Compound
Coated tablets contain 10 mg of nifedipine each as an active substance. Excipients: polyvinyl butyral in an amount of 0.7 mg; talc (1 mg); 0.3 mg magnesium stearate ; 4 mg hydroxypropylcellulose ; lactose monohydrate (15 mg); croscarmellose sodium (13 mg); microcellulose (46 mg). The shell consists of hypromellose - 2.63 mg; titanium dioxide CI 77891 - 0.82 mg; yellow iron oxide - 0.3 mg and magnesium stearate - 0.25 mg.
Long-acting film-coated tablets contain the same active substance, but in a dose of 20 mg. Each of them contains the following substances as auxiliary substances: microcellulose (99 mg); lactose monohydrate (30 mg); croscarmellose sodium (26 mg); copolymers of methyl methacrylate and ethyl methacrylate in a ratio of 1:2 (1.9 mg); talc (2 mg); magnesium stearate (0.6 mg); hyprolose (0.5 mg). The film shell is made of hypromellose - 5.26 mg; titanium dioxide - 1.64 mg; red iron oxide - 0.6 mg; magnesium stearate - 0.5 mg.
Release form
There are two options for the release form of the drug:
- Coated tablets, weighing 10 mg. Every 100 tablets are placed in a brown glass bottle. The bottles are individually packaged in cardboard boxes.
- Film-coated tablets with prolonged action. Each tablet weighs 20 mg. Place 30 or 60 tablets in brown glass bottles. Vials must be sealed with polyethylene caps that have a first-opening control. The bottle is packed in a cardboard box.
Pharmacodynamics and pharmacokinetics
Nifedipine is a selective blocker of slow calcium channels, one of the 1,4-dihydropyridine derivatives. Its effect is manifested in a decrease in the flow of extracellular calcium ions into cardiomyocytes and smooth muscle cells of the arteries. Nifedipine can also increase renal blood flow, causing moderate natriuresis .
After taking one tablet of Cordaflex, which has a prolonged action, the clinical effect usually develops after 20 minutes, the effect lasts from 12 to 24 hours.
After administration, it is quickly, almost completely (at least 90%) absorbed from the digestive tract. And the bioavailability of the drug is in the range of 40-70%.
The maximum concentration of the active substance in the blood is found 30-60 minutes after taking the drug.
After taking one tablet with a prolonged action, the therapeutic concentration in the blood plasma is achieved within an hour and remains at an equal level for up to 6 hours; over the next 30-36 hours, a gradual decrease in concentration is observed.
Nifedipine has the property of binding to blood plasma proteins, in particular albumins , penetrating the blood-brain barrier (in small quantities - no more than 5%), through the placenta , and can be excreted in breast milk.
The half-life is 2 hours for a 10 mg tablet; for a 20 mg extended-release tablet it is approximately 3.8-16.9 hours.
conclusions
Cordaflex is a highly effective antianginal and antihypertensive agent from the group of calcium channel blockers. Due to this, as well as its low cost, it has become widespread in the treatment of acute attacks of cardiovascular diseases.
However, it has a number of contraindications and can also cause various adverse reactions. The most common is a sharp drop in blood pressure. To avoid them, you must strictly adhere to dosages and recommendations for use.
Contraindications
Contraindications are:
- intolerance to nifedipine , other 1,4-dihydropyridine , additional components included in the tablets;
- arterial hypotension;
- unstable angina;
- the current or recent presence of acute myocardial infarction or severe aortic stenosis ;
- idiopathic subaortic stenosis;
- chronic heart failure during the period of decompensation;
- childhood.
It is prescribed with special caution to elderly patients, those with impaired renal function, and patients with diabetes mellitus .
Side effects
Cordaflex is usually well tolerated. Side effects appear rarely, more often at the beginning of treatment (then they may become weaker or disappear).
There are such side effects:
- On the heart and blood vessels: decreased blood pressure, flushing of the face and torso, swelling in the extremities , accelerated heart rate, paradoxical attack of angina , development of acute heart failure .
- On the nervous system: increased fatigue , dizziness , weakness , emotional lability , sleep disturbances, headache, tremor , paresthesia .
- On the gastrointestinal tract: the occurrence of heartburn , nausea , vomiting , flatulence , stool disorders, dryness or inflammation of the oral mucosa, intrahepatic cholestasis , as well as increased activity of certain liver enzymes.
- On the circulatory system: thrombocytopenia , leukopenia , anemia .
- On the urinary system: increased daily diuresis, night urination , decreased renal function.
Allergic reactions may occur in the form of urticaria , exanthema , and skin itching .
Buy Cordaflex RD film-coated tablets 40 mg No. 30 in pharmacies
Instructions for use Cordaflex RD tab p.o 40 mg No. 30
Dosage forms tablets 40 mg Synonyms Adalat Vero-Nifedipine Calcigard retard Cordafen Cordaflex Cordipin Cordipin retard Cordipin HL Corinfar Corinfar retard Corinfar Uno Nifedipine
Nifecard HL Osmo-Adalat Phenigidine Group Calcium channel blockers of the dihydropyridine group International nonproprietary name Nifedipine Composition Active substance - nifedipine. Manufacturers Arena Pharmaceuticals GmbH, packaged by Egis Pharmaceutical Plant (Switzerland), Siegfried Ltd./Egis JSC (Switzerland) Pharmacological action Antianginal, hypotensive. Blocks calcium channels, inhibits the transmembrane flow of calcium ions into smooth muscle cells of arterial vessels and cardiomyocytes. Dilates peripheral, mainly arterial vessels, incl. coronary, lowers blood pressure, reduces total peripheral vascular resistance and afterload on the heart. Increases coronary blood flow, reduces the strength of heart contractions, heart function and myocardial oxygen demand. Improves myocardial function and helps reduce heart size in chronic heart failure. Reduces pressure in the pulmonary artery and has a positive effect on cerebral hemodynamics. Inhibits platelet aggregation, has antiatherogenic properties, improves post-stenotic circulation in atherosclerosis. Increases the excretion of sodium and water, reduces myometrial tone. When taken orally, it is quickly and completely absorbed. The bioavailability of all dosage forms is 40-60%. About 90% of the dose taken is bound to plasma proteins. After oral administration, the maximum concentration in plasma is created after 30 minutes, the half-life is 2-4 hours. It is excreted by the kidneys in the form of inactive metabolites and with feces. In small quantities it passes through the blood-brain barrier and the placental barrier and penetrates into breast milk. Does not have mutagenic or carcinogenic activity. Side effects From the cardiovascular system and blood (hematopoiesis, hemostasis: facial flushing with a feeling of heat, palpitations, tachycardia, hypotension (up to fainting), angina-like pain, very rarely - anemia, leukopenia, thrombocytopenia, thrombocytopenic purpura. With from the nervous system and sensory organs: dizziness, headache, stunnedness, changes in visual perception, impaired sensitivity in the arms and legs. From the gastrointestinal tract: constipation, nausea, diarrhea, gum hyperplasia (with long-term treatment), increased activity of liver transaminases. side of the respiratory system: bronchospasm. From the musculoskeletal system: myalgia, tremor. Allergic reactions: itching, urticaria, exanthema, exfoliative dermatitis. Others: swelling and redness of the hands and feet, photodermatitis, hyperglycemia, gynecomastia (in elderly patients) , burning sensation at the injection site (with intravenous administration) Indications for use Arterial hypertension, including hypertensive crisis, prevention of angina attacks (incl. Prinzmetal's angina), hypertrophic cardiomyopathy (obstructive, etc.), Raynaud's disease, pulmonary hypertension, broncho-obstructive syndrome. Contraindications Hypersensitivity, acute period of myocardial infarction (first 8 days), cardiogenic shock, severe aortic stenosis, heart failure in the stage of decompensation, severe arterial hypotension, tachycardia, pregnancy, breastfeeding. Restrictions on use: You should refrain from using the drug in pediatric practice, since the safety and effectiveness of its use in children have not been determined. Overdose Symptoms: severe bradycardia, bradyarrhythmia, arterial hypotension, in severe cases - collapse, conduction slowdown. When taking a large number of retard tablets, signs of intoxication appear no earlier than after 3-4 hours and can additionally be expressed in loss of consciousness up to coma, cardiogenic shock, convulsions, hyperglycemia, metabolic acidosis, hypoxia. Treatment: gastric lavage, taking activated charcoal, administering norepinephrine, calcium chloride or calcium gluconate in atropine solution intravenously. Hemodialysis is ineffective. Interaction The hypotensive effect is enhanced by nitrates, diuretics, beta-blockers, tricyclic antidepressants, fentanyl, and alcohol. Increases the activity of theophylline, reduces the renal clearance of digoxin. Increases the side effects of vincristine (reduces excretion). Increases the bioavailability of cephalosporins (cefixime). Cimetidine and ranitidine increase plasma levels. Diltiazem slows metabolism (requires a reduction in the dose of nifedipine). Incompatible with rifampicin (accelerates biotransformation and does not allow creating effective concentrations). Grapefruit juice (large quantities) increases bioavailability. Increases the concentration of cardiac glycosides in the blood. Special instructions: Elderly patients are advised to reduce the daily dose (decreased metabolism). Use with caution while working for vehicle drivers and people whose profession involves increased concentration. The drug should be discontinued gradually. In patients with stable angina, at the beginning of treatment, a paradoxical increase in anginal pain may occur; with severe coronary sclerosis and unstable angina, aggravation of myocardial ischemia may occur. It is not recommended to use short-acting drugs for long-term treatment of angina or hypertension, because the development of unpredictable changes in blood pressure and reflex angina is possible. Storage conditions Store at room temperature, in a cool, dry place, away from children.
Instructions for use of Cordaflex (Method and dosage)
The drug is taken orally. 10 mg film-coated tablets are swallowed whole before meals with water.
The dosage is set individually, as it very much depends on the severity of the disease, the type of disease and the body’s response to the therapy. Start with 1 tablet (10 mg) 3 times a day. There should be at least 2 hours between doses of the drug. The maximum dose per day is 40 mg.
Long-acting film-coated tablets are swallowed whole and washed down with water. In this case, the initial dose is 1 tablet 2 times a day. In any case, the daily dose is divided into 2 doses, between which a 12-hour interval must be observed.
According to the instructions for use of Cordaflex, discontinuation of the drug should be carried out gradually.
Cordaflex 20 mg 60 pcs. extended-release film-coated tablets in Perm
Drugs that affect nifedipine
- Nifedipine is metabolized with the participation of the CYP3A4 isoenzyme of cytochrome P450 of the liver and intestinal mucosa. Drugs that induce or block this enzyme may interfere with the first-pass effect (when taken orally) or alter the clearance of nifedipine.
- The extent and duration of these interactions should be considered if nifedipine is co-administered with the following drugs.
Rifampicin
significantly induces the CYP3A4 isoenzyme. When used together with rifampicin, the bioavailability of nifedipine is sharply reduced, thus reducing the effectiveness of the drug. Therefore, the combined use of nifedipine with rifampicin is contraindicated.
- When used together with the following weak/moderate inhibitors of the CYP3A4 isoenzyme, blood pressure control is necessary and it may be necessary to reduce the dose of nifedipine.
Drugs that increase the concentration of nifedipine in the blood:
Macrolides (eg, erythromycin)
The interaction of macrolides with nifepidin has not been studied. It is known that some macrolide antibiotics inhibit the metabolism of other drugs involving the CYP3A4 isoenzyme. Therefore, when used together, a possible increase in the concentration of nifedipine in the blood plasma cannot be excluded.
Despite the fact that azithromycin belongs to the class of macrolides in its structure, it is not an inhibitor of the CYP3A4 isoenzyme.
HIV protease inhibitors (eg, ritonavir)
There have been no clinical studies of the interaction of HIV protease inhibitors with nifedipine. Drugs belonging to this group are known to inhibit the CYP3A4 isoenzyme of cytochrome P450. In addition, it was found that drugs of this group in vitro inhibit the metabolism of nifedipine mediated by the CYP3A4 isoenzyme. Therefore, when used together with nifedipine, it cannot be excluded that its concentration in the blood plasma will increase significantly as a result of a slowdown in the “first pass” effect. In addition, a slower elimination of the drug cannot be ruled out.
Antifungals, azoles (eg, ketoconazole)
There have been no clinical studies of the interaction of azole antifungals with nifedipine. It is known that some drugs in this group inhibit the CYP3A4 isoenzyme of cytochrome P450. In addition, it was found that drugs of this group in vitro inhibit the metabolism of nifedipine mediated by the CYP3A4 isoenzyme. Therefore, when used together with nifedipine, it cannot be excluded that its concentration in the blood plasma will increase significantly as a result of a slowdown in the “first pass” effect; In addition, a slower elimination of the drug cannot be ruled out.
Fluoxetine
There have been no clinical studies of the interaction of fluoxetine with nifedipine. It is known that fluoxetine in vitro inhibits the metabolism of nifedipine mediated by the cytochrome P450 isoenzyme CYP3A4. Therefore, when used together with nifedipine, an increase in its concentration in the blood plasma cannot be ruled out.
Nefazodone
There have been no clinical studies of the interaction of nefazodone with nifedipine. It is known that nefazodone in vitro inhibits the metabolism of nifedipine mediated by the cytochrome P450 isoenzyme CYP3A4. Therefore, when used together with nifedipine, an increase in its concentration in the blood plasma cannot be ruled out.
Quinupristin/dalfopristin
When quinupristin/dalfopristin is co-administered with nifedipine, the plasma concentration of nifedipine may increase.
Valproic acid
There have been no clinical studies of the interaction of valproic acid with nifedipine. Since valproic acid, by inhibiting the enzyme, increases the concentration of another calcium channel inhibitor, nimodipine, in the blood plasma, an increase in the effect in this case cannot be ruled out.
Cimetidine
Since cimetidine inhibits the cytochrome P450 isoenzyme CYP3A4, it increases the concentration of nifedipine in the blood plasma, enhancing its hypotensive effect.
Diltiazem
Increases the exposure (AUC) of nifedipine.
Other types of interaction
Cisapride
The combined use of cisapride with nifedipine leads to an increase in the concentration of nifedipine in the blood plasma.
Drugs that induce the cytochrome P450 isoenzyme CYP3A4:
Antiepileptic drugs (phenobarbital, phenytoin, carbamazepine)
Phenytoin
induces the CYP3A4 isoenzyme of cytochrome P450. With simultaneous use of phenytoin with nifedipine, the bioavailability and, accordingly, the effectiveness of the latter decreases. When using these drugs together, clinical efficacy should be monitored and the dose of nifedipine should be increased if necessary. In this case, upon completion of treatment with phenytoin, it may be necessary to increase the dose of nifedipine. If the dose of nifedipine was increased when the two drugs were used together, then after discontinuation of treatment with phenytoin, the possibility of lowering the dose of nifedipine should be considered.
No clinical studies have been conducted on the interaction of carbamazepine or phenobarbital
with nifedipine. Due to the fact that carbamazepine, as an inducer of the cytochrome P450 isoenzyme CYP3A4, reduces the blood concentration of nimodipine, a calcium channel blocker similar in structure, the possibility of a decrease in the concentration of nifedipine in the blood plasma and a deterioration in its effectiveness cannot be ruled out.
Effect of nifedipine on other drugs:
Antihypertensive drugs
When prescribed together with the following antihypertensive drugs, additive antihypertensive effects are possible:
- diuretics;
- β-blockers;
- angiotensin-converting enzyme inhibitors (ACE inhibitors);
- angiotensin receptor antagonists;
- other calcium channel blockers;
- alpha-blockers;
- phosphodiesterase-5 inhibitors;
- methyldopa;
- magnesium sulfate.
- β-blockers
- When nifedipine is used concomitantly with beta-blockers, careful monitoring is necessary, as worsening of HF has been reported in some cases.
Digoxin
Co-administration with digoxin may lead to an increase in the plasma concentration of this drug due to a decrease in its clearance. Due to the danger of digoxin overdose, patients' condition should be monitored and, if necessary, the dose of the glycoside should be reduced.
Quinidine
When quinidine is used together with nifedipine, the concentration of quinidine in the blood plasma may decrease, and after discontinuation of nifedipine, in some cases an increase in the concentration of quinidine in the blood is observed. According to some literature data, when the two drugs were used together, an increase in the concentration of nifedipine in the blood plasma was observed; other authors did not observe changes in the pharmacokinetics of nifedipine. Thus, if quinidine is necessary during therapy with nifedipine, blood pressure should be carefully monitored and, if necessary, the dose of nifedipine should be reduced.
Tacrolimus
Tacrolimus is metabolized with the participation of the cytochrome P450 isoenzyme CYP3A4. According to the published literature, co-administration of tacrolimus with nifedipine may increase the plasma concentration of tacrolimus. Tacrolimus concentrations should be monitored and the dose reduced if necessary.
Vincristine
When used simultaneously with nifedipine, the excretion of vincristine is reduced, which may require a reduction in its dose.
Cephalosporins
When used simultaneously with nifedipine, the concentration of cephalosporins in the blood plasma increases.
Nitrates
It is necessary to take into account the synergistic effect when using nifedipine and nitrates simultaneously.
Theophylline
Nifedipine increases the concentration of theophylline in blood plasma when used simultaneously.
Fentanyl
The simultaneous use of fentanyl and nifedipine can lead to a significant decrease in blood pressure, therefore, if possible, it is recommended to discontinue nifedipine at least 36 hours before anesthesia with fentanyl.
Indirect anticoagulants
In rare cases, prolongation of prothrombin time has been reported with simultaneous use of indirect anticoagulants (for example, warfarin) with nifedipine. The clinical significance of this effect is unknown.
Interaction with food and drink
Grapefruit juice
inhibits the cytochrome P450 isoenzyme system CYP3A4. Due to a decrease in first-pass metabolism and delayed elimination, the concentration of nifedipine in the blood plasma may increase and the duration of the effect may be prolonged, that is, the antihypertensive effect may become more pronounced. After the last consumption of grapefruit juice, this effect can be observed for three days. Therefore, concomitant use of nifedipine with grapefruit juice should be avoided.
Overdose
An overdose of nifedipine may cause the following consequences:
- arterial hypotension;
- chest pain (similar to an angina );
- tachycardia;
- loss of consciousness;
- collapse;
- ventricular or nodal extrasystole ;
- bradycardia.
In severe cases, the development of metabolic alkalosis , cardiogenic shock with pulmonary edema, hypoxia , hyperkalemia , as well as disturbances of consciousness, which can progress to coma .
Cordaflex
The dosage regimen is set individually, depending on the severity of the disease and the patient’s response to the therapy.
For adults, Cordaflex® in the form of film-coated tablets is prescribed 10 mg (1 tablet) 3 times a day. If necessary, the dose of the drug can be increased to 20 mg (2 tablets) 1-2 times/day. The maximum daily dose is 40 mg. The interval between doses of the drug is at least 2 hours.
To speed up the action of the drug at the beginning of an attack of angina or hypertensive crisis, the tablet should be chewed, held in the mouth for a while, and then swallowed with a small amount of water.
If it is necessary to increase the dose to 80-120 mg/day for the treatment of angina pectoris or arterial hypertension, it is recommended to transfer the patient to take the drug in the form of extended-release tablets.
When carrying out a course of therapy, it is recommended to use Cordaflex® in the form of prolonged-release tablets. The initial dose is 20 mg (1 tablet) 2 times a day with an interval of 12 hours. If necessary, the dose of the drug is gradually increased until the optimal clinical effect is achieved. For long-term maintenance therapy, as a rule, it is enough to take 20-40 mg (1-2 tablets) 2 times a day. The maximum daily dose is 120 mg.
In elderly patients, the pharmacokinetics of nifedipine changes, and therefore the initial dose of the drug is reduced by 2 times and lower doses may be required to maintain the therapeutic effect.
For moderate impairment of liver or kidney function, no dosage adjustment is required. In case of severe liver dysfunction, the maximum daily dose should not exceed 40 mg.
The drug in the form of tablets containing 10 mg of nifedipine is taken orally before meals, in the form of prolonged-release tablets - regardless of meals, without chewing, with a small amount of water.
Overdose
Symptoms: severe arterial hypotension, tachycardia, chest pain (angina), headache, collapse, loss of consciousness, nodal or ventricular extrasystole due to inhibition of the sinus node, bradycardia, fainting. In severe cases, disturbances of consciousness leading to coma, hyperkalemia, metabolic alkalosis, hypoxia, cardiogenic shock with pulmonary edema are possible.
Treatment: given the lack of a specific antidote, in cases of early detoxification, gastric lavage is performed with the administration of activated charcoal. If necessary, small intestinal lavage can be done, which is more appropriate in case of overdose of controlled-release drugs. When prescribing laxatives, it should be taken into account that taking slow calcium channel blockers suppresses intestinal motility to the point of complete atony.
Since nifedipine is highly bound to plasma proteins, hemodialysis is not effective, but plasmapheresis may be effective.
Symptomatic therapy is indicated. Symptoms of cardiac arrhythmias with bradycardia can be eliminated by administering beta-agonists and/or atropine. For life-threatening bradycardia, an artificial pacemaker should be used. With a pronounced decrease in blood pressure, an infusion of usual doses of norepinephrine (norepinephrine) or epinephrine (adrenaline) is indicated; dopamine (maximum dose 25 mcg/kg body weight/min), dobutamine (maximum dose 15 mcg/kg body weight/min), isoprenaline and 10% calcium gluconate solution (10-20 ml i.v.). If symptoms of heart failure develop, intravenous administration of fast-acting cardiac glycosides is recommended.
Interaction
Cordaflex should not be administered with alcohol-containing medications.
Orthostatic hypotension may develop when used with methyldopa , clonidine , as well as prazosin and octadine .
Cimetidine , ranitidine and tricyclic antidepressants will potentiate the antihypertensive effect .
When Cordaflex is combined with theophylline and digoxin , it is necessary to monitor the plasma concentrations of these drugs, as they may increase.
Phenytoin , calcium supplements and rifampicin reduce the effect of nifedipine .
Cordaflex reduces the rate of elimination of vincristine , which increases the risk of side effects. Therefore, dose adjustment is necessary.
Erythromycin , diltiazem , grapefruit juice in large quantities, azole antimicrobial drugs when taken with nifedipine significantly slow down its metabolism.
Cordaflex®
From the point of view of enhancing the antihypertensive and antianginal effect, the combination of Cordaflex with beta-blockers, diuretics, ACE inhibitors, and nitrates is rational. All of the above combinations are safe and effective in most clinical situations, since they lead to summation or potentiation of effects, however, in some cases there is a risk of a pronounced decrease in blood pressure and increased symptoms of heart failure.
The combination of Cordaflex with clonidine, methyldopa, octadine, prazosin is possible according to indications, but can cause severe orthostatic hypotension.
An increase in the hypotensive effect is also observed with combination therapy with cimetidine, ranitidine and tricyclic antidepressants.
Nifedipine increases the concentration of digoxin and theophylline in the blood plasma, and therefore the clinical effect and/or the content of digoxin and theophylline in the blood plasma should be monitored.
Procaine, quinidine and other drugs that cause QT prolongation enhance the negative inotropic effect and increase the risk of QT prolongation. Under the influence of nifedipine, the concentration of quinidine in the blood serum is significantly reduced, which is apparently due to a decrease in its bioavailability, as well as the induction of enzymes that inactivate quinidine. When nifedipine is discontinued, a transient increase in quinidine concentration is observed (approximately 2 times), which reaches a maximum level on days 3-4. Caution should be exercised when using such combinations, especially in patients with impaired left ventricular function.
Nifedipine can displace drugs characterized by a high degree of binding from protein binding (including indirect anticoagulants - derivatives of coumarin and indanedione, NSAIDs), as a result of which their concentrations in the blood plasma may increase.
When administered simultaneously with rifampicin, phenytoin and calcium preparations, the effect of nifedipine is weakened.
Nifedipine inhibits the elimination of vincristine from the body and may cause increased side effects of vincristine; if necessary, the dose of vincristine is reduced.
Diltiazem inhibits the metabolism of nifedipine in the body; if necessary, reduce the dose of nifedipine.
Grapefruit juice, erythromycin and azole antifungals (fluconazole, intraconazole, ketoconazole) may inhibit the metabolism of nifedipine and therefore enhance its effects.
Similarly, the simultaneous use of Cordaflex and cimetidine increases the concentration of nifedipine in the blood plasma and enhances its effects; however, simultaneous use with ranitidine does not lead to a significant increase in the concentration of nifedipine in the blood plasma.
Since nifedipine is metabolized by the CYP3A4 isoenzyme, any inhibitor or inducer of this enzyme may affect the metabolism of nifedipine. Cyclosporine is also a CYP3A4 substrate; therefore, when cyclosporine and nifedipine are used together, each may increase the duration of the effect of the other.
Cordaflex analogues (drugs that have a similar effect)
Level 4 ATC code matches:
Lacipil
Cordafen
Azomex
Nimodipine
Felodipin
Nifedipine
Farmadipin
Amlotop
Nimotop
Tenox
Nifecard HL
Cordipin
Felodip
Normodipine
Phenigidine
Norvask
Lerkamen
Corinfar
Vero-Amlodipine
Amlodipine
Analogs are the following drugs: Adalat , Vero-Nifedipine , Calcigard Retard , Zanifed , Cordafen , Cordaflex Retard , Cordipin , Cordipin Retard , Cordipine XL Corinfar , Nifedicap , Nifedipine and some other drugs.
Cordaflex Retard has particularly similar pharmaceutical characteristics and therapeutic applications.
Cordaflex price, where to buy
The price for 10 mg tablets is 72-95 rubles for 10 pieces, for 20 mg tablets – 63-139 rubles for 30 pieces, 74-168 rubles for 60 pieces.
- Online pharmacies in RussiaRussia
ZdravCity
- Cordaflex tablets p.p.o.
prolonged action 20 mg 60 pcs. Egis 125 rub. order - Cordaflex tab. p.o 10 mg n100Egis
93 RUR order
- Cordaflex RD tablets p.p.o. with control release 40 mg 30 pcs Arena Pharmaceuticals GmbH/Egis
RUB 188 order
- Cordaflex tablets p.p.o. prolonged action 20 mg 30 pcs. Egis
95 rub. order
