Overview of Коринфар

Defining Коринфар: The Active Ingredient and Pharmacological Class

Property	Description
Active Ingredient	Nifedipine
Form	Tablets (Oral Route)
Pharmacological Class	Calcium Channel Blocker (Dihydropyridine)
General Purpose	Regulates vascular tension (Antihypertensive/Antianginal)
Origin	Synthetic

Коринфар is a prescription-only medicine whose therapeutic action is derived from its active ingredient, Nifedipine. This synthetic compound is classified as a Calcium Channel Blocker (CCB), specifically falling into the dihydropyridine subclass, an established group for managing circulatory conditions. The single-component product is manufactured and primarily marketed in Europe and Eastern Europe, where it is a long-standing, clinically recognized formulation for vascular support used to treat conditions characterized by restricted blood flow.

What is the General Therapeutic Purpose of this Drug Type?

The overall purpose of the dihydropyridine CCB class is to manage key cardiovascular disorders; the drug is classified as both an antihypertensive and an antianginal agent. It is utilized for mitigating conditions associated with high vascular tone. Its physiological action is focused on inhibiting the entry of calcium ions through L-type calcium channels in the walls of the blood vessels.

This targeted action leads to vessel relaxation, known as vasodilation, which results in a decrease in peripheral vascular resistance. This primary action of peripheral vasodilation is key because it lowers elevated blood pressure and facilitates improved oxygen delivery to the heart by promoting coronary artery dilation, offering foundational support in managing chronic vascular tension.

Available Forms of Коринфар and Their Primary Difference

The primary delivery method for Коринфар is the oral route, typically formulated as tablets. The specific formulation often involves film-coated tablets that utilize various solid excipients to form the base, which is a key physical characteristic of this brand.

The most relevant formulation difference lies between the standard tablets and the extended-release or sustained-release versions. This distinction is vital because the extended-release type is specifically engineered to release Nifedipine gradually over a prolonged duration, ensuring a more consistent therapeutic effect throughout the day. This sustained-release feature is often preferred in managing chronic, stable hypertension.

Regulatory References

U.S. National Library of Medicine

What side effects are possible with Коринфар?

Possible Side Effects and Safety Information (Based on Official Regulatory Documents)

This information describes the documented adverse reactions and safety restrictions for Коринфар (Nifedipine), categorized by frequency and system affected, as found in government regulatory labels.

Frequency-Classified Adverse Reactions

The following effects are classified based on how often they have been reported in clinical use:

Frequency	Examples of Adverse Reactions (by System-Organ Class)
Very Common (1/10)	Headache, Peripheral edema (swelling of ankles/legs)
Common (1/100)	Dizziness, Flushing (reddening of the face), Palpitations, Constipation, Nausea
Uncommon (1/1,000)	Tachycardia (fast heart rate), Hypotension (low blood pressure), Angina pectoris (chest pain or worsening existing chest pain), Gingival hyperplasia (gum enlargement), Allergic edema
Rare (1/10,000)	Jaundice (yellowing of skin/eyes)

Serious Safety Considerations

Although rare, certain adverse reactions are recognized as serious and documented in regulatory labeling:

Severe Cardiovascular Events: Worsening of Angina Pectoris (chest pain) may occur, particularly at the start of treatment or after a dose increase. Significant Hypotension (excessive blood pressure drop) may also occur.
Severe Hypersensitivity: Reactions such as Angioedema (swelling beneath the skin) or Laryngeal Edema (swelling of the voice box) are documented.
Hematologic/Dermatologic: Very rare severe reactions include Agranulocytosis (a severe blood disorder) and Toxic Epidermal Necrolysis (TEN) (a severe skin reaction).

Key Safety Restrictions

Коринфар is contraindicated (must not be used) in certain circumstances, including patients with known hypersensitivity, cardiovascular shock, severe aortic stenosis, and when used concurrently with the drug Rifampicin. Caution and monitoring are required for specific populations, including those with impaired liver function and pregnant or breastfeeding individuals (especially during the first 20 weeks of pregnancy).

Overdose and Emergency Response

Overdose Map: Overdose and when to seek help — Official Regulatory Information for Nifedipine

Overdose Scope

Official regulatory documents classify Nifedipine overdosage as a severe event associated with life-threatening effects, including the potential for sudden cardiovascular collapse and rapid death in serious cases. The most prominent documented clinical presentation is pronounced hypotension (excessively low blood pressure). Severe intoxication may also manifest as disturbances of consciousness to the point of coma and clinical signs of cardiogenic shock. The physiological systems affected include the cardiovascular and respiratory systems, necessitating continuous monitoring.

Emergency-Response Statements

Given the documented severity, the regulatory basis mandates that individuals must seek medical attention right away upon suspected overdosage. The required immediate action is to contact a poison control center or emergency room at once.

Management and Monitoring Requirements

Management is primarily symptomatic and supportive in nature. The official guidance calls for active cardiovascular support, which includes monitoring of cardiovascular and respiratory function and physical steps such as the elevation of extremities. Clearance of the substance is expected to be prolonged in patients with impaired liver function. No specific antidote is consistently documented in the official prescribing information.

Connection to the Overall Overdose Profile

Regulatory authorities explicitly define the overdose profile by its severe cardiovascular impact, namely pronounced hypotension and the subsequent risk of life-threatening outcomes. This risk profile immediately establishes the mandated condition to seek medical attention right away. Management is officially described as being symptomatic and supportive due to the nature of the intoxication, requiring institutional resources for continuous observation and specialized intervention.

Therapeutic Uses of Коринфар

The medication is commonly used across domains where additional symptomatic support is needed in relation to specific cardiovascular conditions, playing a role in managing conditions requiring sustained support and easing symptomatic distress. Коринфар (Nifedipine) is generally applied for conditions presenting with symptoms related to systemic imbalance.

The drug is commonly used to help with conditions characterized by periods of heightened symptoms, including essential hypertension (high blood pressure) and forms of angina pectoris, such as chronic stable angina and Prinzmetal's (variant) angina.

Management of Persistent High Blood Pressure

This domain is used across conditions presenting with significant symptomatic burden. The medication may assist with maintaining functional stability by supporting a reduction in elevated blood pressure, which helps address symptoms that create noticeable physiological strain. It is considered relevant for easing the overall symptom load.

Relief for Anginal Chest Pain

This therapeutic domain is applied in conditions involving recurrent or episodic manifestations that present with symptoms related to physical discomfort. The drug is commonly used to help with managing the overall burden of symptoms, which supports patients during episodes of heightened discomfort and assists with maintaining functional stability when symptoms interfere with routine activities.

Contextual Note: Management of Anginal Chest Pain

The drug is applied in clinical settings that involve the management of chest discomfort patterns, which may be exertion-triggered (stable angina) or manifest in other episodic patterns (variant angina), assisting with maintaining functional stability.

Regulatory References

NIH MedlinePlus Drug Information overview

Eligibility and Restrictions for Use

Who Can and Cannot Use Коринфар?

Eligibility for using Коринфар (Nifedipine) is strictly defined by regulatory guidelines and is primarily restricted to adults treated for approved cardiovascular conditions.

Contraindications (Who Must Not Use)

Коринфар is formally contraindicated in several groups due to significant risk, as defined by regulatory documents. Patients must not use this medicine if they have a known hypersensitivity to Nifedipine or other dihydropyridines. Use is also strictly prohibited in patients experiencing cardiogenic shock or those concurrently taking the antibiotic rifampicin. Extended-release formulations are contraindicated for patients with severe gastrointestinal narrowing.

Age and Physiological Restrictions

Population Group	Eligibility Status	Key Restriction Detail
Pediatric (Under 18)	Not Recommended	Insufficient data on safety and efficacy are established.
Older Adults	Conditional Use	Requires caution due to potential age-related organ impairment.
Pregnancy	Contraindicated	Prohibited by certain regulatory authorities.
Lactation	Not Recommended	Low levels are excreted into breast milk.

Condition-Based Limitations

Patients with impaired liver function require careful monitoring, and a dose reduction may be necessary in severe cases. Caution is also advised for those with poor cardiac reserve to prevent worsening of heart failure.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Nifedipine is extensively metabolized by the Cytochrome P450 3A4 (CYP3A4) enzyme system. Co-administration with other drugs can significantly alter the concentration of nifedipine in the blood, requiring monitoring and sometimes dose modification or avoidance of the combination.

Interacting Products and Substances

Interaction Type	Interacting Agents / Classes	Resulting Constraint / Requirement
Potent Enzyme Inducers	Rifampicin (Rifampin), Phenytoin, Carbamazepine, Phenobarbital, St. John's Wort	Contraindicated with Rifampicin due to marked loss of therapeutic effect. Avoid or monitor closely with others as they significantly reduce nifedipine concentrations.
CYP3A4 Inhibitors	Azole Antifungals (e.g., ketoconazole, fluconazole), Macrolide Antibiotics (e.g., erythromycin, clarithromycin), HIV Protease Inhibitors (e.g., ritonavir, indinavir), Cimetidine	May significantly increase nifedipine plasma concentrations. Requires close blood pressure monitoring and potential nifedipine dose reduction.
Pharmacodynamic	Beta-blockers and Other Antihypertensive Drugs	May lead to severe or excessive lowering of blood pressure; requires close clinical monitoring.
Other Drugs	Digoxin, Tacrolimus, Cyclosporine	May lead to increased plasma concentrations of the co-administered drug (e.g., Digoxin, Tacrolimus). Requires monitoring of the co-administered drug's levels.
Food/Beverage	Grapefruit and Grapefruit Juice	Consumption must be avoided as it inhibits first-pass metabolism, leading to a marked increase in nifedipine systemic exposure and potential for serious adverse effects.

The regulatory profile mandates careful evaluation of concomitant use, particularly concerning CYP3A4-altering medicines, which may diminish or enhance the therapeutic effect. The most severe restriction is the absolute contraindication with Rifampicin and the avoidance of grapefruit products, due to the critical impact on the drug’s concentration.

Mechanism of Action

How Коринфар Works: Mechanism of Action

Коринфар's action is defined by the pharmacodynamic properties of its single active ingredient, Nifedipine, a blocker that targets the cellular regulation of muscle contraction in arteries.

Nifedipine's primary action involves the selective inhibition of L-type voltage-gated calcium channels ( Cav 1) found on the membranes of vascular smooth muscle cells. By stabilizing these channels in an inactive state, Nifedipine prevents the entry of calcium ions ( Ca^2+) into the cell, which suppresses the molecular sequence necessary for contraction. This targeted blockade initiates the entire mechanistic cascade.

The resulting reduction in intracellular calcium leads to the relaxation of arterial walls (vasodilation), pronounced in peripheral arterioles. This physiological change causes a reduction in systemic vascular resistance (SVR), simultaneously contributing to a reduction in cardiac afterload and facilitating increased blood flow within the coronary arteries.

A mechanistic constraint of rapid vasodilation is the potential for the body’s baroreceptor reflex to engage, involving increased sympathetic nervous system activity that may temporarily elevate heart rate. This feedback loop represents a mechanistic limitation where the body's own regulatory system constrains the initial peripheral effect.

Dosage and Administration Information

Коринфар (Nifedipine) is administered exclusively via the oral route. Its standard usage is differentiated by the specific formulation: immediate-release (IR) and extended-release (ER/MR) products. The Immediate-Release form is typically initiated at a 10 mg dose taken three times per day (t.i.d.), with the dosage gradually adjusted to a maintenance range, but not to exceed a maximum of 180 mg per day.

The Extended-Release formulation, however, is designed for once-daily (q.d.) administration, often starting at 30 mg or 60 mg. Maintenance doses for the ER form generally range between 30 mg and 90 mg once daily, with the maximum allowed dose varying by product, generally up to 120 mg per day. Administration requires specific adherence to the formulation type: Extended-release tablets must not be chewed, crushed, or divided to ensure the controlled release mechanism remains intact. The dose is to be swallowed whole with a small amount of liquid.

Dosage adjustments, when necessary, are recommended to be implemented in incremental steps over intervals of 7 to 14 days. While IR forms may be taken independently of food, the intake relationship for ER forms is formulation-dependent, requiring attention to the specific product label. Furthermore, patients are instructed to avoid consumption of grapefruit or grapefruit juice, as this dietary component is known to interact with the drug’s metabolism. For specific populations, older adults may require lower maintenance doses, and patients with hepatic impairment are often started on the lowest available dose.

Recent Clinical Evidence

Recent Clinical Evidence for Nifedipine (Corinfar)

Nifedipine, the active ingredient in Corinfar, is a calcium channel blocker primarily studied in the management of chronic stable angina and hypertension. Major clinical trials have provided extensive data regarding its long-term use and outcomes.

Core Efficacy Findings

Clinical evidence supports the use of long-acting nifedipine formulations for improving blood pressure control and managing symptoms of angina. Research focusing on patients with coronary artery disease and concurrent hypertension, such as the ACTION trial, explored the effect of nifedipine extended-release (GITS) when added to standard treatment.

Hypertension and Angina: Studies have examined whether the addition of long-acting nifedipine to the regimen of patients with stable symptomatic coronary artery disease and hypertension was associated with a reduction in cardiovascular events, including new overt heart failure and stroke.
Angina Symptoms: In patients with chronic stable angina, nifedipine has been studied for its ability to reduce the frequency of angina episodes and increase exercise tolerance.

Safety and Comparative Studies

Research has explored the safety profile and comparative effects of long-acting nifedipine formulations versus other treatments in specific patient populations.

Hypertensive Disorders in Pregnancy: Systematic reviews and meta-analyses suggest that oral nifedipine may offer comparable efficacy to intravenous hydralazine for achieving optimal blood pressure control in severe hypertensive disorders of pregnancy, while potentially being associated with fewer maternal adverse effects.
Formulation Safety: The immediate-release formulation of nifedipine has historically been associated with safety concerns related to rapid changes in blood pressure. However, extended-release formulations are designed to mitigate this risk by providing a sustained release over a 24-hour period, which has been shown to be generally well tolerated in clinical settings.

Key Studies & References

Comparative efficacy and safety of oral nifedipine with other antihypertensive medications in the management of hypertensive disorders of pregnancy: a systematic review and meta-analysis of randomized controlled trials

Frequently Asked Questions (FAQ)

Common questions about Коринфар (FAQ)

Q: What is the main difference between Коринфар and other blood pressure medicines?

Official information classifies Коринфар as a Calcium Channel Blocker belonging to the dihydropyridine subclass. This means its primary action is achieved by preventing calcium from entering smooth muscle cells in the artery walls. This specific mechanism causes the blood vessels to relax (vasodilation), which helps to lower elevated blood pressure, distinguishing it from other types of blood pressure medications.

Q: How long does it usually take to feel the effect of Коринфар?

The time required to reach the maximum concentration of the drug in the blood depends on the formulation used. The Immediate-Release (IR) form is absorbed rapidly, with maximum concentration typically occurring within 30 to 60 minutes. However, the Extended-Release (ER) forms are designed to delay this peak, reaching maximum concentrations between 6 and 12 hours to provide a smoother, sustained effect throughout the day.

Q: Does Коринфар help with chest pain (angina) right away?

The purpose of the Immediate-Release (IR) form is to show effects rapidly, which can be relevant in certain acute settings. However, the Extended-Release (ER) formulation is primarily designed for sustained blood levels and is not intended for the rapid relief of acute chest pain or symptoms of angina.

Q: Can I stop taking Коринфар suddenly?

Regulatory documents advise that abrupt discontinuation of the drug is generally not recommended. Official warnings indicate that for patients with existing coronary artery disease, suddenly stopping the drug carries a potential risk of increasing the frequency or severity of angina.

Q: What happens if I miss a dose of Коринфар?

Guidance provided in official documentation advises that a missed dose may be taken as soon as it is remembered. However, if the time is close to that of the next scheduled dose, the regulatory guidance states that the missed dose should be passed over to avoid taking two doses too closely together.

Q: Does taking Коринфар affect my ability to drive or operate machinery?

Official warnings state that the ability to drive or operate machinery may be impaired due to potential side effects like dizziness, hypotension (low blood pressure), and fatigue. This risk is noted to be highest particularly at the start of treatment or when the dosage is changed.

Q: Can Коринфар interact with herbal supplements?

Yes, caution is advised because this drug is processed in the body by the CYP3A4 enzyme system. Herbal products that can strongly inhibit or induce this system, such as St. John's Wort, are documented to interact and should be used with caution and professional monitoring.

Q: Can Коринфар change how I respond to anesthesia during surgery?

Regulatory precautions advise that caution is necessary regarding the use of this medication during surgery. The drug’s blood pressure-lowering effects may be intensified when combined with anesthetics, which necessitates careful monitoring by the surgical and anesthesia team.

Q: Is there a generic version of Коринфар available?

Коринфар's active ingredient is Nifedipine. The official product information confirms that generic versions of Nifedipine are available on the market, although the specific formulations (e.g., immediate-release versus extended-release) and brand names may vary regionally.

Q: Why are there different strengths of Коринфар tablets?

Official documents indicate that different strengths of the tablets are available to allow for gradual dose adjustment (titration) and to achieve an effective maintenance dose for various approved conditions.

Q: Is it okay to drink alcohol in moderation while on Коринфар?

Regulatory documentation suggests that alcohol consumption may lead to an increase in the blood pressure-lowering effect of the medication. This potentiation can potentially cause or worsen side effects such as dizziness or lightheadedness.

Q: Does Коринфар cause fatigue or tiredness?

Fatigue is listed in regulatory documents as an adverse reaction associated with the use of this drug. While it is a documented effect, official information generally classifies its reported frequency as uncommon or rare.

Q: Is there a risk of developing a dependency on Коринфар?

Official regulatory information does not describe a risk of physical dependence or addiction associated with the therapeutic use of Nifedipine.

Q: Are there specific warnings about taking Коринфар if I have diabetes?

While the drug is not known to significantly interfere with blood glucose metabolism, official documents advise that caution and routine monitoring are generally recommended for all patients being treated for cardiovascular conditions, including those with diabetes.

Q: Does Коринфар affect kidney function?

Official documents advise caution in patients with severe renal impairment (significant kidney issues). This caution relates to the potential for reduced blood volume in these patients, which may necessitate careful monitoring.

Q: Are there any long-term effects of using Коринфар?

One documented long-term effect reported in clinical use is Gingival Hyperplasia (gum enlargement), which is classified as an Uncommon side effect. Extensive studies on long-acting formulations have supported the long-term use of the drug in stable conditions.

Q: Are the side effects of Коринфар permanent?

Most reported side effects are described as temporary and may diminish with continued use as the body adjusts. However, certain side effects noted with long-term use, such as gum enlargement, may persist until treatment is stopped.

Q: How long after taking a dose of Коринфар does the maximum effect occur?

The time to maximum concentration (Tmax) for the Immediate-Release form is approximately 30 to 60 minutes. For the Extended-Release forms, the drug is released gradually, meaning maximum concentrations are typically reached much later, between 6 and 12 hours.

Q: What is the risk of overdose with Коринфар?

Official information states that overdose can lead to severe cardiovascular symptoms, including excessive drops in blood pressure (severe hypotension), disturbances in heart rhythm, and potentially loss of consciousness. Due to the serious nature of these documented effects, medical professionals should be contacted immediately in the event of a suspected overdose.

Q: What is the difference between the uses of Коринфар for hypertension and angina?

As a Calcium Channel Blocker, the drug is used for two main purposes. Its use for hypertension aims to reduce peripheral resistance and lower overall blood pressure, while its use for angina aims to relax the coronary arteries to improve blood flow and oxygen supply to the heart muscle.

Q: Does the time of day matter when taking Коринфар?

For the Extended-Release (ER) form, it is typically directed to be taken once daily at approximately the same time each day. This consistent timing is important to maintain stable drug levels and ensure continuous therapeutic coverage over 24 hours.

Q: How is the effectiveness of Коринфар usually monitored?

The effectiveness of the drug in treating hypertension is routinely monitored through regular measurements of blood pressure. For angina, monitoring involves assessing the frequency and severity of clinical symptoms.

Q: Is it necessary to have my blood tested while taking Коринфар?

Routine blood testing for Nifedipine itself is not generally specified in regulatory documents. However, monitoring of blood levels is officially required for co-administered drugs like Digoxin, Tacrolimus, or Cyclosporine, as Nifedipine can increase the concentration of these drugs.

Q: What should I do if my blood pressure remains high while taking Коринфар?

Official guidelines state that when therapeutic adjustments are necessary, dosage changes are typically implemented incrementally. This process is usually performed over intervals of 7 to 14 days to allow a healthcare provider to assess the response and safely reach the required blood pressure control.

Q: Is Коринфар commonly used as a standalone treatment?

Official regulatory indications confirm that the drug is used in a variety of patients and conditions. Its use is not exclusively limited to being an add-on therapy and may be prescribed as a monotherapy depending on the patient's condition.

Q: Why is it important to check the expiration date on Коринфар?

Checking the expiration date is important because the drug's stability and strength are guaranteed by the manufacturer only until the end of the month indicated. After that time, the effectiveness and safety of the medication may be compromised.

How should Коринфар be stored and disposed of?

The official regulatory documents specify strict conditions for the storage and disposal of Korinfar (Nifedipine) to maintain product stability and safety.

Storage Requirements

Item	Requirement
Temperature	Store at a temperature not exceeding 25 C and keep from freezing.
Protection	Must be stored to protect it from light, moisture, and excess heat.
Container	Keep the product in its original container, which must remain tightly closed.
Safety	Must be stored out of the sight and reach of children.

Disposal Instructions

Disposal of unused or expired Korinfar must be done in accordance with local regulatory requirements. The preferred methods include utilizing official drug take-back programs or designated collection points. The product must not be disposed of via wastewater (e.g., flushing down the toilet) or general household waste unless local guidelines for mixing with an undesirable substance (e.g., coffee grounds) are followed.

Коринфар