Nifedipine reduces the clearance of digoxin, which leads to an increase in its concentration in the blood plasma, so patients need careful monitoring to detect symptoms of cardiac glycoside overdose, and the dose should be reduced if necessary.
Nifedipine sustanon cycle reduces quinidine concentration in blood plasma, however, when canceling quinidine content can increase significantly, the dose adjustments required. In some cases, the concentration of nifedipine in the plasma can be improved, however, if indicated the dose should be reduced. During concomitant therapy is necessary to control the concentration of quinidine in blood plasma and blood pressure. At simultaneous reception with nifedipine increases the risk of QT interval prolongation.
When combined with procainamide there is a risk of QT prolongation and enhance the negative inotropic effect of both drugs.
Induces cytochrome system P450 3A4 enzymes and reduces the bioavailability of nifedipine and, as a consequence, reduces its effectiveness, which may require increasing the dose.
inhibits cytochrome P450 3A4 system and causes an increase in the concentration of nifedipine in the plasma, thereby enhancing its hypotensive action.
refers to potent inducers of hepatic enzymes, accelerating metabolism of nifedipine, which weakens its effectiveness.
slows down nifedipine from the body, so combination therapy should be carried out very carefully, reducing the dose of nifedipine if necessary.
Increasing the concentration of nifedipine in the blood plasma, so blood pressure should be monitored and if necessary, reduce the dose of nifedipine.
Grapefruit juice inhibits cytochrome sustanon cyclesystem and increases the concentration of nifedipine in plasma, due to the reduction effect of “first pass” through the liver.
As valproic acid causes an increase in plasma concentrations of nimodipine, the structure is close to nifedpinu blocker “slow” calcium channels, it is not ruled out an increase in the plasma concentration of nifedipine, and strengthen its effectiveness.
Nifedipine does not change the antiplatelet effect of aspirin at a dose of 100 mg (platelet aggregation and the duration of bleeding). Acetylsalicylic acid, in turn, does not affect the pharmacokinetic parameters of nifedipine.
Since carbamazepine and fenabarbital cause a decrease in the plasma nimodipine concentration on the structure close to the nifedipine blocker “slow” calcium channels, the concentration may decrease plasma nifedipine and decrease its effectiveness.
Nifedipine may displace from its association with protein drugs containing high binding (indirect anticoagulants – indandiona and coumarin derivatives, quinine, sulfinpyrazone, anticonvulsants, salicylates, NSAIDs), followed by a possible increase in their concentration in the plasma. Since erythromycin, fluoxetine, ritonavir, indinavir, amprenavir, nelfinavir, saquinavir, ketoconazole, itraconazole, fluconazole, inhibit cytochrome P4503A4 enzyme system, it is not excluded increase nifedipine concentrations in plasma as a result of their interaction. It is recommended to monitor blood pressure and to reduce the dose of nifedipine if necessary.
In the case of simultaneous application with disopyramide may increase the negative inotropic effect. Preparations containing Li +, when combined with nifedipine may cause neurotoxic symptoms (nausea, vomiting, diarrhea, ataxia, tremor, and / or tinnitus).
Ajmaline, omeprazole, benazepril, irbesartan, orlistat, ranitidine, rosiglitazone, doxazosin, pantoprazole, talinolol, hydrochlorothiazide triamterene not affect the pharmacokinetics of nifedipine.
Nifedipine is necessary with extreme caution in patients with severe stenosis of any gastrointestinal tract, since it is possible the development of bowel obstruction.
In some cases, symptoms of intestinal obstruction can occur in patients without pathology of the gastrointestinal tract. It should be borne in mind that during the X-ray of the intestine with barium can identify false positive signs of a polyp (a filling defect).
If liver failure is recommended to monitor the patient, if necessary, dose reduction , or use of the drug in other dosage forms.
In an application and blockers, β-adrenergic patients require close monitoring as may develop sustanon cycle pronounced reduction in blood pressure and worsening symptoms of heart failure.
When concomitantly with grapefruit juice may increase the hypotensive action, which persists for 3 days after the last dose of juice.
Nifedipine is a false positive increase concentration vanillylmandelic acid in the urine when determining the spectrophotometric method and does not affect the result of the reaction by using the method of high performance liquid chromatography (HPLC).
during the period of treatment must be careful when engaging in potentially hazardous activities that require high concentration and psychomotor speed reactions, and refrain by use of ethanol.