The sudden appearance of pain behind the sternum and hypertensive crisis, require urgent intervention. "Nifedipine" is an effective tool that helps to quickly reduce blood pressure and relieve the attack. Below we’ll talk in more detail about the principle of the drug’s action, in which cases it helps and whether there are contraindications for use.
Release form and composition
"Nifedipine" is available in the form of coated tablets with a biconvex surface, yellow in color. Two layers are visible on the cross section of the tablet. The main active component of the drug is nifedipine. One tablet contains 10 or 20 milligrams of this component. Excipients include: potato starch, milk sugar, povidone 25, microcrystalline cellulose, magnesium stearate, sodium lauryl sulfate, hypromellose, titanium dioxide E 171, tween-80, talc, macrogol 6000, quinoline yellow E 104.
How does it work
Nifedipine is a derivative of dihydropyridine and is considered selective calcium channel blockers. The drug inhibits the entry of calcium into the smooth muscle cells of the vascular system and into cardiomyocytes. The following effects from the use of this medication are distinguished:
- Antihypertensive and antianginal effects.
- Decreased vascular smooth muscle tone.
- Expansion of peripheral and coronary arteries.
- Decreased blood pressure and peripheral vascular resistance.
- Decreased myocardial contractility.
- Reduced oxygen demand and myocardial afterload.
- Long-term use reduces the risk of new atherosclerotic plaques in the coronary vessels.
- Nifedipine does not inhibit myocardial conduction.
- Improving coronary blood flow.
At the initial stage of treatment with the drug, an increase in cardiac output and a passing reflex tachycardia can be noted. In addition, the drug increases the excretion of water and sodium from the body. With Raynaud's syndrome, the drug reduces or prevents spasm of the vessels of the limbs.
Who is assigned
Individual dosages of nifedipine are most often prescribed in the treatment of high blood pressure. When using this tool, hypertensive crisis is quickly eliminated. Nifedipine is used in the following cases:
- Arterial hypertension.
- Congestive cardiopulmonary failure.
- Coronary artery spasm.
- Angina pectoris.
- Raynaud's Syndrome.
- Hypertrophic cardiomyopathy.
Nifedipine has excellent reviews from therapists and cardiologists. In accordance with the instructions for the drug, it is effectively used for the following diseases:
- Blood stagnation.
- Heart failure.
- Pulmonary hypertension.
- Blockage of blood vessels.
- Bronchospasm.
- Cerebrovascular accident.
- Coronary heart disease.
- Hypertensive crisis.
- Atherosclerosis of the peripheral arteries.
Contraindications
In the following situations, any dosage of Nifedipine is prohibited:
- Tachycardia.
- The period is up to one month after an acute myocardial infarction.
- Lactation.
- Collapse, cardiogenic shock.
- Sick sinus syndrome.
- Arterial hypotension with systolic pressure below 90 mm. Hg. Art.
- Age to 18 years. Any dosage of Nifedipine is contraindicated in children.
- Severe mitral aortic stenosis.
- Idiopathic hypertrophic subaortic stenosis.
- Individual intolerance to the substances that make up the drug.
- Decompensated heart failure.
Due to the possibility of complications, in the following cases, the drug should be used with extreme caution:
- Pregnancy (as prescribed by the doctor).
- Diabetes.
- Malignant arterial hypertension.
- Severe cerebrovascular accident.
- Violations of the liver and kidneys.
- Chronic heart failure.
In addition, individuals on hemodialysis should use Nifedipine with caution.
Use during pregnancy
In some cases, doctors prescribe a specific dosage of "Nifedipine" with uterine tone during pregnancy. This is because the drug belongs to tocolytics, which reduce the ability of the uterus to contract. This property of the drug is used to prevent premature birth and relieve uterine hypertonicity.
It is known that the main provocateur of uterine contractions is calcium, therefore, the use of this medication successfully eliminates hypertonicity and pathological contractions. The drug quickly eliminates the resistance of peripheral vessels, which helps to evenly reduce pressure during hypertensive crisis.
It is worth noting that such a feature of Nifedipine was not immediately discovered. Previously, other tocolytic agents that had a more pronounced teratogenic effect on the fetus were used as therapy for pregnant women. At present, obstetricians practice the use of small doses of Nifedipine during pregnancy. After all, the drug is characterized by insignificant side effects on the mother and baby, compared with analogues. But everyone should know that the drug is taken only in case of emergency.
Danger
Given a decent list of additional chemical components, it is necessary to understand some features of the application when determining the dosage of "Nifedipine" during pregnancy:
- Since the medicine contains lactose, it can have a negative effect on a woman who suffers from galactosemia and lactose deficiency.
- Nifedipine contains glycerol, which can cause stomach upsets and headaches.
- Wheat starch worsens the condition of a pregnant woman with gluten intolerance.
- The combined use of the drug and grapefruit juice enhances side effects from taking the drug.
- Yellow dyes can provoke allergic reactions (urticaria, asthma attack, edema).
When appointed
Nifedipine is used to treat the following complications during pregnancy:
- Hypertension.
- Risk of premature birth.
- Late gestosis.
- Increased uterine tone.
Instructions for use "Nifedipine" during pregnancy (dosage)
Since the drug is dangerous for the fetus, the duration of use and a safe dose is determined only by the attending physician based on the condition of the woman and blood counts. According to the instructions, the norm of taking "Nifedipine" during pregnancy is:
- One or two tablets twice daily.
- The maximum daily dose is 60 milligrams (six tablets).
- The therapeutic course is from one to six weeks.
- Treatment lasting more than three months is addictive to the drug.
The appointment of even the minimum dosage of "Nifedipine" during pregnancy with a tone is justified only in the case of complex treatment of hypertonicity, accompanied by a deficiency of oxygen in the tissues, heart failure and malfunctioning of the kidneys.
In addition to its positive properties, this drug has a number of serious drawbacks, and is considered a potentially dangerous drug during pregnancy. Therefore, faced with the need for treatment, it is necessary to discuss with the doctor the possibility of replacing Nifedipine with a safer drug.
Dosage of tablets "Nifedipine" and method of application
The instructions for the drug indicate that the regimen of taking "Nifedipine", as well as the necessary dosages, are set strictly individually and depend on the patient's response to the treatment and on the severity of the disease. Experts recommend taking the drug during or after a meal with a tablet of water.
The initial dosage of "Nifedipine" is: one tablet 2-3 times a day. If necessary, the dose can be increased to 2 pieces twice a day. In patients receiving combination therapy, in elderly patients, as well as with violations in the liver and cerebral circulation in a patient, the dosage can be reduced.
Side effects
Like other drugs for pressure, Nifedipine can cause side effects from certain systems and organs:
- Endocrine system - gynecomastia.
- Circulatory system - thrombocytopenia and leukopenia.
- The genitourinary system - an increase in diuresis, with a long intake - problems in the work of the kidneys.
- Cardiovascular system - a strong drop in pressure, swelling of the limbs and skin, asystole, sensation of heat, bradycardia, tachycardia, angina pectoris.
- From the gastrointestinal tract: diarrhea, nausea, heartburn, problems in the liver. If you take the drug for a long time in large doses, an increase in transaminases and cholestasis can occur.
Overdose
According to the instructions, the dosage of "Nifedipine" exceeding the recommended value can lead to the following consequences:
- Headache.
- Lowering blood pressure.
- Hyperemia of the face.
- Reduced heart rate.
In this case, treatment consists of washing the intestines, stomach and taking activated charcoal. In a hospital setting, therapy can be carried out aimed at improving the performance of the cardiovascular system, as well as the introduction of an antidote, which will be calcium gluconate or chloride. With a strong decrease in pressure, dopamine is used.
Application features
In order to avoid the risk of withdrawal syndrome, the drug is stopped drinking gradually. During the treatment period, you need to refrain from activities requiring the speed of psychomotor reactions and increased concentration of attention. Also, in the treatment of "Nifedipine" is not recommended to take alcohol.
Very often one can hear the question from patients: "At what pressure is it used?" "Nifedipine" is a fairly powerful tool that is taken only at high blood pressure: from 150 to 110 mm Hg. Art.
Drug interaction
When using this tool, its interaction with other drugs should be taken into account:
- The combination with nitrates enhances the hypotensive effect and tachycardia.
- The simultaneous use of beta-blockers and Nifedipine can only be done under medical supervision, as this can cause a strong decrease in blood pressure, and in some cases lead to symptoms of heart failure.
- The combination with "Rifampicin" weakens the effect of "Nifedipine."
- Blood pressure increases with the joint use of the drug with antihypertensive drugs, diuretics, Ranitidine, Cimetidine and tricyclic antidepressants.
It is worth knowing that this drug reduces the level of quinidine in blood plasma, and also increases the level of theophylline and digoxin, in connection with which it is necessary to control the clinical effects and the content of these substances in the blood.
Reviews about the drug
Most patients who are prescribed "Nifedipine" respond positively to the drug. For many, this drug is a quick ambulance. Patients report a rapid decrease in pressure during exacerbations of various diseases.
Reviews about the use of "Nifedipine" during pregnancy are contradictory. Not all women agree to take this medicine. Experts also say that the drug can be prescribed to a pregnant woman only as a last resort.
Analogues of the drug
Nifedipine has a large number of analogues. These include:
- Kordafen.
- "Adalat SL".
- Vero-Nifedipine.
- "Nifadil."
- Cordaflex.
- Nifesan
- "Phenigidin".
- Sanfidipine.
The prolonged Nifedipine also has analogues:
- Corinfar Uno.
- Cordipin Retard.
- "Nifedipine SS".
- Nifebene Retard.
Before using all of the above drugs, you should consult a doctor.
Storage conditions "Nifedipine"
According to the instructions for use, the drug must be stored at a temperature of 25 degrees in a place protected from moisture and light, inaccessible to small children.
The shelf life of the drug is three years from the date of manufacture.
Holiday conditions and cost of "Nifedipine"
The average price of the drug is 28 rubles (Moscow region). This medicine is dispensed only by prescription.
Conclusion
The information on this tool is for guidance only and does not replace the official instructions for use of Nifedipine. For any exacerbation of the disease, you must consult a doctor. Self-medication can be hazardous to health.