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DRUGS & SUPPLEMENTS
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Apo-Nifed PA
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Apo-Nifed PA uses
Pharmacological action
Apo-Nifed PA is aSelective calcium channel blocker class II, a derivative of dihydropyridine. This medication inhibits the entry of calcium into cardiomyocytes and vascular smooth muscle cells. Apo-Nifed PA has antianginal and hypotensive action. This drug lowers the tone of vascular smooth muscle. Apo-Nifed PA dilates coronary and peripheral arteries, lowers blood pressure and slightly - myocardial contractility, reduces afterload and myocardial oxygen demand. This medicine improves coronary blood flow. Apo-Nifed PA practically does not possess antiarrhythmic activity, it does not inhibit the conductance of myocardium.
Pharmacokinetics
When administered orally Apo-Nifed PA is rapidly absorbed from the gastrointestinal tract. This drug undergoes metabolism in the "first pass" through the liver. The protein binding is 92-98%. Apo-Nifed PA metabolized in the liver to form inactive metabolites. T1/2 is about 2 hours. This medication excreted mainly by the kidneys as metabolites in trace amounts in unchanged form; 20% is excreted from the gut in the form of metabolites.
Why is Apo-Nifed PA prescribed?
Prevention of angina attacks, in some cases - relief of angina attacks, hypertension, hypertensive crises, Raynaud's disease.
Dosage and administration
The dosing regimen is individual. For oral administration the initial dose is 10 mg 3-4 times / day. If necessary the dose gradually increased up to 20 mg 3-4 times / day. In some cases (variant angina, severe hypertension) for a short time the dose can be increased to 30 mg 3-4 times / day. For relief of hypertensive crisis, as well as angina attack this drug can be used sublingually in 10-20 mg (rarely 30 mg).
To IN relieve an angina attack or hypertensive crisis - 5 mg for 4-8 hours.
Intracoronary dose for relief of acute coronary artery spasm injected bolus is 100-200 mcg. With stenosis of major coronary vessels starting dose is 50-100 micrograms.
The maximum daily dose: oral - 120 mg, IV - 30 mg.
Apo-Nifed PA side effects, adverse reactions
Cardiovascular: flushing of the skin, a feeling of warmth, tachycardia, hypotension, peripheral edema; rarely - bradycardia, ventricular tachycardia, asystole, increased angina attacks.
Digestive system: nausea, heartburn, diarrhea, rarely - liver function impairment and in rare cases - gingival hyperplasia. The chronic administration in high doses may cause dyspeptic symptoms, elevated liver enzymes, intrahepatic cholestasis.
CNS and peripheral nervous system: headache. The chronic administration in high doses may cause paresthesia, muscle pain, tremors, visual disturbances light, and sleep disorders.
Hemopoietic system: in rare cases - leukopenia, thrombocytopenia.
Urinary system: an increase in daily diuresis. The chronic administration in high doses may cause renal dysfunction.
Endocrine system: in rare cases - gynecomastia.
Allergic reactions: skin rash.
Local reactions: for IV injections might burning at the injection site.
Within 1 min after intracoronary administration it can be a result in the negative inotropic action of Apo-Nifed PA, the increase in heart rate, hypotension, and these symptoms gradually disappear within 5-15 minutes.
Apo-Nifed PA contraindications
Hypotension, collapse, cardiogenic shock, severe heart failure, severe aortic stenosis; increased sensitivity to Apo-Nifed PA.
Using during pregnancy and breastfeeding
Adequate and well-controlled studies safety of Apo-Nifed PA in pregnancy was not been conducted. The use of Apo-Nifed PA in pregnancy is not recommended.
Because Apo-Nifed PA is excreted in breast milk, you should avoid its use during lactation or to stop breastfeeding during the treatment with this medication.
In experimental studies it have been revealed embryotoxic, fetotoxic and teratogenic effects of Apo-Nifed PA.
Category effects on the fetus by FDA - C.
Special instructions
In patients with stable angina at the beginning of treatment paradoxical enhancement anginalnyh pain may occurs, with pronounced coronary sclerosis and unstable angina - the aggravation of myocardial ischemia. Not recommended to use short-acting drugs for long-term treatment of angina or hypertension, because it is possible the development of unpredictable changes in BP and reflex angina.
Apo-Nifed PA drug interactions
Nitrates, beta-blockers, diuretics, tricyclic antidepressants, fentanyl, alcohol increase the hypotensive effect of Apo-Nifed PA Quality Pharmaceutical Laboratory. This medication increases the activity of theophylline reduces the renal clearance of digoxin. Apo-Nifed PA increases the side effects of vincristine ; increases the bioavailability of cephalosporins (cefixime). Cimetidine and ranitidine increase the level of this drug in plasma. Diltiazem slows the metabolism (requires dose reduction of Apo-Nifed PA) of Apo-Nifed PA Quality Pharmaceutical Laboratory. This medicine is incompatible with rifampicin (accelerates biotransformation and does not allow to create effective concentration). Grapefruit juice (large quantity) increases its bioavailability.
Apo-Nifed PA in case of emergency / overdose
Symptoms: sudden bradycardia, bradyarrhythmia, hypotension, in severe cases - collapse, slowing conduction. When you receive a large number of retard-tablets symptoms of intoxication occur no earlier than 3-4 h and may additionally be expressed in loss of consciousness up to coma, cardiogenic shock, convulsions, hyperglycemia, metabolic acidosis, hypoxia.
Treatment: gastric lavage, activated charcoal method, injections of norepinephrine, calcium chloride or calcium gluconate in a solution of atropine (IV). Hemodialysis is ineffective.
Apo-Nifed PA pharmaceutical active ingredients containing related brand and generic drugs:
Apo-Nifed PA available forms, composition, doses:
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References
- Dailymed."PROCARDIA XL (NIFEDIPINE) TABLET, FILM COATED, EXTENDED RELEASE [PFIZER LABORATORIES DIV PFIZER INC]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
- Dailymed."NIFEDIPINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
- "nifedipine". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
Frequently asked Questions
Can i drive or operate heavy machine after consuming Apo-Nifed PA?Depending on the reaction of the Apo-Nifed PA after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Apo-Nifed PA not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.
Is Apo-Nifed PA addictive or habit forming?Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
Review
sdrugs.com conducted a study on Apo-Nifed PA, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Apo-Nifed PA consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.Visitor reports
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The information was verified by Dr. Rachana Salvi, MD Pharmacology