Cordaflex
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 83 rub.
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Cordaflex is a 1,4-dihydropyridine derivative, a selective slow calcium channel blocker, a drug with antihypertensive and antianginal effects.
Release form and composition
- Film-coated tablets: round, convex on both sides, yellow, with a matte or slightly shiny surface, with a weak characteristic odor (100 pcs. In dark glass bottles, 1 bottle in a cardboard box);
- Sustained-release film-coated tablets: round, convex on both sides, brownish-purple in color, matte or slightly shiny, with a weak characteristic odor or no odor at all; at the break - yellow with a narrow strip of brownish-violet color along the edges (30 or 60 pcs. in dark glass jars, 1 can in a cardboard box).
The active substance is nifedipine:
- 1 coated tablet - 10 mg;
- 1 extended-release tablet - 20 mg.
Excipients of tablets 10 mg: lactose monohydrate, titanium dioxide, hydroxypropyl cellulose, talc, croscarmellose sodium, magnesium stearate, microcrystalline cellulose, polyvinyl butyral, hypromellose, iron oxide yellow.
Additional components of tablets 20 mg:
- Excipients: lactose monohydrate, copolymer of methyl methacrylate and ethyl acrylate [1: 2], microcrystalline cellulose, talc, croscarmellose sodium, hyprolose, magnesium stearate;
- Sheath composition: titanium dioxide, hypromellose, magnesium stearate, iron oxide red dye (E172).
Indications for use
- Arterial hypertension of various origins, including hypertensive crises (10 mg tablets);
- Raynaud's syndrome (for 20 mg tablets);
- Ischemic heart disease: prevention of attacks in various forms of angina pectoris, including angiospastic (Prinzmetal's angina).
Contraindications
Absolute:
- Severe arterial hypotension (indicators of systolic blood pressure below 90 mm Hg);
- Acute stage of myocardial infarction;
- Idiopathic hypertrophic subaortic stenosis, pronounced mitral or aortic stenosis;
- Cardiogenic shock;
- Severe heart failure;
- Age under 18;
- I trimester of pregnancy;
- Lactation;
- Hypersensitivity to drug components.
Relative:
- Chronic heart failure;
- Sick sinus syndrome;
- Hypertrophic obstructive cardiomyopathy;
- Severe disorders of cerebral circulation;
- Severe tachycardia;
- Severe renal / liver dysfunction;
- Malignant arterial hypertension;
- Lactose intolerance;
- Elderly age.
Patients on hemodialysis should use Cordaflex with caution.
In the II and III trimesters of pregnancy, Cordaflex can be prescribed only if other antihypertensive drugs cannot normalize blood pressure.
Method of administration and dosage
Cordaflex should be taken orally without chewing and drinking plenty of water: 10 mg tablets - before meals, 20 mg tablets - regardless of meals.
Doses are determined individually, depending on the severity of the disease and the patient's response to the drug.
Adults are prescribed 10 mg 3 times a day, if necessary, the dose is increased to 20 mg (2 tablets of 10 mg) 1-2 times a day. The maximum permissible daily dose is 40 mg (4 tablets of 10 mg). The interval between doses should not be less than 2 hours.
To accelerate the action of Cordaflex in the development of a hypertensive crisis or an attack of angina pectoris, it is recommended to chew the tablet, hold it in your mouth for a while and only then swallow it with a little water.
If, with arterial hypertension or angina pectoris, it becomes necessary to increase the daily dose to 80-120 mg, the patient is transferred to extended-release tablets at a dose of 20 mg.
When carrying out a course therapy, Cordaflex is recommended to be used in tablets of 20 mg. At the beginning of treatment, 1 tablet is prescribed 2 times a day at 12-hour intervals. If the effect is insufficient, the dose is gradually increased. The maximum allowable daily dose is 120 mg (6 tablets). For long-term maintenance therapy, it is usually sufficient to take 1-2 tablets (20-40 mg) 2 times a day.
For elderly patients, the initial dose is reduced by 2 times. Lower doses may also be required to maintain the therapeutic effect.
In patients with severe liver dysfunction, the daily dose should not exceed 40 mg.
Side effects
- Allergic reactions: rarely - exanthema, pruritus, urticaria; in some cases - autoimmune hepatitis;
- Cardiovascular system: peripheral edema, severe arterial hypotension, tachycardia, hyperemia of the facial skin; rarely - fainting, increased heart failure, increased angina attacks;
- Central and peripheral nervous system: vertigo, headache, sleep disturbances (insomnia or drowsiness), increased fatigue; in isolated cases - visual impairment, mood lability; with prolonged use in high doses - tremor, paresthesia in the limbs;
- Digestive system: heartburn, nausea, diarrhea / constipation; rarely (with prolonged use of the drug) - flatulence, dry mouth, increased activity of hepatic transaminases, intrahepatic cholestasis; in some cases - gingivitis, gingival hyperplasia, anorexia;
- Urinary system: increased daily urine output; rarely - deterioration of renal function in patients with chronic renal failure;
- Endocrine system: in isolated cases - galactorrhea, gynecomastia, changes in body weight, hyperglycemia;
- Hematopoietic system: rarely - leukopenia, thrombocytopenic purpura, thrombocytopenia; in some cases - anemia;
- Musculoskeletal system: myalgia; in isolated cases - arthritis;
- Others: feeling of heat; in isolated cases - fever, sweating, chills, photodermatitis, weakness.
special instructions
With hypovolemia, the hypotensive effect of Cordaflex is enhanced. A decrease in pulmonary artery pressure and hypovolemia after dialysis can also enhance the effect of the drug, so a decrease in its dose is recommended.
In rare cases, at the beginning of therapy or when the dose of the drug is increased soon after taking it, chest pain may appear, indicating angina pectoris due to paradoxical ischemia. If the development of angina pectoris is associated with taking Cordaflex, treatment should be discontinued.
In patients with arterial hypertension and coronary artery disease, abrupt withdrawal of the drug can lead to myocardial ischemia or hypertensive crisis (the phenomenon of "rebound").
If it is necessary to conduct a planned surgical intervention using general anesthesia, the anesthesiologist should be warned about taking Cordaflex.
During the course of therapy, it is not recommended to consume alcoholic beverages, because an excessive decrease in blood pressure is possible.
At the initial stage of treatment, one should refrain from driving vehicles and performing potentially hazardous activities that require a speed of mental and physical reactions. Further, the degree of restrictions is determined individually.
Drug interactions
- Tricyclic antidepressants, ranitidine, cimetidine: there is an increase in the hypotensive effect;
- Digoxin, theophylline: their concentration in blood plasma increases;
- Rifampicin, phenytoin, calcium preparations: the effect of nifedipine is weakened;
- Vincristine: its excretion is inhibited, which can lead to increased side effects;
- Grapefruit juice, diltiazem, erythromycin and antifungal agents of the azole group (ketoconazole, itraconazole, fluconazole): the metabolism of nifedipine in the body is suppressed, as a result of which its side effects may increase;
- Quinidine, procaine, other drugs that cause prolongation of the QT interval: the negative inotropic effect increases, the risk of QT interval prolongation increases. Nifedipine helps to reduce the concentration of quinidine, and after its withdrawal, a transient increase in the concentration of quinidine (approximately 2 times) is observed, reaching a maximum level on 3-4 days. When using such combinations, special care should be taken, especially in patients with impaired left ventricular function;
- Inhibitors and inducers of the CYP3A4 isoenzyme: the metabolism of nifedipine changes. With the simultaneous use of cyclosporine, which is a substrate of the isoenzyme CYP3A4, each of the drugs can increase the duration of the effect of the other drug.
Also, nifedipine can displace from the connection with proteins drugs characterized by a high degree of binding (including nonsteroidal anti-inflammatory drugs, indirect anticoagulants - derivatives of indandione and coumarin), which may increase their concentration in blood plasma.
If it is necessary to enhance the antianginal and hypotensive action, Cordaflex can be combined with nitrates, diuretics, beta-blockers, angiotensin-converting enzyme inhibitors. These combinations lead to the summation or potentiation of the effects. In most cases, they are effective and safe, but in some cases they can lead to a marked decrease in blood pressure and increased symptoms of heart failure.
If indicated, Cordaflex can be combined with methyldopa, prazosin, clonidine, octadine, but the likelihood of severe orthostatic hypotension should be taken into account.
Analogs
Analogs of Kordaflex are: Adalat, Vero-Nifedipine, Calcigard Retard, Zanifed, Kordafen, Kordaflex Retard, Kordipin, Kordipin Retard, Kordipin XL, Corinfar, Nifedikap, Nifedipine, Nifecard HL, Kordafen.
Terms and conditions of storage
Store out of the reach of children and protected from light. Observe the temperature regime 15-25 ºС.
Shelf life is 4 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Cordaflex: prices in online pharmacies
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Drug name Price Pharmacy |
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Cordaflex tablets p.p. prolonged action 20mg 30 pcs. 83 rbl. Buy |
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Cordaflex 20 mg film-coated tablets of prolonged action 30 pcs. 83 rbl. Buy |
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Cordaflex 10 mg film-coated tablets 100 pcs. RUB 96 Buy |
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Cordaflex 20 mg film-coated tablets of prolonged action 60 pcs. 126 RUB Buy |
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Cordaflex tablets p.p. prolonged action 20mg 60 pcs. 130 RUB Buy |
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Cordaflex RD 40 mg film-coated controlled release tablets 30 pcs. 190 RUB Buy |
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Kordaflex RD tablets p.o. with control. release 40mg 30 pcs. 232 RUB Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
