Action Nifedipine XL
Nifedipine XL is a dihydropyridine derivative. The mechanism of action is blockade of slow calcium channels. Inhibits the transport of calcium ions through the membranes of myocardial cells and vascular smooth muscle cells, without affecting plasma concentrations of calcium. The result of this action is the dilation of the arteries and arterioles, the decrease in peripheral vascular resistance and, consequently, a decrease in blood pressure. Nifedipine XL is the major dilation of coronary arteries and arterioles both in normal and in ischemic myocardial areas, and prevents coronary artery spasm. Nifedipine XL increases myocardial oxygen supply decreases oxygen demand, which allows you to use the drug for the treatment of angina pectoris.
Pharmacokinetics Nifedipine XL
Nifedipine XL quickly and almost completely absorbed after oral administration. Characterized by a high percentage of binding to plasma proteins. T1 / 2 is approximately 2 hours. Displayed in the kidneys as inactive metabolites.
Nifedipine XL due to delayed release of active ingredient, provides a gradual controlled increase in plasma concentrations of Nifedipine XL. Plasma concentrations of Nifedipine XL reaches a plateau after about 6 hours and maintained with minor fluctuations within 24 hours.
Testimony Nifedipine XL
Hypertension, Coronary artery disease: stable angina, vasospastic angina (Prinzmetal).
Contraindications Nifedipine XL
Hypotension. Severe aortic stenosis. Obstructive cardiomyopathy. Porphyria. Hypersensitivity to Nifedipine XL.
Precautions Nifedipine XL
Nifedipine XL is not indicated in cardiogenic shock with residual angina (risk of myocardial infarction). With care given to patients with congestive heart failure, liver dysfunction and diabetes. For patients with severe obstructive coronary artery disease are at risk of increasing the frequency, severity and duration of manifestations of angina after taking Nifedipine XL. In this case, requires removal of the drug.
No data on the safety of using Nifedipine XL during pregnancy, so the appointment of Nifedipine XL pregnant shown only if the potential effect of the drug exceeds the potential risk to the fetus. Nifedipine XL passes into breast milk, and the drug is not appointed during lactation.
Drug interactions Nifedipine XL
- Concurrent assignment Nifedipine XL and fentanyl can cause severe hypotension, therefore, recommended abolition of Nifedipine XL, for at least 36 hours prior to anesthesia (if possible).
- In conjunction with Nifedipine XL antihypertensives, nitrates, and tricyclic antidepressants is enhanced hypotensive effect.
- In an appointment with b-blockers, along with increased hypotensive action, in some cases may develop heart failure.
- Combination of Nifedipine XL with cardiac glycosides, with theophylline is usually well tolerated by patients, in very rare cases may increase the level of digoxin and theophylline in blood plasma.
- Joint application of Nifedipine XL and cimetidine (to a lesser extent – ranitidine) may lead to increased levels of Nifedipine XL in blood plasma.
- The individual The case of a combination of Nifedipine XL and quinidine ingestion decreases the concentration of quinidine in plasma.
Special precautions Nifedipine XL
Effect on ability to concentrate (driving, using machinery) is unknown.
Dosing regimen Nifedipine XL
Drug is prescribed individually. The initial dose is 30 mg or 60 mg once a day. Tablets should be taken without chewing, you can not divide or divide (the integrity of the shell provides a controlled release of active ingredient). Titration is carried out gradually, at intervals of 7-14 days. The maximum daily dose – 90 mg. If necessary remove the drug, the dosage is reduced gradually to a complete withdrawal.
Overdose Nifedipine XL
Nifedipine XL overdose causes peripheral vasodilatation with marked and probably prolonged systemic hypotension. Treatment of overdose is to remove the drug from the body and careful monitoring of vital functions of the heart, lungs and excretory system. Clearance Nifedipine XL is increased in patients with failure of liver function. Due to the high degree of binding to plasma proteins, hemodialysis is not effective.
Side effects Nifedipine XL
Of the side effects of the drug most frequently detected: headache, flushing of skin, dizziness, nausea, weakness, swelling. In some cases, may cause retrosternal pain after 15-30 minutes after ingestion.
There are anecdotal reports of occurrence of such side effects, such as: lethargy, hypotension, syncope, palpitations, decompensated heart failure, gingival hyperplasia, convulsions of the upper and lower extremities and diarrhea.
