Cardipin
Generic Name
Nifedipine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cardipin 5 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Nifedipine is a dihydropyridine calcium channel blocker used to treat hypertension (high blood pressure) and chronic stable angina pectoris (chest pain). It works by relaxing blood vessels, making it easier for the heart to pump blood.
Uses & Indications
Dosage
Adults
For hypertension or angina: Initially 5-10 mg orally, 3 times daily. Doses may be adjusted according to patient response; usual maintenance dose is 10-20 mg 3 times daily. Maximum recommended dose is 30 mg 3 times daily for immediate-release tablets.
Elderly
Start with lower doses (e.g., 5 mg 2-3 times daily) and titrate carefully due to increased sensitivity and potential for adverse effects.
Renal_impairment
No dose adjustment is usually required for patients with renal impairment, but caution is advised in severe cases.
How to Take
Cardipin-5 mg tablets should be taken orally, preferably with a glass of water, usually before meals. Do not chew, crush, or break the immediate-release tablets.
Mechanism of Action
Nifedipine selectively blocks L-type voltage-gated calcium channels in vascular smooth muscle and cardiac muscle. This blockade leads to vasodilation, primarily in arteries and arterioles, thereby reducing peripheral vascular resistance and lowering blood pressure. It also improves myocardial oxygen supply by dilating coronary arteries.
Pharmacokinetics
Onset
Approximately 20 minutes (for immediate-release oral tablets).
Excretion
Primarily excreted in urine as inactive metabolites (60-80%), with the remainder eliminated in feces.
Half life
2-5 hours (for immediate-release formulations).
Absorption
Rapidly and almost completely absorbed from the gastrointestinal tract following oral administration (bioavailability 45-70% due to first-pass metabolism). Peak plasma concentrations occur within 30-60 minutes for immediate-release formulations.
Metabolism
Extensively metabolized in the liver, primarily via cytochrome P450 3A4 (CYP3A4) into inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to nifedipine or any component of the formulation
- Cardiogenic shock
- Unstable angina pectoris
- Severe aortic stenosis
- Concomitant use with rifampicin
Drug Interactions
Digoxin
Nifedipine may increase digoxin plasma levels; monitor digoxin levels.
Rifampicin
Significantly reduces nifedipine efficacy due to CYP3A4 induction.
Beta-blockers
Increased risk of hypotension and heart failure.
Grapefruit juice
Increases nifedipine plasma concentrations, enhancing effects and adverse reactions.
Cimetidine, Erythromycin, Fluoxetine
May increase nifedipine levels due to CYP3A4 inhibition.
Phenytoin, Carbamazepine, Phenobarbital
May reduce nifedipine efficacy by inducing CYP3A4.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, metabolic acidosis, hyperglycemia, and in severe cases, cardiac arrest. Management is supportive, including fluid replacement, vasopressors, calcium gluconate, and atropine for bradycardia.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Nifedipine is excreted in human milk; use with caution during lactation.
Side Effects
Contraindications
- Hypersensitivity to nifedipine or any component of the formulation
- Cardiogenic shock
- Unstable angina pectoris
- Severe aortic stenosis
- Concomitant use with rifampicin
Drug Interactions
Digoxin
Nifedipine may increase digoxin plasma levels; monitor digoxin levels.
Rifampicin
Significantly reduces nifedipine efficacy due to CYP3A4 induction.
Beta-blockers
Increased risk of hypotension and heart failure.
Grapefruit juice
Increases nifedipine plasma concentrations, enhancing effects and adverse reactions.
Cimetidine, Erythromycin, Fluoxetine
May increase nifedipine levels due to CYP3A4 inhibition.
Phenytoin, Carbamazepine, Phenobarbital
May reduce nifedipine efficacy by inducing CYP3A4.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, metabolic acidosis, hyperglycemia, and in severe cases, cardiac arrest. Management is supportive, including fluid replacement, vasopressors, calcium gluconate, and atropine for bradycardia.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Nifedipine is excreted in human milk; use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Nifedipine has undergone extensive clinical trials demonstrating its efficacy and safety for treating hypertension and angina pectoris. Research continues to refine its use and explore new applications, particularly with various extended-release formulations.
Lab Monitoring
- Blood pressure monitoring (regularly)
- Liver function tests (if signs of hepatic dysfunction occur)
- Renal function tests (periodically, especially in patients with pre-existing impairment)
Doctor Notes
- Educate patients about common side effects like flushing and edema, assuring them they often subside with continued use.
- Emphasize the importance of continuous therapy and the dangers of abrupt discontinuation, especially in angina.
- Counsel patients on significant drug and food interactions, particularly with grapefruit juice.
- Advise regular blood pressure monitoring and follow-up appointments.
- Consider using extended-release formulations for better compliance and fewer fluctuations in blood pressure.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking Cardipin abruptly without consulting your doctor, as it may worsen your condition.
- Report any new or worsening side effects to your doctor immediately.
- Avoid grapefruit and grapefruit juice while taking this medication.
- Monitor your blood pressure at home if advised by your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Cardipin may cause dizziness, lightheadedness, or fatigue, especially at the start of treatment or when the dose is increased. Avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid excessive alcohol consumption.
- Quit smoking to improve cardiovascular health.
- Manage stress effectively through relaxation techniques.
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