Nytenso
Generic Name
Nifedipine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nytenso 10 mg tablet | ৳ 20.00 | ৳ 200.00 |
Description
Overview of the medicine
Nytenso 10 mg Tablet contains Nifedipine, a calcium channel blocker used to treat high blood pressure (hypertension) and to prevent or treat angina pectoris (chest pain) caused by coronary artery disease. It works by relaxing blood vessels so blood can flow more easily, which helps to lower blood pressure and reduce the heart's workload.
Uses & Indications
Dosage
Adults
For Hypertension: Initially 10 mg orally 2-3 times daily. May be increased up to 20 mg 2-3 times daily, if needed. For Angina: Initially 10 mg orally 3 times daily. Max daily dose typically 60-120 mg depending on formulation.
Elderly
Lower initial doses (e.g., 5 mg 2-3 times daily) may be considered, with careful titration due to increased sensitivity.
Renal_impairment
No dosage adjustment is usually required in patients with renal impairment, but caution is advised in severe cases.
How to Take
Take Nytenso 10 mg Tablet orally, with or without food. Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet, as this can lead to a rapid release of the drug and potential side effects.
Mechanism of Action
Nifedipine selectively blocks the transmembrane influx of calcium ions into cardiac muscle and vascular smooth muscle cells. This inhibition of calcium influx decreases peripheral vascular resistance, leading to vasodilation and reduced blood pressure. It also dilates coronary arteries and arterioles, improving myocardial oxygen supply and reducing angina.
Pharmacokinetics
Onset
Approximately 20 minutes for immediate-release tablets.
Excretion
Primarily excreted in the urine (60-80%) as inactive metabolites, with the remainder excreted in the feces.
Half life
2 to 5 hours (for immediate-release formulations).
Absorption
Rapid and nearly complete absorption from the gastrointestinal tract following oral administration. Peak plasma concentrations are reached within 30 minutes to 2 hours for immediate-release formulations.
Metabolism
Extensively metabolized in the liver (approximately 90%) by the cytochrome P450 3A4 (CYP3A4) enzyme system. Undergoes significant first-pass metabolism.
Side Effects
Contraindications
- Hypersensitivity to nifedipine or any component of the formulation
- Cardiogenic shock
- Significant aortic stenosis
- Unstable angina or acute myocardial infarction (for immediate-release formulations)
- Concomitant use with rifampicin
Drug Interactions
Rifampicin
Strong inducer of CYP3A4, significantly decreases nifedipine plasma concentrations; concomitant use is contraindicated.
Beta-blockers
May enhance hypotensive effect and potentially increase the risk of heart failure.
Grapefruit juice
Inhibits CYP3A4 metabolism, significantly increasing nifedipine plasma levels and effects.
Cimetidine, Erythromycin, Fluoxetine
May inhibit nifedipine metabolism, increasing plasma concentrations and effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include marked hypotension, bradycardia, metabolic acidosis, hyperglycemia, and unconsciousness. Management involves gastric lavage, activated charcoal, IV fluids, vasopressors (e.g., dopamine, norepinephrine) to counteract hypotension, and intravenous calcium gluconate to counteract calcium channel blockade.
Pregnancy & Lactation
Pregnancy Category C. Nifedipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk in small amounts; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to nifedipine or any component of the formulation
- Cardiogenic shock
- Significant aortic stenosis
- Unstable angina or acute myocardial infarction (for immediate-release formulations)
- Concomitant use with rifampicin
Drug Interactions
Rifampicin
Strong inducer of CYP3A4, significantly decreases nifedipine plasma concentrations; concomitant use is contraindicated.
Beta-blockers
May enhance hypotensive effect and potentially increase the risk of heart failure.
Grapefruit juice
Inhibits CYP3A4 metabolism, significantly increasing nifedipine plasma levels and effects.
Cimetidine, Erythromycin, Fluoxetine
May inhibit nifedipine metabolism, increasing plasma concentrations and effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include marked hypotension, bradycardia, metabolic acidosis, hyperglycemia, and unconsciousness. Management involves gastric lavage, activated charcoal, IV fluids, vasopressors (e.g., dopamine, norepinephrine) to counteract hypotension, and intravenous calcium gluconate to counteract calcium channel blockade.
Pregnancy & Lactation
Pregnancy Category C. Nifedipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk in small amounts; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available, patent expired
WHO Essential Medicine
YesClinical Trials
Nifedipine has undergone extensive clinical trials since its introduction, demonstrating its efficacy and safety in managing hypertension and angina. Ongoing research continues to explore its applications and long-term outcomes.
Lab Monitoring
- Blood pressure monitoring
- Heart rate monitoring
- Liver function tests (periodically, especially with prolonged use or symptoms of hepatic dysfunction)
Doctor Notes
- Monitor patient's blood pressure and heart rate closely, especially during initiation and dose titration.
- Educate patients on the importance of adherence to therapy and potential side effects, including flushing and peripheral edema.
- Advise patients to avoid grapefruit products due to significant drug-food interaction.
- Consider alternative formulations (e.g., extended-release) if immediate-release causes pronounced side effects.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking Nytenso suddenly without consulting your doctor, as this may worsen your condition.
- Report any severe side effects like severe dizziness, fainting, or persistent swelling immediately.
- Avoid grapefruit juice and grapefruit products while on this medication.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, 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
Nytenso may cause dizziness, lightheadedness, or fatigue, especially at the beginning of treatment or when the dose is changed. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet, low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption to help manage blood pressure and heart health.
- Monitor your blood pressure regularly at home if advised.
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