Cilmedip
Generic Name
Cilnidipine
Manufacturer
General Pharmaceuticals Ltd. (example for Bangladesh)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cilmedip 5 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Cilmedip 5 mg tablet contains Cilnidipine, a dihydropyridine calcium channel blocker used for the treatment of essential hypertension. It works by relaxing blood vessels, making it easier for the heart to pump blood.
Uses & Indications
Dosage
Adults
The usual starting dose is 5 mg once daily. The dose may be increased to 10 mg once daily, and if necessary, up to a maximum of 20 mg once daily, depending on the patient's blood pressure response.
Elderly
A starting dose of 5 mg once daily is generally recommended, with careful monitoring and dose adjustment based on individual response and tolerability.
Renal_impairment
No specific dose adjustment is generally required for mild to moderate renal impairment, but caution is advised. For severe renal impairment, dose adjustment might be necessary, and monitoring is crucial.
How to Take
Cilmedip 5 mg tablet should be taken orally, once daily, preferably after breakfast. It can be taken with or without food, but consistency in timing is important.
Mechanism of Action
Cilnidipine blocks both L-type and N-type voltage-dependent calcium channels. This inhibition reduces calcium ion influx into vascular smooth muscle cells, leading to peripheral vasodilation and a reduction in blood pressure. The N-type calcium channel blockade may also contribute to reduced sympathetic nerve activity.
Pharmacokinetics
Onset
Hypotensive effect typically begins within a few hours after administration.
Excretion
Primarily excreted in the feces (about 60%), with a smaller portion (about 20%) excreted in the urine, mainly as metabolites.
Half life
Plasma elimination half-life is approximately 3-7 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract. Peak plasma concentrations are typically reached within 1-2 hours after oral administration.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 3A4 (CYP3A4) enzyme system.
Side Effects
Contraindications
- Known hypersensitivity to Cilnidipine or any other dihydropyridine calcium channel blockers.
- Cardiogenic shock.
- Unstable angina or acute myocardial infarction.
- Severe aortic stenosis.
Drug Interactions
Diuretics
May enhance the hypotensive effect of cilnidipine.
Beta-blockers
May have an additive hypotensive effect when co-administered with cilnidipine. Careful monitoring is advised.
CYP3A4 Inducers (e.g., Rifampicin, Carbamazepine, Phenytoin)
May decrease plasma concentrations of cilnidipine, potentially reducing its therapeutic effect.
CYP3A4 Inhibitors (e.g., Ketoconazole, Erythromycin, Ritonavir)
May increase plasma concentrations of cilnidipine, leading to increased hypotensive effects and risk of side effects.
Storage
Store in a cool, dry place, below 30°C. Protect from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include excessive peripheral vasodilation with marked hypotension, reflex tachycardia, and possibly shock. Management involves symptomatic and supportive treatment. Intravenous fluids and vasopressors may be administered for severe hypotension. Close monitoring of cardiac and respiratory function is essential.
Pregnancy & Lactation
Pregnancy Category C. Cilmedip should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether cilnidipine is excreted in human milk; caution is advised when administering to nursing mothers.
Side Effects
Contraindications
- Known hypersensitivity to Cilnidipine or any other dihydropyridine calcium channel blockers.
- Cardiogenic shock.
- Unstable angina or acute myocardial infarction.
- Severe aortic stenosis.
Drug Interactions
Diuretics
May enhance the hypotensive effect of cilnidipine.
Beta-blockers
May have an additive hypotensive effect when co-administered with cilnidipine. Careful monitoring is advised.
CYP3A4 Inducers (e.g., Rifampicin, Carbamazepine, Phenytoin)
May decrease plasma concentrations of cilnidipine, potentially reducing its therapeutic effect.
CYP3A4 Inhibitors (e.g., Ketoconazole, Erythromycin, Ritonavir)
May increase plasma concentrations of cilnidipine, leading to increased hypotensive effects and risk of side effects.
Storage
Store in a cool, dry place, below 30°C. Protect from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include excessive peripheral vasodilation with marked hypotension, reflex tachycardia, and possibly shock. Management involves symptomatic and supportive treatment. Intravenous fluids and vasopressors may be administered for severe hypotension. Close monitoring of cardiac and respiratory function is essential.
Pregnancy & Lactation
Pregnancy Category C. Cilmedip should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether cilnidipine is excreted in human milk; caution is advised when administering to nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, when stored under recommended conditions.
Availability
Available in pharmacies and hospitals
Approval Status
Approved in various countries, including Bangladesh and Japan
Patent Status
Generics available, patent expired
Clinical Trials
Cilnidipine has undergone extensive clinical trials demonstrating its efficacy and safety in managing essential hypertension, particularly noting its favorable effects on renal function and reduced incidence of ankle edema compared to some other CCBs.
Lab Monitoring
- Regular blood pressure monitoring.
- Assessment of renal function (creatinine, BUN) for long-term therapy, especially in patients with pre-existing renal impairment.
- Liver function tests (ALT, AST) periodically, particularly if symptoms of hepatic dysfunction appear.
Doctor Notes
- Advise patients to take medication consistently and not to discontinue without consultation.
- Emphasize the importance of lifestyle modifications alongside pharmacotherapy.
- Monitor for peripheral edema and advise patients on measures to alleviate it.
- Be aware of potential drug interactions, especially with CYP3A4 modulators.
Patient Guidelines
- Take Cilmedip 5 mg tablet exactly as prescribed by your doctor, at the same time each day.
- Do not stop taking this medication suddenly without consulting your doctor, as it may worsen your condition.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Report any unusual or severe side effects to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next scheduled 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
Cilmedip may cause dizziness, lightheadedness, or fatigue, especially at the beginning of treatment or when the dose is increased. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy diet, low in sodium and saturated fats.
- Engage in regular physical activity, as recommended by your doctor.
- Avoid smoking and limit alcohol consumption, as these can negatively impact blood pressure.
- Manage stress through relaxation techniques or other activities.
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