Hypernal 10

Country of origin: Germany
Pharm-Group: Calcium channel blockers of the dihydropyridine group

Manufacturers: Berlin-Chemie AG (Germany)
International name: Nifedipine
Synonyms: Adalat, Adalat SL, Anifed, Apo-Nifed, Vero-Nifedipine, Hypernal, Hypernal 5, Hypernal drops, Depin-E, Calcigard, Calcigard retard, Calcigard-10, Calcigard-5, Karin-Fer, Cordafen, Cordaflex, Cordaflex RD, Cordipin, Cordipin XL, Cordipin HL, Cordipin-r
Dosage forms: capsules 10 mg, film-coated tablets 10 mg
Composition: Active substance - nifedipine.

Indications for use: Arterial hypertension, including hypertensive crisis, prevention of angina attacks (including Prinzmetal's angina), hypertrophic cardiomyopathy (obstructive, etc.), Raynaud's disease, pulmonary hypertension, broncho-obstructive syndrome.

Contraindications: Hypersensitivity, acute period of myocardial infarction (first 8 days), cardiogenic shock, severe aortic stenosis, heart failure in the stage of decompensation, severe arterial hypotension, tachycardia, pregnancy, breastfeeding.

Restrictions on use: You should refrain from using the drug in pediatric practice, since the safety and effectiveness of its use in children have not been determined.

Side effect:

1. From the cardiovascular system and blood: facial flushing with a feeling of heat, palpitations, tachycardia, hypotension (up to fainting), angina-like pain, very rarely - anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura.

2. From the nervous system and sensory organs: dizziness, headache, stupor, changes in visual perception, impaired sensitivity in the arms and legs.

3. From the gastrointestinal tract: constipation, nausea, diarrhea, gingival hyperplasia (with long-term treatment), increased activity of liver transaminases.

4. From the respiratory system: bronchospasm.

5. From the musculoskeletal system: myalgia, tremor.

6. Allergic reactions: itching, urticaria, exanthema, exfoliative dermatitis.

7. Other: swelling and redness of the arms and legs, photodermatitis, hyperglycemia, gynecomastia (in elderly patients), burning sensation at the injection site (with intravenous administration).

Interaction:

1. Enhance the hypotensive effect: nitrates, diuretics, beta-blockers, tricyclic antidepressants, fentanyl, alcohol.

2. Increases the activity of theophylline, reduces the renal clearance of digoxin.

3. Increases the side effects of vincristine (reduces excretion).

4. Increases the bioavailability of cephalosporins (cefixime).

5. Cimetidine and ranitidine increase plasma levels.

6. Diltiazem slows metabolism (requires a reduction in the dose of nifedipine).

7. Incompatible with rifampicin (accelerates biotransformation and does not allow creating effective concentrations).

8. Grapefruit juice (large quantities) increases bioavailability.

9. Increases the concentration of cardiac glycosides in the blood.

Overdose:

Symptoms: severe bradycardia, bradyarrhythmia, arterial hypotension, in severe cases - collapse, conduction slowdown. When taking a large number of retard tablets, signs of intoxication appear no earlier than after 3-4 hours and can be further expressed.

Special instructions:

1. Elderly patients are advised to reduce the daily dose (decreased metabolism).

2. Use with caution while working for vehicle drivers and people whose profession involves increased concentration of attention.

3. The drug should be discontinued gradually.

4. In patients with stable angina at the beginning of treatment, a paradoxical increase in anginal pain may occur, with severe coronary artery disease