What do you need to know before taking Nifedipine for blood pressure?

Nifedipine has antianginal and antihypertensive effects. Relaxes vascular smooth muscle (relieves spasm), dilates coronary and peripheral (mainly arterial) vessels, reduces blood pressure and peripheral vascular resistance, and reduces afterload. Possessing a cardioprotector effect, it reduces the need for oxygen in the heart muscle. Increases coronary blood flow.

Nifedipine effectively reduces blood pressure and also helps relieve muscle spasms. Without affecting the heart rhythm, it significantly lowers blood pressure. After administration, Nifedipine begins to act within 20 minutes. (chewing accelerates the effect) and lasts up to 12 hours.

Active ingredient – ​​tablets and capsules 0.005 and 0.01 g. Dragees 0.01 g. Retard tablets 0.02 and 0.04 g.

Nifedipine photo

What is nifedipine

Chemical structure of the nifedipine molecule
The drug belongs to the group of “calcium channel blockers” and has a hypotensive and antianginal effect, that is, it lowers blood pressure and eliminates angina attacks.

The therapeutic effect of nifedipine is realized by reducing the amount of calcium ions in the muscle cells of blood vessels. Due to this, the peripheral and coronary arteries expand. This ensures the therapeutic effects of the drug: blood pressure decreases, blood flow to the myocardium increases and an attack of angina is eliminated.

Among other things, the drug reduces the aggregation ability of platelets and prevents the formation of thrombosis and microthrombosis in the bloodstream. The drug nifedipine reduces myometrial tone, which is actively used in obstetrics and gynecology to treat uterine hypertonicity (that is, increased tone). It has been established that long-term use of nifedipine tablets for 2-3 months or more is accompanied by the development of tolerance and addiction.

For the drug nifedipine, the instructions for use recommend using the medicine for the following conditions.

Indications for use of nifedipine:

1. Arterial hypertension (hypertension). Many patients ask the question: “at what pressure should I take nifedipine tablets?” The answer is simple: “at elevated levels.” Today, this can be considered pressure, which is consistently in the range of more than 140/90. In this case, doctors may say that you have hypertension. In modern practice, nifedipine is more often used to relieve hypertensive crises, and other drugs are used to maintain blood pressure.
2. Hypertensive crisis. This is a quick and sharp increase in blood pressure to a level of 180/110 mmHg. Art. and higher.
3. Prevention of angina attacks (including Prinzmetal's angina). Angina pectoris or “angina pectoris” is a sharp chest pain that is provoked by myocardial ischemia.
4. Hypertrophic cardiomyopathy. The disease is associated with an increase in the muscle layer of the myocardium (usually the left ventricle and interventricular septum). Because of this, disturbances in the pumping function of the heart occur, which can cause sudden death. The famous Russian rap artist Decl suffered from this disease and died at the age of 35 due to acute heart failure.
5. Raynaud's syndrome is a vascular spasm of the hands or feet. It is formed when a person is exposed to cold or stress.
6. Pulmonary hypertension (increased pressure in the blood vessel system of the lungs).
7. Broncho-obstructive syndrome (that is, narrowing and blockage of the bronchial tube for any reason).
8. Nifedipine is also used during pregnancy. Despite instructions in the instructions for use that this medicine is contraindicated for pregnant and breastfeeding women, obstetricians and gynecologists use it to reduce increased uterine tone. This condition can provoke arbitrary termination of pregnancy (miscarriage) or trigger premature labor. However, doctors rarely resort to nifedipine and only in a hospital setting. A higher priority for reducing uterine hypertonicity is considered to be the drug ginipral, droppers with which are also placed only in obstetric and gynecological hospitals.

Features of the drug

Pharmacological group of Nifedipine is selective calcium antagonists. It is a derivative of dihydroperidines. The medicine acts selectively and is fundamentally different from the work of calcium blockers. Initially, this group of drugs was intended to treat angina pectoris, and during the process of use, doctors drew attention to the ability of the drugs to lower blood pressure.

Selective agents, including Nifedipine, partially limit the access of calcium ions into cells. The drugs themselves are not calcium channel blockers, and Nifedipine cannot be classified as a calcium antagonist. The main function of the drug is to slow down the opening of calcium channels, so that a limited amount of this substance enters the cell.

This group of the drug makes it possible to:

• reduce the load on the heart muscle,
• dilate blood vessels,
• normalize heart rate by influencing the conduction system,
• reduce the risk of blood clots.

Possible unwanted effects

Like any drug, Nifedipine can cause side effects in the patient, which must be taken into account by the cardiologist.

Since Nifedipine is not a long-acting drug, but works for 6-8 hours, in patients suffering from coronary heart disease, the symptoms of the disease may worsen, and in some cases even myocardial infarction develops. Fortunately, such cases are rare.

The hematopoietic organs can produce the following negative effects - leukopenia, anemia, thrombocytopenia. Agranulocytosis is rarely recorded. Also, some patients experienced metabolic abnormalities. In particular, hyperglycemia was recorded.

The nervous system can cause negative complications such as headache, fatigue, drowsiness, and dizziness. Reactions such as anxiety, fear, manifestations of depression, tremors, insomnia, and decreased sensitivity are possible.

Negative changes in the organs of vision are also possible - changes in the perception of images, hemorrhages in the eyes, deterioration of vision. At the beginning of taking the drug, side effects also occur on the part of the heart - increased heart rate, severe hypotension, and occasionally angina pectoris.

People suffering from allergies may experience symptoms such as skin rashes, itching, urticaria, erythema, angioedema, photodermatitis. A weak urinary system may respond to taking the drug with impaired kidney function and frequent urination.

Comparison of "Kordipin" and "Nifedipine"

Some patients are trying to determine which is better: Cordipine or Nifedipine. It is worth noting that both drugs have the same active ingredient – ​​nifedipine. The composition of medications differs only in excipients.

The drugs have exactly the same method of use, similar indications, contraindications and side effects. The differences are that it is manufactured in Russia, while Cordipin is manufactured in Slovakia.

“Cordipine retard” contains an increased dose of the active substance, 20 mg in one tablet, in contrast to the standard “Cordipine”, which, like “Nifedipine”, has 10 mg of nifedipine in one pill. This is a long-acting drug. The medicine “Corinfar retard” has exactly the same effect.

Instructions for use of the drug

Before using Nifedipine tablets, the instructions for use should be studied with special care.
Perhaps, when visiting the doctor, you forgot about some concomitant diseases for which taking the medication is contraindicated. Or you are simultaneously taking other medications that can weaken or, conversely, enhance the effect of BMCC.

No information contained in the instructions for use of the drug should be neglected.

How to use?

The method of using Nifedipine for blood pressure is standard for tablets from the BMKK group. They are drunk during a meal or immediately after it, using clean water for washing down.

This is important, since Nifedipine cannot be taken with certain liquids, in particular grapefruit juice - it completely suppresses the metabolism of BMCC

Is it possible under the tongue?

For emergency cases of hypertensive crisis, you can put Nifedipine under the tongue - this will speed up its action and lead to a decrease in blood pressure. But during prolonged therapy, Nifedipine tablets to lower blood pressure should be swallowed whole.

Dosage

Regarding dosage, you should strictly adhere to the doctor’s prescriptions, who will select it individually.

The starting dose of Nifedipine is usually 5-10 mg (½-1 tablet), the number of doses per day is 2-3 times. After a week, you can increase the therapeutic dose to 20 mg by taking Nifedipine 20 mg 1-2 times a day, or 2 tablets morning and evening of Nifedipine 10 mg. Instructions for use indicate the maximum daily dose – 40 mg.

Nifedipine dosage adjustment is required for patients:

• taking other antihypertensive and antianginal drugs;
• with severe cerebral perfusion disorders;
• with impaired liver function;
• elderly.

Any changes in doses and dosage regimen should be agreed with your doctor.

How long does it take for it to start working?

When describing the pharmacodynamic properties of Nifedipine, the instructions for use provide the following information on the question of how long after Nifedipine begins to act:

• for oral administration – 20 minutes;
• with sublingual – 5-10 minutes.

The duration of the effect is 4-6 hours for short-acting tablets and 12-24 hours for long-acting tablets.

special instructions

The section of the instructions for use about special instructions for Nifedipine blood pressure tablets begins with a warning.

Do not drink alcohol during treatment with Nifedipine

The active ingredient of these tablets, which belongs to the BMKK pharmaceutical group, is absolutely incompatible with ethanol. The instructions for use warn that at the initial stage of use, the development of angina pectoris is possible, and against the background of simultaneous use of beta-blockers, increased signs of heart failure. Nifedipine should be taken with caution in patients on hemodialysis, with hypovolemia and irreversible renal failure. As indicated in the instructions for use, if surgical intervention is necessary, the doctor should be notified about Nifedipine therapy

As indicated in the instructions for use, if surgical intervention is necessary, the doctor should be notified about Nifedipine therapy.

Pharmacology of Nifedipine

The principle of action of nifedipine is based on its ability to block the activity of calcium channels in cell membranes. As a result, calcium ions enter the peripheral vessels and arteries of the heart in smaller quantities.

This has a beneficial effect on the body: spasm of peripheral and coronary vessels is eliminated, the negative inotropic effect is reduced, and the myocardial need for oxygen is reduced. The active component also has slight antiarrhythmic activity.

With regular use of the drug, the following results are achieved:

• renal blood circulation increases;
• the blood supply to the heart muscle is improved;
• the process of removing sodium from the body is activated, thereby eliminating swelling;
• Diastolic and systolic pressure decreases.

Nifedipine is absorbed fairly quickly when taken orally. Its maximum concentration in the blood is reached after an hour. The substance is metabolized in the liver. The half-life is 3-4 hours. Most of it comes out with urine, the smaller part comes out with feces.

With prolonged use, tolerance develops to the drug.

Instructions for use

The recommendation included in the medicine package states that the treatment regimen is usually drawn up by a doctor. He focuses on the patient's condition, but still adheres to the minimum and maximum dosage. The maximum concentration is thirty milligrams of the active substance.

You need to take the tablet with plenty of water. In this case, the medication must be combined with food. It's better if it's something light and liquid. For example, soup or porridge.

You cannot take the drug with juice or soda, since the substances contained in these liquids can completely dissolve the tablet shell before the prescribed time.

Regardless of the disease, the minimum dosage of Nifedipine Retard should be twenty milligrams per day. Moreover, this amount must be divided into two doses.

The average course of treatment lasts about two months. The doctor can extend it or shorten it, based on the patient’s tests. However, it is worth remembering that the product has a withdrawal syndrome. You cannot stop taking pills right away, as the patient will notice a sharp deterioration in their health. Withdrawal should be gradual and invisible to the body.

What is better when compared with other drugs?

Let's try to compare Nifedipine with other medications with antihypertensive or similar effects. Long-term therapy sometimes requires rotation of the drugs used, so familiarization with the most common medications will not be superfluous.

Amlodipine

The basis of white cylindrical Amlodipine extended-release tablets is amlodipine besylate, a substance belonging to the second generation BMCC.

This is also a dihydropyridine derivative, the effect of which is to block calcium channels, reducing the transmembrane penetration of Ca ions into the cell. According to the instructions for use, it has not only a hypotensive, but also an anti-ischemic effect. Available in dosages of 5 and 10 mg, it contains lactose. When comparing which is better - Nifedipine or Amlodipine, you need to remember the duration of action of both drugs.

Andipal

Instructions for use Andipala calls this drug a combined analgesic drug, the active core of which consists of a non-narcotic analgesic (metamizole sodium), an antispasmodic (papaverine), a vasodilator (bendazole or dibazole) and a barbiturate (phenobarbital). A slight vasodilating effect has an effect on the smooth muscle layer of the walls of blood vessels; the indications for use include migraines, all kinds of colic and other pain syndromes. The section of the instructions for use on interactions talks about the ability of Andipal tablets to enhance the hypotensive effect of BMCC, ACE inhibitors, nitrates and other antihypertensive drugs. Therefore, it is not correct to compare Nifedipine or Andipal, which is better.

Ginipral

Ginipral tablets are prescribed for the threat of premature termination of pregnancy (uterine tone), starting from the 20th week. Today this medicine is difficult to find in pharmacies, and you can often hear that Nifedipine is prescribed to women instead of Ginipral. This is where their question arises - which is better, Ginipral or Nifedipine. If we compare these medications in terms of their effect on the tone of the uterus, then without a doubt Ginipral is preferable. But some women (it has been noticed that they have hypertension) tolerate Nifedipine well. Others, judging by the reviews, advise to refrain from taking it, as they are faced with side effects. This means that you need to select a medication individually. We should not forget that these medications, according to their instructions for use, have completely different indications for use, so it is wrong to talk about their interchangeability.

Kapoten

The drug Capoten belongs to the pharmacological group of long-acting angiotensin-converting enzyme (ACE) inhibitors. Indicated for hypertension, dysfunction of the left ventricle in the post-infarction period, chronic heart failure, diabetic nephropathy accompanying type 1 diabetes.

It is the drug of choice for a huge number of patients with arterial hypertension, not burdened by severe kidney or liver failure and other severe pathologies. The active ingredient is captopril. In patients with bronchial obstruction or a tendency to bronchospasm, taking ACE inhibitors may cause a side effect in the form of a dry, hysterical cough. In this case, when choosing Capoten or Nifedipine, BMKK Nifedipine is preferable.

Captopril

The same active substance is the core of the drug of the same name - Captopril. To compare Nifedipine or Captopril, which is better, you should focus on the lists of contraindications and side effects, as well as the individual tolerance of the components, and select the medicine in accordance with these factors. Another factor that is worth paying attention to is the possibility of using Nifedipine in the treatment of pregnant women from the 20th week, which cannot be said about Captopril. ACEIs are contraindicated for pregnant women at any stage.

Cordaflex

One thing can be said about the preparation Cordaflex - it is a direct, or structural, analogue of Nifedipine, and all indications for use, lists of side effects and warnings in the instructions for use of this medication are presented for the active substance nifedipine. True, the indications include, in addition to hypertension and coronary artery disease, Raynaud's syndrome, as well as the prevention of Prinzmetal's angina. Those who prefer European manufacturers can pay attention to Cordaflex made in Hungary or Switzerland.

Instructions for use

• Nifedipine tablets are taken orally during meals, preferably liquid. It is acceptable to swallow the tablets with water.
• If the doctor does not prescribe a larger dosage, then taking more than 2 tablets per day of 20 mg on your own is prohibited.
• The maximum daily dose of Nifedipine should not exceed 80 mg (four tablets per day), if a dose of 40 mg is ineffective.

Systemic cerebral circulatory disorders and liver failure limit the use of Nifedipine. A lower dosage should be prescribed to elderly and geriatric patients, especially in combination with other angiotensive agents. The duration of use of the drug should be within the competence of the attending physician.

Reviews from patients who took the medicine

Examining the characteristics of Nifedipine according to reviews of patients who tested the effect of the drug on themselves, we can conclude the following:

• The reaction of patients to the drug is ambiguous - for some it helps to quickly relieve a hypertensive crisis, others complain of side effects and poor tolerability;
• Nifedipine received a good rating in reviews of pregnant women experiencing gestosis (“late toxicosis”) or uterine hypertonicity, starting from the 20th week; women write about stopping uterine contractions and improving blood circulation;
• at the same time, women who did not notice an increase in blood pressure, but tried to treat increased uterine tone with Nifedipine, note poor tolerability of the drug;
• there are reviews calling for choosing Nifedipine according to the manufacturer - European quality, as a rule, is given more votes;
• There is a unanimous opinion about Russian-made tablets - they are the cheapest way to quickly lower blood pressure.

From this we can conclude that if the drug is taken as prescribed by a doctor and taking into account the warnings prescribed in the instructions for use, Nifedipine reduces blood pressure as an effective and fast-acting medication.

Drug interactions

When used simultaneously with antihypertensive drugs, diuretics, phenothiazine derivatives, the antihypertensive effect of nifedipine is enhanced.

When used simultaneously with anticholinergic drugs, memory and attention problems may occur in elderly patients.

When used simultaneously with beta-blockers, severe arterial hypotension may develop; in some cases - the development of heart failure.

When used simultaneously with nitrates, the antianginal effect of nifedipine is enhanced.

When used simultaneously with calcium preparations, the effectiveness of nifedipine decreases due to an antagonistic interaction caused by an increase in the concentration of calcium ions in the extracellular fluid.

Cases of the development of muscle weakness have been described when used simultaneously with magnesium salts.

When used simultaneously with digoxin, it is possible to slow down the excretion of digoxin from the body and, consequently, increase its concentration in the blood plasma.

When used simultaneously with diltiazem, the antihypertensive effect is enhanced.

When used simultaneously with theophylline, changes in the concentration of theophylline in the blood plasma are possible.

Rifampin induces the activity of liver enzymes, accelerating the metabolism of nifedipine, which leads to a decrease in its effectiveness.

When used simultaneously with phenobarbital, phenytoin, carbamazepine, the concentration of nifedipine in the blood plasma decreases.

There are reports of an increase in the concentration of nifedipine in the blood plasma and an increase in its AUC when used simultaneously with fluconazole and itraconazole.

When used simultaneously with fluoxetine, the side effects of nifedipine may increase.

In some cases, when used simultaneously with quinidine, a decrease in the concentration of quinidine in the blood plasma is possible, and when nifedipine is discontinued, a significant increase in the concentration of quinidine is possible, which is accompanied by a prolongation of the QT interval on the ECG.

Cimetidine and, to a lesser extent, ranitidine, increase the concentration of nifedipine in the blood plasma and, thus, enhance its antihypertensive effect.

Ethanol may enhance the effect of nifedipine (excessive hypotension), which causes dizziness and other undesirable reactions.

Possible overdose

As already mentioned, drugs should be taken strictly in the dosage that the attending physician will select for the drug Nifedipine. An overdose, the symptoms of which can occur even if the maximum dose is slightly exceeded, usually manifests itself:

• bradycardia (significant slowing of heart rate);
• suppression of sinus node function, which is expressed by inadequate heart rate, deterioration of blood supply to the myocardium;
• strong and prolonged decrease in blood pressure;
• redness of the face;
• headache.

In case of severe intoxication with Nifedipine, the following is necessary:

• gastric lavage;
• taking activated carbon;
• slow, over 5 minutes, administration of antidotes - 10% calcium chloride or gluconate under the control of its concentration in plasma.

For severe hypotension, dobutamine or dopamine is administered intravenously; for acute heart failure, strophanthin is administered. The hemodialysis procedure is ineffective in such a situation. Treatment of overdose should be carried out in a hospital setting.

Contraindications

The drug Nifedipine also has contraindications. This is a standard list for BMCC of conditions in which taking drugs can provoke effects dangerous to health and life. It is prohibited to be treated with Nifedipine if:

• acute myocardial infarction (and within 4 weeks after it);
• pregnancy and lactation period;
• decompensated CHF;
• simultaneous treatment with Rifampicin;
• arterial hypotension (SBP
• cardiogenic shock, collapse;
• intolerance to any of the ingredients of the drug.

Due to the lack of clinical data on the safety and effectiveness of use in persons under 18 years of age, Nifedipine is contraindicated for them.

Can it be combined with Elevit?

The multivitamin and mineral-containing product Elevit is often prescribed to pregnant and lactating women for the treatment and prevention of micro- and macronutrient deficiency and hypovitaminosis. Women who are forced to take BMCC even during this period are interested in whether it is possible to take Nifedipine with Elevit, and what the instructions for use say about the compatibility of these drugs.

An impressive list of restrictions on the compatibility of Nifedipine casts doubt on the possibility of its simultaneous administration with Elevit.

Elevit contains the trace element magnesium in the form of oxide, stearate and hydrogen phosphate trihydrate. And the instructions for use of Nifedipine indicate that simultaneous use with drugs containing magnesium sulfate can provoke blockade of neuromuscular synapses (points of contact between neurons and effector cells) in pregnant women. There have been no clinical studies on the safety of such a combination, and the lack of data can be considered a strong argument against combining medications, especially when it comes to treating pregnant women.

Analogues of Nifedipine for hemorrhoids

The drug for hemorrhoidal disease Nifedipine in the form of an emulsion-gel or ointment has no structural, qualitative or quantitative analogue. However, the modern pharmaceutical market offers a huge selection of medicinal antihemorrhoidal drugs in the form of ointment, cream or gel for external and rectal use, which exhibit similar therapeutic effects:

• Relief (Relief Advance, Relief Ultra);
• Proctosan;
• Procto-glivenol;
• Gepatrombin-G;
• Proctosedyl;
• Troxevasin;
• Troxerutin;
• Vishnevsky's balsamic liniment;
• Levomekol;
• Levosin;
• Levomethyl;
• Tar ointment;
• Calendula ointment;
• Menovazin.

Analogues and synonyms

In the process of antihypertensive therapy, the question often arises of replacing Nifedipine with synonyms - medications with an identical composition. The medicine in question has many of them.

Nifecard HL

Round Nifecard XL tablets of brown-yellow-orange shades are classified as long-acting antihypertensive medications. The effect is achieved due to the modified (in this case, gradual) release of the active substance from the film shell, which allows you to control the level of nifedipine in the plasma for 24 hours.

Cordaflex

We have already come across this medication with the active ingredient nifedipine prolonged action - Cordaflex. These are brown-purple, round-shaped pills in a dissolving coating. The drug is available in a dosage of 20 mg, recommended for the treatment of hypertension, ischemic heart disease, Raynaud's syndrome, and the prevention of angina pectoris.

Osmo-Adalat

Pink round pills with black markings on one side “Adalat30” (or 60, depending on the dosage) are the German analogue of Nifedipine Osmo-Adalat. Thanks to the mechanism of controlled release of the active substance, it has a prolonged effect . An important difference from the drugs discussed above is that it does not contain lactose, as indicated by the instructions for use.

Cordafen

Sales in the Russian Federation of a medicine with the trade name Cordafen have been temporarily stopped for unknown reasons, although this drug from the Polish company Polpharma has a perpetual license. Round, yellow tablets are available in a dosage of 10 mg and exhibit a rapid hypotensive effect.

Calcigard retard

An analogue of the Indian production, Calcigard retard, is a brown round-shaped tablet in a polymer shell, notched on one side. The auxiliary ingredients contain lactose, the active component is the BMCC in question in a dosage of 20 mg.

Phenigidine

A structural analogue of nifedipine, the instructions for use of which warn about the content of lactose and sucrose in the tablets - Phenigidine. Yellow or yellowish-green cylindrical pills with a quick effect. To speed up the effect, it is recommended to chew the tablet and hold it in the mouth.

Corinfar

Yellow round-shaped pills coated with a soluble coating - Corinfar - are produced in Croatia and Germany using the technology of Israeli pharmaceutical companies Teva. The instructions for use indicate that this long-acting drug is available in a dosage of 10 mg and contains lactose. When comparing which is better: Corinfar or Nifedipine, many patients choose the drug Corinfar.

Corinfar retard

Separate instructions for use for the medicine Corinfar retard, produced in Croatia. Yellow round pills are available in a dosage of 20 mg, have a prolonged effect, and contain lactose.

Cordipin

LS Kordipin is produced by KRKA in Slovenia and its branches in the Russian Federation. The instructions for use indicate the following dosage of nifedipine in these tablets – 10 mg. They contain lactose. This is a fast and short-acting medicine.

Kordipin HL

A medicine with a modified release of nifedipine produced in Slovenia (KRKA) and the company's branches in the Russian Federation. Available in the maximum dosage allowed for this active ingredient – ​​40 mg.

Cordipin retard

Slovenian drug Kordipin retard does not contain lactose. The dosage of the active ingredient is 20 mg. According to the instructions for use, it has a prolonged effect. Like all of the medications listed, it is a direct analogue of Nifedipine.

Release form

The instructions for use of Nifedipine stipulate that the drug is available in several forms. Each has features of use and action. Doctors prescribe:

• Dragees are balls with a pleasant taste. They can be swallowed, but for a quick effect it is better to dissolve them under the tongue. Used as an ambulance to relieve symptoms.
• Solution for intravenous administration - used in clinical settings of cardiology departments, in intensive care.
• Syringes with composition for intracoronary administration.
• Gel for the treatment of hemorrhoids.

A special conversation about Nifedipine tablets. According to the instructions, two types are used:

• Short action. The medicine is used to urgently reduce high blood pressure and eliminate chest pain for patients in whom attacks are rare.
• Long-acting nifedipine. The drug is prescribed for daily use in order to maintain a stable condition of a patient with arterial hypertension and coronary heart disease. It is easy to choose an individual course of compensatory therapy - tablets are available in a variety of dosages.

Can it be used during a hypertensive crisis?

In the official instructions for Nifedipine, the indications for use do not include hypertensive crisis. Patients with hypertension should receive continuous antihypertensive therapy to prevent blood pressure from rising, rather than using medications occasionally in emergency situations.

However, practical experience has confirmed the ability of this medication to quickly and effectively reduce high blood pressure when administered sublingually.

1. To lower blood pressure with Nifedipine during a hypertensive crisis, you should put 1 tablet of Nifedipine 10 mg under the tongue and wait for it to completely dissolve (usually the effect occurs within a few minutes).
2. At this time, it is advisable for the patient to be in a lying or reclining position (dizziness may occur).
3. If there is no effect, it is allowed to take the pill again no earlier than half an hour after the first dose.
4. The maximum dose for hypertensive crisis is 30 mg, taken in 3 doses with an interval of 30 minutes.

Before each subsequent dose, it is necessary to measure blood pressure and, when it normalizes, stop taking Nifedipine tablets.

Instructions for use

How to take Nifedipine? Use any medicinal form of the drug as prescribed by your doctor. The dosage and regimen are determined by a specialist based on the patient’s medical history and diagnosis.

Taking pills

For various conditions, the dose of the drug is usually 1 tablet three times a day. It is recommended to take the medicine after meals. Take the tablet with water. If necessary, the dose is increased by the attending physician. This is possible if the drug is well tolerated and there are no side effects. For elderly patients or patients suffering from kidney pathologies, the dose is reduced.

Use of injections

Indications for the use of Nifedipine injections include severe conditions in patients. Injections are used exclusively in hospital settings during intensive care. Nifedipine is administered to patients intravenously or via a drip.

The solution is available in ready-made form; dilution of the drug is not required. Before administration to a person, a sensitivity test to the drug component is performed. If there is no reaction, the drug can be used. The dose is determined by the doctor. Typically it ranges from 15 to 30 mg over 24 hours.

Application of ointment

The use of Nifedipine in the form of an ointment or gel can be done at home. Before applying the medicine, it is recommended to carry out hygiene procedures and cleanse the intestines. For external hemorrhoids, treat cavernous formations with a small amount of ointment or gel, gently rubbing the product into the skin. If the pathology is internal, it is necessary to treat the hemorrhoids located inside with ointment.

In some cases, the drug is used to apply compresses. To do this, a small amount of the product is applied to linen or cotton fabric and applied to the affected area. This method is suitable for the treatment of external hemorrhoids.

Disadvantages of the drug

Nifedipine can significantly reduce the force of heart contractions. In recent years, information has spread about the dangers of taking a rapid form of medication at high blood pressure levels, due to an increased risk of developing myocardial infarction. The question remains open about the justification of the systematic use of a fast-acting form in patients with coronary artery disease - there is evidence of an increased risk of deaths.

The drug Nifedipine can be taken only if the patient has no contraindications to its use

Nifedipine can produce a number of undesirable side effects:

1. From the side of blood vessels and heart:

• excessive vasodilation (a drop in blood pressure below the physiological norm, rapid heartbeat, hot flashes, lightheadedness);
• increased symptoms of insufficient ability of the heart to pump blood, the appearance or intensification of peripheral swelling (ankles, legs, abdomen);
• triggering pathological rhythms of heart contractions, sometimes provoking an episode of angina pectoris; a few cases of myocardial infarction have been recorded.

1. From the gastrointestinal tract:

• nausea, heartburn, diarrhea or constipation;
• disturbances in the normal functioning of the liver (manifested in increased transaminase activity, excessive concentration of bilirubin in the blood, subjectively - a feeling of intoxication, weakness, yellowish coloration of the mucous membranes);
• swelling of the gums and bleeding from them, as with stomatitis or periodontal disease (rare);

1. From the nervous system:

• headache;
• lethargy, excessive need for sleep;
• disorders of the Parkinson's disease type - sensory disturbances, involuntary trembling of the hands, shuffling of the feet when walking, difficulty swallowing, poor facial expressions (with long-term use of significant doses); deterioration of cognitive abilities (with systematic use by elderly patients);
• depression, anxiety.

If the contraindications of the drug are not taken into account, taking the medication can cause serious consequences for the body.

1. From the hematopoietic system (with a long course):

• anemia; decrease in platelet count,
• thrombocytopenic purpura
• decrease in the number of leukocytes.

1. Allergic manifestations:

• urticaria, measles-like rash;
• peeling and inflammation of the skin, photodermatosis;
• autoimmune inflammation of the liver (extremely rare).

1. On the part of the kidneys - an increase in the excretion of water and sodium: with prolonged use of large doses, a decrease in the excretory function of the kidneys is possible.
2. From the joints and muscles:

• inflammation of the joints or intermittent pain in the joints without an inflammatory process;
• swelling of the joints;
• muscle soreness and cramps.

Redness of the face and upper torso is common

1. Other:

• visual impairment (including transient blindness at peak drug concentrations in the blood), very rare;
• gynecomastia (enlarged mammary glands), galactorrhea (abnormal discharge of milk or colostrum from the nipples, including men), regressing after discontinuation of the medication;
• increased blood glucose levels;
• pulmonary edema, bronchospasm;
• excess weight gain;
• erectile dysfunction, decreased libido.

pharmachologic effect

The medication has an effect that dilates blood vessels, both coronary and peripheral. The drug also reduces the need for oxygen in the heart muscle. The big advantage of the drug is that it does not inhibit the myocardial conduction system and does not have strong antiarrhythmia activity. It has a good effect on blood pressure (lowers it) and on peripheral vessels, reducing their resistance. In addition, doctors note the excellent absorption of Nifedipine and the speed of its action - the maximum effect occurs within an hour after its ingestion. But there are also disadvantages. The main thing is the development of tolerance to the drug in case of its long-term use in therapy (at least two months).

Analogs

If for some reason the drug is not suitable, then Nifedipine analogues will help replace it. The drugs listed below have a similar effect. Many of them allow you to achieve long-term remission and stabilize blood pressure.

The closest short-acting analogues of Nifedipine are the following medications:

• "Phenigidine";
• "Cordafen";
• "Nicardia";
• "Corinfar";
• "Procardia";
• "Cordaflex";
• "Cordipin";
• "Farmadipin".

Long-acting medications can serve as substitutes for Nifedipine. Among them, such drugs as “Nifebene-retard” and “Cordipine retard” have gained popularity. An analogue of long-term exposure can be “Nifedipine SS”, “Adalat-SL”. Often, in order to replace Nifedipine, Corinfar retard and Corinfar Uno are prescribed.

Instructions for use at what pressure to take

Nifedipine tablets or tablets

The dosage regimen is set individually, depending on the severity of the disease and the patient’s response to the therapy. It is recommended to take the drug during or after meals with a small amount of water.

Initial dose: 1 pill (tablet) (10 mg) 2-3 times a day. If necessary, the dose of the drug can be increased to 2 tablets or pills (20 mg) - 1-2 times a day. The maximum daily dose is 40 mg.

In elderly patients or patients receiving combination (antianginal or antihypertensive) therapy, as well as in patients with impaired liver function, in patients with severe cerebrovascular accidents, the dose should be reduced.

Retard tablets

Taken orally. The tablets should be swallowed whole, without chewing, during or after meals, with a small amount of water. The recommended dose of the drug is 20 mg 2 times a day. If the effect is not sufficiently pronounced, it is possible to increase the dose of the drug to 40 mg 2 times a day. The maximum daily dose is 80 mg.

If liver function is impaired, the daily dose should not exceed 40 mg. In elderly patients or patients receiving combination (antianginal or antihypertensive) therapy, lower doses are usually prescribed. The duration of treatment is determined in each case individually.

How to take the drug

The dosage should be recommended by a doctor in each case individually. The initial dose is 10 mg per dose. If necessary, it is increased to 20 mg; for extended-release drugs, 40 mg is taken.

The number of doses depends on the half-life of the drug. Short-acting nifedipine should be taken 3-4 times, medications that are eliminated within 12 hours are taken twice a day, and medications with a 24-hour duration of circulation in the blood require a single use.

Rules for the use of Nifedipine and its analogues:

• The tablet should be taken half an hour before breakfast at the same time every day;
• You can’t drink it with grapefruit juice, it’s better to use clean water (at least 1 glass);
• if you take the drug with food, this will slow down its entry into the blood, but will not change its effectiveness;
• It is not recommended to stop taking it on your own; when prescribing high doses, their reduction should be gradual;
• Extended-release tablets should not be chewed or divided.

Indications for use

We will tell you how to take Nifedipine correctly in the next section of the article, but now we will discuss the indications that may lead to the prescription of this potent medicine.

The main problem that the drug helps to cope with is arterial hypertension. But, in addition to its direct use, the drug is also effective for diseases caused by high blood pressure or accompanying it. Patients should understand that under no circumstances should they start taking pills themselves. The fact of arterial hypertension must be determined by a doctor, and this is done after a thorough diagnostic examination. It is strictly forbidden for hypotensive patients to take the drug even once during an attack. This can lead to serious consequences.

The instructions for use do not provide information about what tonometer readings require treatment with Nifedipine. These are purely individual indicators and recommendations on them can only be given by a doctor.

The instructions for the tablets also indicate coronary heart disease. The tablets also relieve symptoms of exertional angina, cardiopulmonary failure and Raynaud's syndrome.

Doctors have long outlined the range of problems, when identified, Nifedipine Retard is prescribed. These include atherosclerosis, bronchospasm, vascular occlusion, cerebrovascular accidents and pulmonary hypertension. Moreover, this is not a complete list of diseases, but only the most common of them.

How to take Nifedipine during a hypertensive crisis and is it necessary? Patients often ask this question and this is the right tactic, because with high blood pressure, actions must be quick and precise. In addition, patients suffering from hypertension must take blood pressure-lowering medications on a regular basis. Letting the disease take its course is life-threatening. Therefore, if the treatment regimen is followed, a hypertensive crisis is unlikely to occur. But if this does happen, is it possible to take Nifedipine?

Doctors, despite the absence of such an indication in the instructions for use, strongly recommend immediately taking a tablet of the drug at the slightest suspicion of a hypertensive crisis. The minimum dose should be ten milligrams, the maximum – thirty. The time interval between taking tablets cannot be less than thirty minutes. Moreover, the patient should be in a lying position and regularly measure blood pressure.

What can replace the drug Nifedipine?

Every patient has often encountered such a problem as the lack of the necessary medicine in the pharmacy. This often happens with the drug Nifedipine. This is a very popular medicine, and pharmacies may not have it, but there are analogues of Nifedipine. Among their huge number, you can choose the one that may suit your body even better.

If you are prescribed Nifedipine emulsion, but the pharmacy does not have it, you can choose a similar drug from this list:

• "Adalat".
• "Cordafen".
• "Cordaflex".
• "Corinfar".
• "Cordipin."
• "Nicardia".
• "Procardia".
• "Farmadipin".
• "Phenigidine."

All of these drugs are available in tablets or capsules, except for Farmadipin - it comes in drops. There are also long-acting analogues of Nifedipine:

• "Adalat-SL".
• "Corinfar Uno".
• "Corinthard retard".
• "Cordipin retard."
• "Nifebene-retard."
• "Nifedipine SS".

As can be seen from the lists above, this drug has a large number of synonyms, and this is due to its popularity. Most pharmaceutical companies produce an analogue of the drug "Nifedipine". Reviews from patients indicate that most of them are in no way inferior to it in terms of effectiveness.

Before choosing the right analogue, you need to clearly define for yourself for what purposes and what kind of drug you need, short-acting or extended-acting.

Thus, a quick-acting medicine is not recommended for long-term treatment of hypertension and diseases of the cardiovascular system. In these cases, it is better to choose a long-acting drug, but in case of a hypertensive crisis, a quick-acting drug will be useful to you.

Before choosing an analogue or the main drug for yourself, carefully study the instructions for the drug "Nifedipine", indications and contraindications, so as not to harm your health with the wrong medicine.

But be also prepared for the fact that at the pharmacy the pharmacist may ask you a question: do you need the drug “Nifedipine” - gel or tablets? It is better to consult your doctor about this in advance.

Contraindications for prescribing the drug

The drug is contraindicated during pregnancy, breastfeeding, and is also not used for children.

In addition, the medicine should not be taken by patients with the following pathologies:

• in the presence of hypovolemia or circulatory shock (sharp decrease in circulating blood volume),
• history of myocardial infarction that occurred less than a month,
• the need to take Rifampicin,
• unstable angina,
• aortic stenosis.

Important! Obvious contraindications to the use of the drug are intolerance to the main active ingredient and other components that make up the medicinal substance. Also, the instructions for use warn doctors against prescribing the drug for decompensated heart failure, hypotension, and those on hemodialysis

When taking into account contraindications, doctors always analyze the compatibility of drugs and in some cases replace Nifedipine with other drugs. It is also worth considering that alcohol and Nifedipine are incompatible - doctors especially warn patients with hypertension.

Composition and active substance

The therapeutic effect of this drug is provided by the composition of Nifedipine. The active ingredient is a 1,4-dihydropyridine derivative - the chemical compound nifedipine.

The auxiliary ingredients, in addition to calcium stearate, povidone, cellulose and potato starch, contain the milk sugar lactose. This should be taken into account by people who suffer from intolerance to this carbohydrate or a deficiency of the enzyme that helps absorb it (lactase).

The release form of Nifedipine is tablets.

Instructions for use of Nifedipine during pregnancy dosage

Since the drug is dangerous for the fetus, the duration of use and safe dose are determined only by the attending physician based on the woman’s condition and blood counts. According to the instructions, the dosage rate for Nifedipine during pregnancy is:

• One or two tablets twice a day.
• The maximum daily dose is 60 milligrams (six tablets).
• The therapeutic course ranges from one to six weeks.
• Treatment lasting more than three months causes addiction to the drug.

Prescribing even the minimum dosage of Nifedipine during pregnancy with tone is justified only in the case of complex treatment of hypertension, accompanied by oxygen deficiency in the tissues, heart failure and malfunction of the kidneys.

In addition to its positive properties, this drug has a number of serious disadvantages and is considered a potentially dangerous drug during pregnancy. Therefore, when faced with the need for treatment, it is necessary to discuss with your doctor the possibility of replacing Nifedipine with a safer drug.

Possible side effects

Dilation of the arteries leads to compensatory activity of the sympathetic nervous system, so the main side effects manifest themselves as follows:

• there is heat in the body,
• skin turns red,
• pulse quickens,
• headache and dizziness appear.

High doses may excessively lower blood pressure. All these effects are more characteristic of short-acting drugs. And the development of edema syndrome applies to various dosage forms, this is especially noticeable in patients with reduced renal function.

Rare cases of increased frequency or intensification of angina attacks are called the pro-ischemic effect of Nifedipine. It is typical for all drugs from the group of calcium blockers. Decreased exercise tolerance or even resting angina may occur if use is abruptly stopped.

Therefore, Nifedipine is withdrawn very slowly over 5 or more days. An addiction to the drug develops in patients who use this drug for a long time to lower blood pressure. In this case, they take a break for a month, but the cancellation is also carried out gradually.

Use for pregnant women and children

The active ingredients of the drug are not able to penetrate into the blood through the placenta. That is why it is allowed to be used to treat representatives of the fairer sex during pregnancy.

Treatment of hemorrhoids with this medication can also be carried out during the period of breastfeeding a newborn baby. Despite the relative safety of the medicine, you should consult a doctor before using it.

The medicine is approved for the treatment of hemorrhoids in children only on the recommendation of a doctor, who will determine the presence of contraindications.

What does Nifedipine help with?

The drug Nifedipine is prescribed in the following cases:

• Chronic stable angina (angina pectoris);
• Vasospastic angina (Prinzmetal's angina);
• Arterial hypertension (in monotherapy or in combination with other antihypertensive drugs);
• Raynaud's disease and syndrome.

special instructions

Each drug has its own prescription characteristics, neglect of which can lead to very unpleasant consequences. Therefore, carefully read what is written below.

Does Felodipine affect the ability to drive vehicles?

Due to the risk of dizziness or increased drowsiness, try to avoid driving at the beginning of the therapeutic course. After your body gets used to the therapy you are receiving, you can get behind the wheel again.

During pregnancy and lactation

Pregnancy is an absolute contraindication for the use of Felodipine. Therefore, it must be replaced with an analogue that does not have a pathogenic effect on the developing fetus.

Alcohol compatibility

Alcohol-containing drinks may distort the effect of the described drug. Moreover, the effects of such a combination are very difficult to predict. A number of studies have shown that the hypotensive effect is enhanced by alcohol, and therefore various collapsed and syncope conditions may occur. We strongly do not recommend drinking alcoholic beverages while taking this pharmaceutical.

Analogues of the drug

Nifedipine is a fairly affordable drug. Its price usually does not exceed one hundred rubles per package. But it is not always possible to buy this particular drug in pharmacies, so patients have to look for its analogues based on nifedipine.

"Corinfar Retard" is used by doctors no less often than the original drug. It has identical composition, indications and list of contraindications. Calcigard Retard is also effective (nifedipine is its main active ingredient). Cardiologists often prescribe Adalat and Nifebene as analogues.

Who is prescribed

Individual dosages of nifedipine are most often prescribed in the treatment of high blood pressure. When using this remedy, a hypertensive crisis is quickly eliminated. Nifedipine is used in the following cases:

• Arterial hypertension.
• Congestive cardiopulmonary failure.
• Spasm of the coronary arteries.
• 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:

• Stagnation of blood.
• Heart failure.
• Pulmonary hypertension.
• Blockage of blood vessels.
• Bronchospasms.
• Cerebrovascular accident.
• Cardiac ischemia.
• Hypertensive crisis.
• Atherosclerosis of peripheral arteries.

Use during pregnancy and breastfeeding

According to the instructions for the drug, it should not be taken during pregnancy. There are no reliable studies on the safety of the active substance, nifedipine, for a pregnant child. In experiments on animals, an increase in the frequency of congenital deformities and pathologies or intrauterine death of embryos was recorded.

It is prohibited to drink Nifedipine in the first weeks after conception.

However, according to specialists from the Russian National Research Medical University, there is a correlation between the use of Nifedipine by women in the first weeks (when they did not yet know that conception had occurred) or in the second half of pregnancy and the frequency of missed pregnancies, miscarriages or congenital pathologies in no children found.

And yet, the drug is sometimes prescribed, but mainly after the 20th week, when the baby is mostly formed, and only for justified indications, such as:

• dangerously high blood pressure that is unresponsive to safer medications;
• hypertonicity;
• attacks of angina.

Contraindicated during pregnancy.

FDA category of effect on the fetus is C.

Breastfeeding should be stopped during treatment.

Features of application

Before using the drug, read the sections of the instructions for use about contraindications, possible side effects and other important information.

Side effects of Nifedipine

Instructions for use warn of the possibility of side effects of the drug Nifedipine:

• From the cardiovascular system: often - peripheral edema (feet, ankles, legs), symptoms of vasodilation (redness of the facial skin, feeling of heat); infrequently - tachycardia, rapid heartbeat, marked decrease in blood pressure, fainting; in some cases - chest pain (angina) up to the development of myocardial infarction, development or worsening of chronic heart failure, arrhythmia.
• From the nervous system: very often - headache; often - dizziness, drowsiness; infrequently - asthenia, sleep disturbance (including insomnia), nervousness, increased fatigue, dysesthesia, tremor, mood lability.
• From the digestive system: often - nausea; uncommon - gastrointestinal and abdominal pain (pain in the stomach and intestines), diarrhea, constipation, dry oral mucosa, increased appetite; rarely - gum hyperplasia (bleeding, pain, swelling).
• With long-term use: infrequently - liver dysfunction (intrahepatic cholestasis, increased activity of hepatic transaminases), rarely - jaundice; in some cases - insufficiency of the cardiac sphincter.
• From the respiratory system: infrequently - shortness of breath, rarely - pulmonary edema (difficulty breathing, cough, wheezing).
• From the musculoskeletal system: rarely - arthralgia, joint swelling, myalgia, muscle cramps.
• From the hematopoietic organs: rarely - anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura; very rarely - asymptomatic agranulocytosis.
• From the urinary system: uncommon - increased daily diuresis, deterioration of renal function (in patients with renal failure).
• Allergic reactions: often - erythema; rarely - itching, urticaria, exanthema, photosensitivity, autoimmune hepatitis; uncommon - angioedema; in some cases - toxic epidermal necrolysis.
• Other: rarely - visual impairment (including transient loss of vision against the background of the maximum concentration of nifedipine in the blood plasma), eye pain, hyperglycemia, gynecomastia (in elderly patients; completely disappearing after discontinuation of the drug), galactorrhea, erectile dysfunction, weight gain , chills, nosebleeds, nasal congestion.

Contraindications

The use of Nifedipine is contraindicated for the following diseases or conditions:

• Arterial hypotension (systolic blood pressure below 90 mm Hg);
• Cardiogenic shock;
• Collapse;
• Severe aortic or subaortic stenosis;
• Acute heart failure;
• Chronic heart failure in the stage of decompensation;
• Unstable angina;
• Acute period of myocardial infarction (during the first 4 weeks);
• Hypertrophic obstructive cardiomyopathy;
• Sick sinus syndrome;
• AV blockade 2-3 degrees;
• Pregnancy (up to 20 weeks) and lactation period;
• Age up to 18 years;
• Hypersensitivity to the components of the drug.

The drug is used with caution in chronic heart failure, a marked decrease in the functional activity of the liver and kidneys, severe circulatory disorders in the brain, diabetes mellitus, especially at the stage of decompensation, and malignant arterial hypertension.

It is prescribed with special caution to persons undergoing hemodialysis (hardware blood purification) due to the high risk of developing severe arterial hypotension.

Overdose

Symptoms of overdose are headache, facial skin flushing, prolonged pronounced decrease in blood pressure, suppression of sinus node function, bradycardia, bradyarrhythmia.

In severe poisoning - loss of consciousness, coma, metabolic acidosis, hypoxia, cardiogenic shock with pulmonary edema.

In case of severe overdose (collapse, depression of the sinus node), gastric lavage is performed and activated charcoal is prescribed. The antidote is calcium - slow intravenous administration of 10% calcium chloride or calcium gluconate at a dose of 0.2 ml/kg (but not more than 10 ml) over 5 minutes is indicated; if ineffective, repeated administration is possible under the control of the content of calcium ions in the blood serum, with If symptoms resume, you can switch to a constant infusion at a rate of 0.2 ml/kg/h, but not more than 10 ml/h.

With a pronounced decrease in blood pressure, intravenous administration of dopamine or dobutamine.

For conduction disorders - atropine, isoprenaline or an artificial pacemaker.

With the development of heart failure - intravenous administration of strophanthin.

Catecholamines should be used only when there is a threat to life (due to their reduced effectiveness, a high dosage is required, which increases the risk of developing arrhythmia).

It is recommended to monitor the concentration of glucose in the blood (insulin release may decrease) and electrolytes (potassium ions, calcium ions).

Hemodialysis is ineffective.

Compatibility with drugs and alcohol

Alcohol and pills do not mix.
"Nifedipine" enhances the effectiveness of antihypertensive drugs of other groups, increases the saturation of plasma with cardiac glycosides. Concomitant use with a diuretic or organic nitrates, as well as antidepressants, increases the risk of collapse and increases the frequency of myocardial contractions. Combination with beta blockers threatens arterial critical hypotension and heart failure. Nifedipine is not prescribed in combination with Rifampicin, since the anti-tuberculosis drug weakens the antihypertensive effect. Combined use with anticoagulants potentiates the effect of coumarin derivatives. Alcohol significantly increases the hypotensive effect of Nifedipine.

Can this medicine be used during pregnancy?

Many women are interested in whether it is possible to take Nifedipine during pregnancy? Reviews from doctors and expectant mothers have shown that it can be taken only in extreme cases and under the supervision of the attending physician.

Although studies have not been conducted on pregnant women, animal experiments have shown that taking Nifedipine can lead to perinatal asphyxia, premature birth and intrauterine growth retardation.

Although it is impossible to say for sure whether the drug causes such consequences, or whether some diseases of the mother lead to similar pathologies. But after careful study, similar symptoms were noted in pregnant women after taking this drug. Therefore, it is best not to take Nifedipine during pregnancy. Reviews about the drug have not been confirmed by laboratory tests, and it is best not to risk the health of the mother and fetus.

I would also like to say that Nifedipine is strictly contraindicated for children under 18 years of age.

How will Nifedipine help with blood pressure?

The hypotensive effect of the drug is manifested due to the ability to inhibit the movement of calcium through the cell membrane of the smooth muscles of the arteries. Calcium ions lead to vasospasm, increasing their contraction. Therefore, when the supply of this microelement slows down, the lumen of the coronary and peripheral branches of the arterial network expands, the resistance of the vascular walls and the load on the heart decreases.

Conventional tablet forms and drops of Nifedipine are very well absorbed in the digestive tract, penetrating into the blood from the oral mucosa; their onset of action appears in the first 8 to 10 minutes and reaches a maximum within half an hour.

This is an advantage when it is necessary to quickly lower blood pressure (in the case of a hypertensive crisis).

For course treatment, extended forms are recommended - retard tablets with gradual release of the active substance. They can maintain normal blood pressure levels throughout the day.

When is Nifedipine prescribed?

The instructions for use indicate the following indications for the use of Nifedipine tablets: to lower blood pressure (treatment of arterial hypertension), coronary artery disease (prevention of stable forms of angina, vasospastic form of angina).

In the case of vasospastic angina, prolonged Nifedipine is prescribed when one of the following criteria is met:

• classic manifestations of angina at rest, accompanied by an increase in the ST segment on the ECG;
• anginal or coronary spasm caused by ergonovine;
• angiographically documented coronary artery spasms.

The drug helps reduce the incidence of angina and increase exercise tolerance.

Important! The use of blood pressure medication is intended for adult patients.

Side effects

Like other blood pressure medications, Nifedipine can cause side effects from certain systems and organs:

• Endocrine system - gynecomastia.
• Circulatory system - thrombocytopenia and leukopenia.
• Genitourinary system - increased diuresis, with long-term use - problems with the kidneys.
• Cardiovascular system - severe drop in pressure, swelling of the limbs and skin, asystole, feeling of warmth, bradycardia, tachycardia, angina pectoris.
• From the gastrointestinal tract: diarrhea, nausea, heartburn, liver problems. If you take the drug for a long time in large dosages, an increase in transaminases and cholestasis may occur.

Reviews

On the Internet you can find a large number of reviews about Felodipine. But do not forget that first of all you should be guided by the doctor’s recommendations.

Doctors

• Ekaterina Mikhailovna, cardiologist, echocardiography specialist. Felodipine is a fairly good drug. During the entire period of my practical medical activity, there were practically no cases of intolerance to it. Of course, the fact that the risk of developing orthostatic collapse is minimal is captivating.
• Alexander Ivanovich, cardiologist, associate professor. I have seen complications with the use of Felodipine several times, but this in no way negates all the advantages of this drug. With its proper administration, rapid positive dynamics of the disease can be achieved.

Patients

• Olga, 62 years old. I have been using Felodipine against high blood pressure for more than six months now. Before this, I took Enalapril, but complications developed with it, but there were no problems with these tablets. One of the disadvantages is the high cost of the drug. It is also not always available in pharmacies.
• Polina, 56 years old. I am a hypertensive patient with extensive experience. Recently, I have been saving myself only with Felodipine, on which the pressure remains stable within 130-140 (and previously it jumped to 180). With the start of treatment, headaches and heart problems disappeared.

Adverse events

Side effects of Nifedipine are presented in the table:

Less common side effects of the medication:

• Nifedipine is dangerous because it can increase the manifestations of angina pectoris. The medication reduces blood pressure and causes reflex tachycardia. The situation can be prevented by the simultaneous administration of beta-blockers.
• As a calcium channel blocker, the drug reduces the shelf life of sperm for fertilization.

Efficacy of Nifedipine

Since the development of the drug, sufficient international studies of effectiveness have been conducted; reports on the benefits, safety and advisability of prescribing Nifedipine have been presented. In 2000, the results of the INSIGHT study were presented, according to which the drug is safe, effectively helps with hypertension, is well tolerated compared to diuretics, and helps reduce the risk of heart attack and stroke in hypertensive patients.

The results of the Action study confirmed the safety of long-term Nifedipine and its ability to reduce the need for coronary artery bypass grafting and coronary angiography. In combination with other drugs, Nifedipine improves the prognosis in hypertensive patients and patients with angina pectoris, including the condition after myocardial infarction.

Tablets with short-term effects are recommended as an emergency treatment for hypertensive crisis; if taken for a long time, this is fraught with complications.