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Corinfar 20 mg coated (30 tablets)

  • $13.00
Sku: 9c3b25cb5106
Ingredient: Nifedipine
The instruction for medical use

of medicine

Corinfarum retard



the Trade name

of the drug Corinfarum retard



the International unlicensed





name Nifedipine Dosage Form

of the Tablet, coated, 20 mg



Structure

One tablet contains

active agent - nifedipine of 20 mg,

excipients: lactoses monohydrate, potato starch, cellulose microcrystalline, PVP K 25, magnesium stearate, methylhydroxypropyl cellulose, macrogoal 6000, macrogoal 35000, dye quinolinic yellow (E 104), titan dioxide (E 171), talc



Description

Yellow, biconvex, round tablets, coated



Pharmacotherapeutic group

Blockers of slow calcium channels. Blockers of slow calcium channels selection. Dihydropyridinic derivatives. Nifedipine.

The ATX C08CA05 code



Pharmacological



Framakokinetika Posle properties of use inside on an empty stomach active ingredient nifedipine quickly and almost is completely soaked up from digestive tract. Nifedipine is exposed to active metabolism at the first passing through a liver so the system bioavailability is 50 - 70%. The maximum concentration in plasma or serum are reached approximately in 0.9 - 3.7 hours and their value averages 28.3 ng/ml. Gets through hematoencephalic and placentary barriers, it is allocated with breast milk. About 95% of the nifedipine entered into an organism contact proteins of blood plasma (albumine). In the form of metabolites, nifedipine is removed from an organism mainly through kidneys. At the same time the main metabolite is M-1, 60 - 80% of the accepted nifedipine dose fall to its share. Other amount of medicinal substance is removed in the form of metabolites together with a stake. Only traces of active agent in not changed form meet in urine (less than 0.1%). Elimination half-life makes 2-5 hours. Accumulation of medicinal substance in an organism when performing long-term treatment by therapeutic doses was not described. At the lowered function of a liver the accurate lengthening of elimination half-life of active agent and reduction of the general plasmatic clearance is noted. Chronic kidney disease, a hemodialysis and peritoneal dialysis do not influence pharmacokinetics

the Pharmacodynamics

Corinfarum retard is the representative of antagonists of calcium of group derivative 1.4 dihydropyridines. Antagonists of calcium in a highly specific form react with potentsialzavisimy calcium channels and block receipt of calcium ions through calcium channels like L in a cell. There is lowering of concentration of calcium in cells and by that oppression of intracellular momentum transfer. Corinfarum retard first of all influences smooth muscle cells of coronary arteries and peripheral vessels. Expansion of coronary and peripheral arterial vessels is a consequence of it. At use in therapeutic doses Corinfarum retard has practically no direct impact on a myocardium. In heart Corinfarum retard reduces a muscle tone of coronary vessels therefore there is their expansion and the coronary blood stream increases. Due to the expansion of arterial vessels Corinfarum retard at the same time reduces peripheric vascular resistance. In an initiation of treatment the heart rate and minute volume of heart reflex can increase. This increase is not rather severe to compensate a vazodilatation. As a result of it blood pressure goes down. At long-term treatment Corinfarum retardy the increased minute volume returns to initial level again. Especially accurate lowering of blood pressure at treatment Corinfarum retardy is noted at patients with a hypertension.



Indications

- stable stenocardia (angina of exertion)

- vasospastic stenocardia (Printsmetal's stenocardia, alternative stenocardia)

- arterial essential hypertension



the Route of administration and doses

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

1. Stable and vasospastic stenocardia

the Average daily dose of 40 mg, frequency rate of appointment on 1 tablet (20 mg) 2 times a day.

At insufficient expressiveness of clinical effect perhaps gradual increase in a daily dose of drug to 80 mg, frequency rate of appointment on 2 tablets (20 mg) 2 times a day.

The maximum daily dose, should not exceed 80 mg.

2. Essential hypertensia

the Average daily dose of 40 mg, frequency rate of appointment on 1 tablet (20 mg) 2 times a day.

At insufficient expressiveness of clinical effect perhaps gradual increase in a daily dose of drug to 80 mg, frequency rate of appointment on 2 tablets 2 times a day.

The maximum daily dose, should not exceed 80 mg.

The pill Corinfarum retard is taken inside after a meal, without chewing and washing down with enough liquid. The interval between receptions of two single doses of Corinfarum retard, should not be less than 4 hours. The recommended interval in reception of tablets retard makes about 12 hours (in the morning and in the evening). Sudden interruption of treatment can lead to sharp deterioration in a disease therefore the therapy which is especially carried out by high doses and/or during the long period is stopped a gradual dose decline, after preliminary consultation of the doctor.

To people 60 years drug are more senior appoint carefully.



Side effects

- a headache, dizziness and fatigue

- rush of blood to the person and a dermahemia (erythema, eritromelalgiya)

- paresthesias are possible at long reception of high doses

- the lowering of arterial pressure is lower than normal

- temporary deterioration in renal function. In the first weeks of treatment

the daily amount of the emitted urine can increase.

Seldom

- tachycardia, strong heartbeat, and owing to a vazodilatation, anklebone hypostasis

- concern, sleep disorders

- erectile dysfunction

- nausea, an abdominal distension and diarrhea, a constipation, dryness in a mouth, an abdominal pain

- the itching, urticaria and rash, an erythema

- pathological hyper sexuality, especially at elderly patients at long-term treatment

- in an initiation of treatment are possible attacks of stenocardia or the frequency, duration and severity of attacks at patients with the available stenocardia

Very seldom

- changes in gums (hypertrophic ulitis)

- myalgias, a tremor, muscular spasms, puffiness of joints

- minor temporary changes in visual perception (can increase at a big dosage)

- anemia, a leukopenia, thrombocytopenia and a Werlhof's disease, an agranulocytosis, a hyperglycemia

In isolated cases

- intra hepatic stagnation of bile, increase in activity of transaminases, jaundice

- esfoliativny dermatitis, a photodermatitis, a toxic epidermal necrolysis

- a syncope

- reversible anaphylactic tests, a Quincke's disease (including throats with a possible zhizneugrozhayushchy outcome)

- a myocardial infarction

- short wind

- vomiting



Contraindications

- cardiogenic shock

- the profound stenosis of the mouth of an aorta

- unstable stenocardia

- an acute period of a myocardial infarction (within the first 4 weeks)

- at the carried-out treatment by rifampicin

- hypersensitivity to nifedipine

- pregnancy and the period of a lactation

- cirrhosis

- dekompensirovanny liver, renal and heart

failure

- arterial hypotension (systolic arterial blood pressure is lower than 90 mm Hg)

- children's and teenage age up to 18 years

- hereditary intolerance of fructose, deficiency of Larr-lactases enzyme, glucose malabsorption - galactoses

Medicinal interactions

the Hypotensive effect of Corinfarum can amplify at simultaneous use of other antihypertensive drugs and also tricyclic antidepressants.

At simultaneous use of Corinfarum and beta-blockers for patients the careful observation since at the same time there can be a sharp falling of arterial blood pressure is established, besides, cases of weakening of warm activity were observed.

Certain medicines from group of blockers of calcium channels can enhance even more the negative inotropic effect (lowering force of warm reduction) of such antiarrhytmic means (the means applied at disturbances of a warm rhythm) as Amiodaronum and quinidine.

At combination therapy with quinidine it is recommended to control the level of concentration of quinidine in blood since in some cases Corinfarum retard causes lowering it or after Corinfarum cancellation retard there is its sharp increase.

Corinfarum retard can cause increase in level of digoxin (cardiac glycoside) and theophylline (antiasthmatic means) therefore it is necessary to control their content in blood plasma.

Cimetidinum, and to a lesser extent, ranitidine can strengthen effect of Corinfarum retard.



Special instructions

Under careful observation patients should appoint Corinfarum with an abnormal liver function.

With care to apply the patient with the hypertrophic subaortic stenosis expressed by bradycardia or tachycardia, a sick sinus syndrome, heart failure, slight or moderate arterial hypertension, heavy disturbances of cerebral circulation, impassability of digestive tract.

At patients with high arterial blood pressure or a coronary artery disease after the sudden termination of administration of drug the phenomenon of the cancellation which is expressed by sharp increase in arterial blood pressure (hypertensive crisis) or reduction of blood supply of a cardiac muscle (myocardium ischemia) can develop therefore drug should be cancelled gradually.

Features of influence of medicine on ability of control of transport and performance of work, the demanding exact movements.

It is necessary to consider a possibility of delay of the psychomotor reactions connected with a lowering of arterial pressure.



Overdose

Symptoms: a loss of consciousness up to development of a coma, falling of arterial blood pressure, tachycardia or bradycardia, a hyperglycemia, a metabolic acidosis, a hypoxia.

Treatment: drug removal, restoration of a stable condition of a cardiovascular system.

First of all cause vomiting, plentifully wash out a stomach if it is necessary, then in combination with washing of a small intestine. If necessary carrying out a plasma exchange is recommended. At development of bradycardia it is necessary to appoint atropine and/or beta sympathomimetics, in bradycardia, life-threatening temporarily to implant the patient the pacemaker.

In arterial hypotension in/in enter 1-2 g of a gluconate of calcium, in into by drop infusion dopamine (to 25 mkg/kg of body weight/min.), Dobutaminum up to 15 mkg/kg of body weight/min., adrenaline or noradrenaline up to 2 ml.



The form of release and packing

from polyvinylchloride and aluminum foil place 10 tablets In blister strip packaging. On 3 strip packagings together with the instruction for use in the state and Russian languages put in a cardboard pack.



Storage conditions

of Hranit in the place protected from light, at

a temperature not higher than 30 S. Hranit out of children's reach!





3 years

not to apply a period of storage after an expiration date.



Prescription status

According to the prescription





PLIVA Producer of Hrvatsk of of the lake

of the island of Prilaz of a barun of Filipovich, 25

10 000 Zagreb, Croatia



the Owner of the registration certificate

of Teva Pharmaceutical Industries Ltd,

the Address of the organization accepting in the territory of the Republic of Kazakhstan claims from consumers on quality of products (goods)
Representative office
Pliva Hrvatsk in

Republic of Kazakhstan 050040 Republic of Kazakhstan Almaty, Al-Farabi Avenue 19
Business center of Nurla Tau 1B of office
603 Phone number, fax (727) 311-09-15, 311-07-34
Teva@teva.kz

to Develop Israel
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