Corinfar is a selective blocker of slow calcium channels that has antianginal and hypotensive effects.
Release form and composition
Corinfar dosage form - tablets with prolonged action: round, biconvex, with beveled edges, film-coated yellow (10 pieces in blisters, in a cardboard bundle 3 blisters; 50 or 100 pieces in brown glass bottles, in a cardboard bundle 1 bottle).
Ingredients 1 tablet:
- Active ingredient: nifedipine - 10 mg;
- Auxiliary components: potato starch, lactose monohydrate, microcrystalline cellulose, magnesium stearate, povidone K25;
- Shell composition: macrogol 35000, macrogol 6000, hypromellose, talc, titanium dioxide (Е171), dye quinoline yellow (Е104).
Indications for use
- Variant angina (Prinzmetal stenocardia);
- Angina pectoris (chronic stable angina pectoris);
- Arterial hypertension.
- Severe aortic stenosis;
- Chronic heart failure in the stage of decompensation;
- Unstable Angina;
- Arterial hypotension (systolic blood pressure below 90 mmHg);
- The first 4 weeks after acute myocardial infarction;
- Cardiogenic shock, collapse;
- I trimester of pregnancy;
- Lactation period;
- Combined use with rifampicin;
- Hypersensitivity to nifedipine, auxiliary components of the drug or other 1,4-dihydropyridine derivatives.
Relative (special caution required):
- Sick sinus syndrome;
- Malignant arterial hypertension;
- Hypertrophic obstructive cardiomyopathy;
- Mitral valve stenosis;
- Severe bradycardia or tachycardia;
- Myocardial infarction, accompanied by left ventricular failure;
- Severe disorders of cerebral circulation;
- Kidney and liver failure;
- Period of hemodialysis;
- Obstruction of the gastrointestinal tract;
- II and III trimesters of pregnancy;
- Age up to 18 years;
- The need to simultaneously receive digoxin or beta-blockers.
Dosing and Administration
The drug should be taken orally after a meal, swallowing the pill whole, squeezed enough liquid.
The doctor in each case selects the dose individually, depending on the severity of the course of the disease and the tolerance of nifedipine. Elderly people and patients with concomitant severe cerebrovascular diseases reduce the dose.
The recommended initial dose is 10 mg, the multiplicity of reception - 2-3 times a day. When the effect is insufficient, it is gradually increased to 20 mg 1-2 times a day. The maximum permissible daily dose is 40 mg.
In the case of double use of the drug, the minimum interval between doses should be at least 4 hours.
The duration of treatment is determined by the doctor.
- Musculoskeletal system: swelling of the joints, myalgia, cramps of the upper and lower extremities, arthritis;
- Cardiovascular system: excessive vasodilation (asymptomatic reduction in blood pressure (BP), flushing of the skin of the face, feeling of heat, flushing of the skin of the face, development / aggravation of heart failure), peripheral edema (lower legs, ankles, feet), arrhythmias, tachycardia, heart palpitations, syncope; rarely - marked reduction in blood pressure. In some patients, especially at the beginning of therapy or with an increase in dose, angina may appear, and in isolated cases - myocardial infarction;
- Allergic reactions: rarely - autoimmune hepatitis, urticaria, exanthema, exfoliative dermatitis, photodermatitis, pruritus, anaphylactic reactions;
- Central nervous system: general weakness, dizziness, fatigue, drowsiness, headache; with long-term administration in high doses - tremor, paresthesias of the extremities, depression, extrapyramidal disorders (shuffling gait, mask-like face, ataxia, difficulty swallowing, tremor of the hands and fingers);
- Urinary system: an increase in daily diuresis; in patients with renal insufficiency - impaired renal function;
- Digestive system: nausea, diarrhea / constipation, increased appetite, flatulence, dry mouth; rarely - gingival hyperplasia (completely disappears after drug withdrawal); with long-term use - increased activity of hepatic transaminases, intrahepatic cholestasis;
- Blood system: thrombocytopenia, leukopenia, thrombocytopenic purpura, anemia, agranulocytosis;
- Other: rarely - bronchospasm, pulmonary edema, hyperglycemia, weight gain, galactorrhea, visual impairment (including, at the maximum concentration of nifedipine in the blood plasma, transient blindness); in older people - gynecomastia (completely disappears after stopping treatment).
During the application of Corinfar, you must refrain from taking alcoholic beverages.
The treatment of patients taking beta-blockers simultaneously should be carried out under close medical supervision, since An excessive reduction in blood pressure is possible, and in some cases, aggravation of the severity of heart failure.
At the initial stage of therapy, there is a likelihood of developing angina, especially after abrupt withdrawal of beta-blockers (therefore, they should be canceled gradually).
With great caution should dispense the drug in patients with severe heart failure.
Diagnostic criteria for the appointment of Corinfar with vasospastic angina are: a classic clinical picture with an increased ST segment, the development of spasm of the coronary arteries or ergonovine-induced angina, the detection of coronary spasm during angiography or angiospastic component without confirmation electrocardiogram data indicate transient angiospasm).
Patients with severe obstructive cardiomyopathy are at risk of increasing the frequency, severity, and duration of strokes after taking Corinfar. In this case, the drug should be canceled.
In patients with irreversible renal failure on hemodialysis, in the case of high blood pressure or reduced blood volume, a sharp drop in blood pressure is possible.
Special observation is required for patients with impaired liver function. You may need to reduce the dose of Corinfar or the appointment of other dosage forms of nifedipine.
Under the influence of the drug, it is possible to obtain false-positive results of laboratory tests for antinuclear antibodies, direct Coombs reaction.
Patients who have undergone surgery under general anesthesia should warn the anesthesiologist about the course of treatment with Corinfar.
When conducting in vitro fertilization (IVF), it should be borne in mind that slow calcium channel blockers (BMCC) can cause changes in the head of the sperm, which can lead to a violation of their function. If repeated IVF fails, the use of BMCC can be considered a possible cause of failure.
When spectrophotometric determination of vanillic acid in the urine during the period of application of Corinfar it is possible to obtain a falsely overestimated result, therefore, if such a study is necessary, it is recommended to prescribe high performance liquid chromatography: nifedipine has no effect on it.
During treatment, care should be taken when engaging in any kind of activity that requires quick reactions and increased concentration of attention, including when driving vehicles.
Corinfar should not be abolished abruptly, treatment should be stopped gradually.
With the simultaneous use of Corinfar with other drugs should consider the possible interaction reactions:
- Other antihypertensive drugs, nitrates, inhalation anesthetics, tricyclic antidepressants, diuretics, cimetidine - enhancing the hypotensive effect of nifedipine;
- Nonsteroidal anti-inflammatory drugs (NSAIDs), sympathomimetics, estrogens - reduction of the hypotensive effect;
- Amiodarone, quinidine, disopyramide, flecainamide - increased inotropic action;
- Quinidine - a decrease in its concentration in the blood plasma;
- Cephalosporins, digoxin, theophylline - an increase in their concentration in the blood;
- Nitrates - increased tachycardia;
- Diltiazem - suppression of nifedipine metabolism;
- Rifampicin - acceleration of nifedipine metabolism;
- Preparations with a high degree of binding to proteins, including indirect anticoagulants - derivatives of indanedione and coumarin, NSAIDs, salicylates, anticonvulsants, quinine, sulfinpyrazone - increase their concentration in the blood plasma;
- Prazosin and other alpha-blockers - suppression of their metabolism, increased hypotensive action;
- Vincristine - slowing its excretion and, as a consequence, increased side effects;
- Lithium drugs - increased toxic effects (diarrhea, nausea, vomiting, ataxia, tinnitus, tremor);
- Procainamide, quinidine and other drugs that cause lengthening of the QT interval - the risk of significant lengthening of the QT interval;
- CYP3A isoenzyme inhibitors, including antiviral drugs (for example, nelfinavir, indinavir, ritonavir, saquinavir, amprenavir), azoles antifungal agents (fluconazole, itraconazole, ketoconazole), valproic acid, and the increase in the prevalence of heart disease.
- Carbamazepine, phenobarbital - a decrease in the concentration of nifedipine in the blood plasma.
During the period of treatment with Corinfar you should not drink grapefruit juice, because it inhibits nifedipine metabolism.
Terms and conditions of storage
Store at temperatures up to 25 ºC in a place inaccessible to children, protected from light.
Shelf life - 5 years.