According to statistics, about 26% of adults in the world regularly suffer from hypertension. Most often, such a disease is associated with a person's genetic predisposition. However, there are other reasons for its occurrence. These include obesity, smoking, excessive consumption of table salt, a deficiency of trace elements and vitamins in the body, alcohol abuse, stressful situations, low physical activity, and others.
It should also be noted that the development of hypertension directly depends on the person's age. The older he is, the higher the risk of such a pathological condition. At the age of 40 years, this disease is almost always the result of sclerotic vascular lesions.
general information
Most often, doctors diagnose essential hypertension to their patients . What it is? This is a chronic disease and a form of arterial hypertension. Its main clinical symptom is a persistent and prolonged increase in blood pressure.
Changes in this disease can be different. However, they primarily relate to blood vessels and the heart.
To improve the condition of the patient, doctors recommend taking a drug such as Zanidip. Reviews of patients about the effectiveness of this medication we will consider in the materials of this article. Also in it you will find information on how to take the mentioned medication, whether it has analogues and side effects.
Description, composition, shape and packaging
The medicine "Zanidip", the instruction of which is in a cardboard box, is available in the form of tablets of light yellow color, as well as a round and biconvex shape with a risk on one side. They are film-coated and have a yellowish tinge at the fracture.
The active ingredient in this medicine is lercanidipine hydrochloride. Also, its composition includes auxiliary components, which are presented in the form of povidone K30, lactose monohydrate, sodium carboxymethyl starch, microcrystalline cellulose and magnesium stearate.
As for the film coating of the drug, it includes substances such as opadray yellow, talc, hypromellose, titanium dioxide, iron dye oxide yellow and macrogol 6000.
You can buy Zanidip tablets in blisters that are placed in paper boxes.
Pharmacological characteristics of the drug
Do you know what Zanidip is? Instructions for use indicate that it is a slow calcium channel blocker. Its active ingredient is a racemic mixture of right- and left-handed stereoisomers. It should also be noted that it is a derivative of 1,4-dihydropyridine.
This medication selectively blocks the flow of calcium ions into the heart cells, vascular wall cells and smooth muscles.
The principle of prolonged antihypertensive effect of the drug is due to the direct relaxing effect on vascular smooth muscle cells.
According to the attached instructions, the therapeutic effect after taking the medication is achieved after 5-7 hours. Moreover, the duration of its action is maintained throughout the day.
Due to the high selectivity of the drug to smooth muscle cells of blood vessels, it has no negative inotropic effect.
So what is the medicine Zanidip-Recordati? The instruction states that this is a metabolically neutral drug that does not have a special effect on the content of apolipoproteins and lipoproteins in the blood serum, and also does not change the fat profile in people with arterial hypertension.
Drug kinetics
Where is the Zanidip drug absorbed? Instructions for use inform us that after taking tablets (10 or 20 mg) inside, lercanidipine is almost completely absorbed from the digestive tract. After 1.5-3 hours, the maximum concentration of the drug in blood plasma reaches 3.3 ng / ml or 7.66 ng / ml, respectively.
The distribution of the drug to organs and tissues occurs rather quickly. Communication with plasma proteins exceeds 98%. With the repeated use of tablets, their cumulation is not observed.
The metabolism of the drug is carried out during the first passage through the liver. This happens through the biological transformation of CYP3A4. In this case, a number of metabolites are formed that do not have pharmacological activity.
The medicine Zanidip is being withdrawn, reviews of which are presented a little lower, through the intestines and kidneys. There are two phases of excretion of lercanidipine: the early, the period of which is 2-5 hours, and the final - 8-10 hours.
In an unchanged form, the drug is practically not found in feces and urine.
In people with hepatic and renal failure, the plasma protein content is significantly reduced. In this regard, the free fraction of the active substance of the drug can be significantly increased.
Indications for taking the medicine
For what purpose can the Zanidip medication be prescribed? Reviews of doctors report that this tool effectively manifests itself in essential hypertension of moderate and mild severity.
Contraindications to taking pills
According to the instructions, the drug "Zanidip" should not be taken in the presence of the following conditions:
- severe violations of the liver;
- heart failure of a chronic nature (especially in the stage of decompensation);
- impaired kidney function;
- unstable angina pectoris;
- combinations with potent inhibitors of the CYP3A4 isoenzyme (for example, Ketoconazole, Erythromycin, Itraconazole), as well as Cyclosporin and grapefruit juice;
- during pregnancy;
- vascular obstruction that originates from the left ventricle of the heart;
- lactose intolerance, lactase deficiency and galactose / glucose malabsorption syndrome;
- during breastfeeding;
- recently suffered myocardial infarction (in the period of one month);
- in the childbearing age of women who do not use reliable contraception;
- at a minor age (efficacy and safety have not been established);
- hypersensitivity to lercanidipine, as well as other derivatives of the dihydropyridine series or any components of the drug.
Acute medication
Zanidip-Recordati is recommended to be used with caution in people with impaired liver function (moderate and mild severity), with chronic heart failure, sinus node syndrome , left ventricular failure, and ischemic heart disease, as well as with the use of Digoxin, beta-blockers.
Zanidip tablets: instruction for use
Due to the presence of a large number of side effects, the drug in question should be prescribed only by an experienced specialist. As a rule, this medication is recommended to be taken in an amount of 10 mg once a day.
Pills should be taken in the morning, ¼ hours before breakfast.
Depending on the therapeutic effect, the dosage of the drug in question can be doubled, that is, up to 20 mg. Increasing doses of the drug should occur gradually. If required, then an increase in the amount of medication is carried out after two weeks after the start of therapy.
How should I take Zanidip-Recordati? The tablets are not chewed. They are swallowed as a whole and washed down with a sufficient amount of liquid.
In older people, dose adjustment is not required. But when taking the drug, their condition requires regular monitoring.
In the presence of moderate or mild hepatic or renal failure, dosage adjustment is also not required. In the first few days, the drug is prescribed in an amount of 10 mg, and then with caution increase the dose to 20 mg per day.
If the antihypertensive effect is very pronounced, then the indicated dosage is reduced.
Side effects
Can “Zanidip-Recordati” cause unwanted reactions? Customer reviews report that while taking this drug, they often have side effects. Which ones, we will consider right now:
- Immune system: hypersensitivity.
- Cardiovascular system: tachycardia, angina pectoris, palpitations, fainting, flushing of the face, chest pain, marked decrease in blood pressure, myocardial infarction.
- Nervous system: drowsiness, headaches, dizziness.
- Digestive tract: vomiting, dyspepsia, nausea, reversible increase in liver enzyme activity, diarrhea and abdominal pain.
- Skin: rash.
- Musculoskeletal system: myalgia.
- Urinary system: polyuria.
- Other: peripheral edema, asthenia, gingival hyperplasia, increased fatigue.
Overdose Signs
What effects will follow if you take high doses of the Zanidip medication? The instruction indicates the following symptoms of an overdose: myocardial infarction, reflex tachycardia, peripheral vasodilation with a marked decrease in blood pressure, an increase in the duration and frequency of angina attacks.
To eliminate such conditions, symptomatic treatment is performed.
Drug interaction
Is it possible to combine Zanidip medication with other drugs? Instructions for use indicate that this product should not be combined with such CYP3A4 inhibitors (isoenzymes of liver cytochrome P450), such as Itraconazole, Ketoconazole and Erythromycin. This is due to the fact that all of the listed drugs increase the concentration of lercanidipine in the blood, and also lead to an antihypertensive effect.
The simultaneous use of the drug in question with Cyclosporine is contraindicated, as this can lead to an increase in the content of both substances in the patient’s blood.
Lercanidipine is forbidden to use with grapefruit juice. Such a combination can lead to a potentiation of the antihypertensive effect and inhibition of the metabolism of lercanidipine.
Extreme caution should be exercised while taking Zanidip with drugs such as Astemizole, Terfenadine and Quinidine, as well as third-class antiarrhythmic drugs (for example, Amiodarone).
The combination of the medication in question with anticonvulsant drugs (Phenytoin, Carbamazepine) and Rifamycin can help lower the level of lercanidipine in the blood, as a result of which the antihypertensive effect of lercanidipine will decrease.
With the combination of the drug with Digoxin, continuous monitoring of signs of intoxication should be carried out.
The concomitant use of the drug with Midazolam in adulthood can lead to an increase in the absorption of lercanidipine and a decrease in the rate of its absorption.
Experts say that Metoprolol is able to reduce the bioavailability of lercanidipine by 50%. At the same time, the bioavailability of Metoprolol itself remains unchanged. This effect occurs due to a decrease in hepatic blood flow caused by beta-blockers.
The drug "Cimetidine" at a dosage of 800 mg per day does not lead to significant changes in the concentration of lercanidipine in the blood. But when taking it, special care is required, since at increased doses the bioavailability of lercanidipine can increase, and therefore its antihypertensive effect may increase.
When combining Zanidip with Simvastatin, the first drug must be taken in the morning, and the second in the evening.
The drug "Fluoxetine" has no effect on the kinetics of lercanidipine.
The concomitant use of Zanidip with Warfarin does not affect the pharmacokinetics of the latter.
The drug in question can be combined with diuretics, beta-blockers and ACE inhibitors.
It should be noted that ethanol enhances the antihypertensive effect of drug medication.
Special recommendations
The drug "Zanidip", the analogues of which are listed below, should be prescribed with special care to people with impaired renal function and coronary heart disease, since in this case there is a high risk of an increase in angina attacks.
Before taking the drug, it is necessary to compensate for chronic heart failure.
Particular care must be taken at the very beginning of therapy, especially for patients with moderate and mild severity of liver failure.
During treatment, it is advisable to carefully perform work that requires increased attention, including when driving. This is due to the fact that at the very beginning of therapy and when doses of the drug are exceeded, there is a risk of headache, drowsiness and dizziness.
Storage conditions, shelf life and sale of the drug
Where can I buy Zanidip-Recordati tablets? Analogues of this tool and the medication itself are sold in any pharmacy. However, they can only be purchased by medical prescription.
It is advisable to store this medicine out of the reach of small children, where the air temperature does not exceed 30 degrees.
The shelf life of the drug in question is three years. After this period, taking medication is prohibited.
Analogues of the drug
Do you know how to replace Zanidip tablets? Analogues of this tool are quite difficult to find. Specialists report that drugs such as Lerkamen and Lerkanidipine have similar properties and the principle of action. These medications should be taken only on medical advice.
The drug "Zanidip": reviews of patients and specialists
It is a very effective antihypertensive agent. This is the opinion held by many doctors. Almost all patients who took Zanidip tablets agree with them. They claim that after taking the medicine, their condition improves markedly. Signs of moderate to mild essential hypertension go away almost immediately.
The only disadvantage of this medicine is that its administration very often causes adverse reactions, especially from the digestive tract and the cardiovascular system.
It should also be noted that many people complain that the price of this medicine is overpriced. This drug in the amount of 28 tablets can be purchased for 450-500 rubles. It should be noted that the analogues of the mentioned medication in the form of “Lerkamen” and “Lerkanidipin” are not cheaper at all. They can be purchased at the same price.
Experts say that the cost of the anti-hypertensive drug Zanidip is fully consistent with its quality. This shows almost all of his long-term application experience.