Nifedipine tablets
[character] this product is a sugar coated tablet, which is yellow after removing the sugar coating.
[indications] 1. Angina pectoris: variant angina pectoris; unstable angina pectoris; chronic stable angina pectoris. 2. Hypertension (alone or in combination with other antihypertensive drugs).
The dosage of nifedipine should be adjusted gradually according to the tolerance of patients and the control of angina pectoris. Excessive nifedipine can cause hypotension. 2. Starting from a small dose, the general starting dose is 10mg / time, three times a day; the commonly used maintenance dose is 10-20mg / time, three times a day. For some patients with obvious coronary spasm, it can be used to 20-30mg / time, 3-4 times a day. The maximum dose should not exceed 120 mg / day. If the patient's condition is urgent, it can be chewed or sublingually taken 10mg / time. According to the patient's reaction to the drug, it is decided to give the drug again. 3. It usually takes 7-14 days to adjust the dose. If the patient's symptoms are obvious and the condition is urgent, the dose adjustment period can be shortened. The dosage of nifedipine can be adjusted from 10-20mg to 30mg / time within 3 days, three times a day, according to the patient's reaction to the drug, the frequency of attack and the dosage of sublingual nitroglycerin. 4. According to the control of angina pectoris or ischemic arrhythmia, patients under strict monitoring can add 10mg every 4-6 hours
[adverse reactions] 1. Peripheral edema (4% at 60 mg / day and 12.5% at 120 mg / day), dizziness, headache, nausea, fatigue and facial flushing (10%). The incidence of transient hypotension was 2% at 60 mg / day and 5% at 120 mg / day. Angina pectoris occurred in individual patients, which may be related to hypotension. There were palpitations, nasal congestion, chest tightness, shortness of breath, constipation, diarrhea, gastrointestinal spasm, abdominal distension, skeletal muscle inflammation, joint stiffness, muscle spasm, mental tension, trembling, nervousness, sleep disorder, blurred vision, and imbalance (2%). Syncope (0.5%) did not occur when the dosage was reduced or combined with other anti angina drugs. 2. Rare anemia; leucopenia; Thrombocytopenia; purpura; allergic hepatitis; gingival hyperplasia; depression; paranoia; instantaneous blindness at peak blood concentration; erythematous limb pain; antinuclear antibody positive arthritis, etc. (0.5%). 3. Possible serious adverse reactions: the incidence of myocardial infarction and congestive heart failure is 4%; the incidence of pulmonary edema is 2%; the incidence of arrhythmia and conduction block is less than 0.5%. 4. Allergic hepatitis, skin rash and exfoliative dermatitis may occur in patients allergic to this product.
[contraindication] it is forbidden to be allergic to nifedipine.
[caution] it is forbidden to be allergic to nifedipine. 1. Hypotension: most patients only have mild hypotension reaction after taking nifedipine, and some patients have severe hypotension symptoms. This kind of reaction often occurs in the period of dose adjustment or dosage addition, especially when combined with? - receptor blockers. During this period, blood pressure should be monitored, especially when combined with other antihypertensive drugs. 2. In patients undergoing coronary artery bypass grafting (or other operations) under fentanyl anesthesia, nifedipine alone or in combination with beta blockers can cause severe hypotension, and the drug should be stopped for at least 36 hours if possible. 3. A small number of patients with angina pectoris and / or myocardial infarction, especially those with severe coronary artery stenosis, have reflexive sympathetic excitement and increased heart rate after antihypertensive treatment, and the incidence of angina pectoris or myocardial infarction increases. 4. Peripheral edema 10% of patients had mild to moderate peripheral edema, which was related to arterial dilatation. Most of the edema initially occurred at the end of the lower limbs, which can be treated with diuretics. For patients with congestive heart failure, it is necessary to distinguish whether edema is caused by further deterioration of left ventricular function. 5. The symptoms of "rebound" of β - blockers, sudden withdrawal of β - blockers and use of nifedipine, occasionally with angina pectoris. The dosage of the former should be reduced gradually. 6. Congestive heart failure. A small number of patients who received beta blockers began to take nifedipine can develop heart failure. Patients with severe aortic stenosis are at greater risk. 7. Interference in diagnosis: when using this product, there are occasionally increases in alkaline phosphatase, creatine phosphokinase, lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase, generally without clinical symptoms, but there have been reports of cholestasis and jaundice; decreased platelet aggregation, prolonged bleeding time; positive direct Coomb test with / without hemolytic anemia 8. Patients with liver and kidney dysfunction and taking beta blockers should be cautious, and should start from a small dose to prevent inducing or aggravating hypotension and increasing the incidence of angina pectoris, heart failure and even myocardial infarction. The relationship between nifedipine and reversible increase of blood urea nitrogen and creatinine in patients with chronic renal failure is not clear. 9. Long term administration is not suitable for sudden stop, in order to avoid the occurrence of drug withdrawal syndrome and rebound phenomenon.
[medication for special population] precautions for children:
It's not clear.
Precautions during pregnancy and lactation:
1. No detailed clinical data. Nifedipine is clinically used in pregnant women with hypertension. 2. Nifedipine can be secreted into milk, and lactating women should stop taking nifedipine or lactating.
Precautions for the elderly:
The half-life of nifedipine in the elderly is prolonged, and the dosage should be adjusted.
[drug interaction] 1. The combination of nitrates and this product can control angina pectoris and has good tolerance. 2. Beta blockers are well tolerated and effective in most patients, but individual patients may induce or aggravate hypotension, heart failure and angina pectoris. 3. Digitalis may increase the concentration of digoxin in blood. It is suggested that the concentration of digoxin in blood should be monitored when using digitalis for the first time, adjusting the dosage or stopping using digitalis. 4. The free concentrations of dicoumarins, phenytoin sodium, quinidine, quinine and warfarin with high protein binding rate often change when they are used together with this product. 5. When cimetidine is used together with this product, the peak plasma concentration of this product increases. Pay attention to adjust the dose.
[pharmacological action] nifedipine is a dihydropyridine calcium antagonist, which can selectively inhibit the transmembrane transport of calcium into cardiomyocytes and smooth muscle cells, and inhibit the release of calcium from cells without changing the concentration of plasma calcium. Pharmacological action (1) this product can relax the coronary artery in normal blood supply area and ischemic area at the same time, antagonize spontaneous or ergonoxine induced coronary artery spasm, increase the delivery of myocardial oxygen in patients with coronary artery spasm, relieve and prevent coronary artery spasm. (2) This product can inhibit myocardial contraction, reduce myocardial metabolism and oxygen consumption. (3) This product can relax peripheral resistance vessels, reduce peripheral resistance, reduce systolic and diastolic blood pressure, and reduce cardiac afterload. (4) This product can delay the function of sinoatrial node and atrioventricular conduction in isolated heart; the electrophysiological study of the whole animal and human has not found that this product can delay atrioventricular conduction, prolong the recovery time of sinoatrial node and slow down the rate of sinoatrial node. Carcinogenic, mutagenic and reproductive toxicity had no carcinogenic effect. There was no mutagenicity. High dose application can reduce the fecundity of female rats, cause teratogenesis, and cause abortion (the drug absorption rate of fetal rats increases, the mortality rate of fetal rats increases, and the survival rate of newborn rats decreases). Taking 2 / 3-2 times of the maximum dose of human to pregnant monkeys can lead to hypoplasia of small placenta and villi; giving 3 times of the maximum dose of human to rats can lead to prolonged pregnancy. The impact on human fertility is unclear.
[storage] shading and sealing.
[Specification] 20mg
[packaging specification] plastic bottle or glass bottle packaging 10mg * 100 pieces / bottle: aluminum plastic packaging
[validity] 36 months.
Audited Supplier 
){kind=link}