shock.
Elimination of symptoms of overdose is carried out in the following ways: reception of activated carbon with gastric lavage, plasmapheresis, etc. The matter is complicated by the fact that there is no antidote to this medicine.
Symptomatic therapy is also indicated in case of an overdose of the remedy:
- with bradycardia apply an artificial pacemaker,
- with a decrease in blood pressure, a norepinephrine (norepinephrine) infusion is administered,
- symptoms of violations of heart rhythms are eliminated by the introduction of beta-adrenomimetics or atropine,
- the development of symptoms of heart failure is eliminated by the introduction of intravenously high-speed glycosides.
special instructions
- With hypovolemia, the antihypertensive effect of the drug is enhanced.
- With a sharp withdrawal of nifedipine in patients with arterial hypertension or coronary artery disease, there may be myocardial ischemia or hypertensive crisis (the phenomenon of "bounce").
- In rare cases, at the beginning of therapy or with an increase in the dose of Cordaflex at some time after taking the drug, there may be chest pain (angina due to paradoxical ischemia). If the causal relationship between angina and the administration of the drug is established, treatment should be discontinued.
- In elderly patients, due to severe peripheral vasodilation, a decrease in cerebral circulation is likely.
- If surgical intervention is required under general anesthesia during Kradaflex therapy, you should inform about the treatment of an anesthesiologist.
- During the course therapy is not recommended to drink alcoholic beverages because of the risk of excessive lowering of blood pressure.
At the initial stage of treatment, Cordaflex is forbidden to drive vehicles and engage in other potentially dangerous activities requiring rapidity of psychomotor reactions. In the future, the degree of restriction is determined by the individual response of the patient to the drug.
Drug Interactions
Cordaflex is well combined with such antihypertensive drugs as:
- beta-blockers;
- diuretics;
- ACE inhibitors;
- nitrates.
In some cases, there is a danger of excessive reduction in blood pressure and the development of orthostatic hypotension, so the selection of an integrated therapy requires careful monitoring and monitoring of daily changes in blood pressure and other parameters of the cardiovascular system.
The combination of Cordaflex with clonidine, methyldopa, octadine and prazosin can cause orthostatic hypotension and is only permissible for individual indications.
The effect of nifedipine is weakened by the simultaneous administration of rifampicin, phenytoin and calcium preparations.
Strengthens the hypotensive effect of the simultaneous administration of Cordaflex and ranitidine, cimetidine and tricyclic antidepressants.
The intake of erythromycin and antifungal drugs based on azoles suppresses the natural metabolism nifedipine, as a result of which it remains in the body and has a hypotensive effect for a longer time. The same effect is provided by grapefruit juice and alcohol, which are natural inhibitors of the isoenzyme CYP3A4, which is responsible for the metabolism of nifedipine.
Reviews
Kordaflex tablets have mixed reviews of patients, although positive still prevail. This may be due to the fact that in most cases the choice of the drug and dose is made by the doctor, and the side effects when using the drug are relatively rare.
Analogues
The analogues of Cordaflex are:
- On the active substance - Nifedikap, Nifedipine, Kalzigard, Adalat, Zanifed, Kordafen, Nykardiya, Kordipin, Osmo-Adalat, Fenigidin;
- By the mechanism of action - octidipine, Felodip, Corvadil, Amlodigamma, Amlovas, Amlodipine, Amlo, Agen, Foridon, Amlodak, Amlodil, Kalchek, Norvasc, Sakur, Amlodifarm, Latsipil, Amlong, Amlonorm, Karmagip, Amlosor, Cardilopin, Tenox, Nimopin, Norvadin, Normodipin, Foridon.
Before using analogues, consult your doctor.
Storage conditions and shelf life
To injure a medicine it is necessary in a place inaccessible to children at a temperature of no more than 25 degrees. The shelf life of the tablets is indicated on the package, after expiration, the medicine should be discarded.
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