Nifatenol

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Nifatenol uses

Nifatenol consists of Atenolol, Nifedipine.

Atenolol:


Pharmacological action

Nifatenol is a cardioselective beta1-blocker without intrinsic sympathomimetic activity. This medication has antihypertensive, antianginal and antiarrhythmic action. Nifatenol (Atenolol) reduces the stimulatory effect on the heart sympathetic innervation and circulating catecholamines.

The hypotensive effect of this drug is associated with a decrease in minute volume of blood, decreased activity of the renin-angiotensin system (has a greater significance for patients with initial hypersecretion of renin), sensitivity of baroreceptors of the aortic arch (not going to enhance their activity in response to decreased blood pressure) and the effect on the CNS; manifested lower both systolic and diastolic blood pressure, decreasing stroke volume and cardiac output. In the medium therapeutic doses it has no effect on the tone of peripheral arteries.

The antianginal effect of Nifatenol (Atenolol) is associated with decreased myocardial oxygen demand by decreasing heart rate (lengthening of diastole and improved myocardial perfusion) and contractility, as well as reduced sensitivity to the effects of myocardial sympathetic innervation. Decrease in heart rate occurs at rest and during exercise.

The antiarrhythmic effect of this medicine is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increase of cAMP, hypertension), decrease in the rate of spontaneous excitation of the sinus and ectopic pacemakers and slowing of AV conduction.

The hypotensive effect lasts 24 hours, with regular admission is stabilized by the end of 2 weeks of treatment. The negative chronotropic effect is manifested by 1 h after administration, reaches a maximum after in 2-4 hours and lasts up to 24 hours.

Pharmacokinetics

After oral administration the absorption of Nifatenol (Atenolol) from the gastrointestinal tract is 50-60%, its bioavailability is 40-50%. This drug is practically not metabolized in the body; poorly penetrates the BBB. The plasma protein binding is 6-16%. T1/2 is 6-9 h. Nifatenol (Atenolol) is primarily excreted by the kidneys in unchanged form. Renal dysfunction accompanied mainly to the increase of T1/2 and cumulation. This medication is excreted during hemodialysis. For elderly patients T1/2 of Nifatenol (Atenolol) is increased.

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Why is Nifatenol prescribed?

Hypertension, hypertensive crisis, mitral valve prolapse, cardiac hyperkinetic syndrome of functional origin, neurocirculatory dystonia of hypertensive type.

Treatment: coronary artery disease, angina pectoris (stress, rest and unstable).

Treatment and prevention of: myocardial infarction (acute phase in stable hemodynamic parameters, secondary prevention).

Arrhythmias (including at the general anesthesia, congenital syndrome prolongation QT, myocardial infarction without signs of congestive heart failure, thyrotoxicosis), sinus tachycardia, paroxysmal atrial tachycardia, supraventricular and ventricular premature beats, supraventricular and ventricular tachycardia, atrial tachyarrhythmia, atrial flutter.

Essential and senile tremor, agitation and tremors withdrawal syndrome.

In the combined therapy: hypertrophic obstructive cardiomyopathy, pheochromocytoma (only in combination with alpha-blockers), hyperthyroidism; migraine (prophylaxis).

Dosage and administration

The dosing regimen of Nifatenol is set individually. The usual dose for adults for oral administration at the beginning of treatment is 25-50 mg 1 time / day. If necessary the dose is increased gradually. If impaired renal function in patients with CC 15-35 ml / min - 50 mg / day; with CC less than 15 ml / min - 50 mg every other day.

The maximum dose for adults for oral administration is 200 mg / day in 1 or 2 doses.

Nifatenol (Atenolol) side effects, adverse reactions

Cardiovascular system: in some cases - bradycardia, hypotension, AV-conduction disturbances, symptoms of heart failure.

Digestive system: at the beginning of therapy it is possible nausea, constipation, diarrhea, dry mouth.

CNS and peripheral nervous system: at the beginning of therapy may be fatigue, dizziness, depression, mild headache, sleep disturbances, coldness and paresthesia in extremities, reduced reactivity of the patient, reducing the secretion of tear fluid, conjunctivitis.

Endocrine system: reduced potency, hypoglycemic state in patients with diabetes.

Respiratory system: in predisposed patients - symptoms of bronchial obstruction.

Allergic reactions: itching.

Other: increased sweating, redness of the skin.

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Nifatenol contraindications

AV-block II and III degree, sinoatrial block, SSS, bradycardia (HR < 40 bpm), hypotension (in case of myocardial infarction, systolic blood pressure less than 100 mm Hg), cardiogenic shock, congestive heart failure IIB-III stages, acute heart failure, Prinzmetal's angina, lactation, concomitant use of MAO inhibitors, hypersensitivity to Nifatenol (Atenolol).

Using during pregnancy and breastfeeding

Nifatenol crosses the placental barrier, so use during pregnancy is only possible if the intended benefits to the mother justifies potential risk to the fetus.

Nifatenol (Atenolol) is excreted in breast milk, so if you need to use during lactation is recommended to stop breastfeeding.

Category effects on the fetus by FDA - D.

Special instructions

With caution use this medication in hepatic failure.

Nifatenol (Atenolol) should be used with caution in diabetes, COPD (including asthma, emphysema), metabolic acidosis, hypoglycemia, allergic reactions, a history of chronic heart failure (compensated), obliterating peripheral arterial disease (intermittent claudication, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal insufficiency, myasthenia gravis, hyperthyroidism, depression (including in history), psoriasis, pregnancy, elderly patients, in pediatrics (the efficacy and safety are not defined).

While taking Nifatenol (Atenolol) it can decrease tear fluid production, which is important for patients who use contact lenses.

Cancellation of this drug after prolonged treatment should be carried out gradually under medical supervision.

Upon the termination of the combined use of Nifatenol (Atenolol) and clonidine, clonidine treatment continued for several days after discontinuation of Nifatenol (Atenolol), otherwise you may experience severe arterial hypertension.

When the need for inhaled anesthesia in patients receiving Nifatenol (Atenolol) Meliapharm, a few days before anesthesia to stop taking Nifatenol (Atenolol) or find a medication for anesthesia with minimal negative inotropic effects.

Patients whose work requires high concentration, the question of outpatient use of Nifatenol (Atenolol) should be addressed only after an assessment of individual response.

Nifatenol drug interactions

Antiarrhythmic and anesthetic facilities increase cardiodepressive action of this drug (increased risk of developing bradycardia, arrhythmia, hypotension, heart failure).

Reserpine, methyldopa, clonidine, guanfacine, cardiac glycosides potentiate the negative chrono-, drome- and bathmotropic effect, insulin and other antidiabetic funds - hypoglycemia.

NSAIDs, estrogens, sympathomimetics, xanthines weaken the anti-hypertensive effect, absorption; sympatholytic, nitroglycerin, hydralazine, and other antihypertensive drugs increase it; antacids slow down this medication absorption.

Cimetidine inhibits the metabolism of Nifatenol (Atenolol) Meliapharm.

This medication prolongs the action of anti-depolarizing muscle relaxant, anticoagulant effect of coumarins.

Three / tetracyclic antidepressants, antipsychotics, sedatives, hypnotics and alcohol potentiate CNS depression.

Nifatenol (Atenolol) is incompatible with MAO inhibitors.

Nifatenol in case of emergency / overdose

Symptoms: bradycardia, AV block II-III degree, heart failure, respiratory failure, hypotension, bronchospasm, hypoglycemia.

Treatment: gastric lavage and the appointment of adsorbing medications; Symptomatic treatment: atropine, isoprenaline, orciprenaline, cardiac glycosides or glucagon, diuretics, pressor agents (dopamine, dobutamine or norepinephrine), selective beta-adrenoceptor agonists, IV glucose solution, installation of an artificial pacemaker. Perhaps dialysis.

Nifedipine:


Pharmacological action

Nifatenol 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. Nifatenol (Nifedipine) has antianginal and hypotensive action. This drug lowers the tone of vascular smooth muscle. Nifatenol (Nifedipine) dilates coronary and peripheral arteries, lowers blood pressure and slightly - myocardial contractility, reduces afterload and myocardial oxygen demand. This medicine improves coronary blood flow. Nifatenol (Nifedipine) practically does not possess antiarrhythmic activity, it does not inhibit the conductance of myocardium.

Pharmacokinetics

When administered orally Nifatenol (Nifedipine) is rapidly absorbed from the gastrointestinal tract. This drug undergoes metabolism in the "first pass" through the liver. The protein binding is 92-98%. Nifatenol (Nifedipine) 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 Nifatenol prescribed?

Prevention of angina attacks (including vasospastic angina), 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 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.

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Nifatenol (Nifedipine) 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 Nifatenol (Nifedipine), the increase in heart rate, hypotension, and these symptoms gradually disappear within 5-15 minutes.

Nifatenol contraindications

Hypotension (systolic blood pressure below 90 mm Hg), collapse, cardiogenic shock, severe heart failure, severe aortic stenosis; increased sensitivity to Nifatenol (Nifedipine).

Using during pregnancy and breastfeeding

Adequate and well-controlled studies safety of Nifatenol in pregnancy was not been conducted. The use of Nifatenol (Nifedipine) in pregnancy is not recommended.

Because Nifatenol (Nifedipine) 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 Nifatenol (Nifedipine).

Category effects on the fetus by FDA - C.

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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.

Nifatenol drug interactions

Nitrates, beta-blockers, diuretics, tricyclic antidepressants, fentanyl, alcohol increase the hypotensive effect of Nifatenol (Nifedipine) Quality Pharmaceutical Laboratory. This medication increases the activity of theophylline reduces the renal clearance of digoxin. Nifatenol (Nifedipine) increases the side effects of vincristine (reduced elimination); 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 Nifatenol (Nifedipine)) of Nifatenol (Nifedipine) 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.

Nifatenol 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.

Nifatenol pharmaceutical active ingredients containing related brand and generic drugs:

Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Nifatenol available forms, composition, doses:

Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Nifatenol destination | category:

Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Nifatenol Anatomical Therapeutic Chemical codes:

A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Nifatenol pharmaceutical companies:

Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. Dailymed."ATENOLOL TABLET [LAKE ERIE MEDICAL & SURGICAL SUPPLY DBA QUALITY CARE PRODUCTS LLC]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  2. Dailymed."PROCARDIA XL (NIFEDIPINE) TABLET, FILM COATED, EXTENDED RELEASE [PFIZER LABORATORIES DIV PFIZER INC]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  3. 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).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Nifatenol?

Depending on the reaction of the Nifatenol after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Nifatenol 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 Nifatenol 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.

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Review

sdrugs.com conducted a study on Nifatenol, 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 Nifatenol 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.

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The information was verified by Dr. Rachana Salvi, MD Pharmacology

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