Nitrendipin 20 mg. 30 tablets

WHAT Nitrendipin Actavis AND WHAT IT IS USED
Nitrendipin Actavis is the product of a group called calcium channel blockers. It reduces peripheral resistance of blood vessels and leads to a decrease of elevated blood pressure.
Nitrendipin Actavis is used to treat hypertension (high blood pressure)

2. WHAT YOU NEED TO KNOW BEFORE nitrendipin Actavis
Nitrendipin Actavis does not apply to:
• Allergy to nitrendipine other dihydropyridine calcium channel blockers or to any of the excipients;
• cardiogenic shock;
• acute myocardial infarction (during the first 4 weeks);
• high-grade aortic or subaortic stenosis (narrowing of the aortic valve);
• unstable angina;
• hypotension (systolic blood pressure below 90 mmHg);
• pregnancy and lactation.
In the application of this product, please note the following:
During treatment should be controlled blood pressure, cardiac, renal and hepatic function. Particular care is required when administered to patients with decompensated heart failure, liver and kidney diseases and glaucoma. During treatment with nitrendipine can alter the results of some diagnostic and laboratory tests (titer of antinuclear antibodies; direct test of Coombs; increases in serum transaminases and alkaline phosphatase). In elderly patients at increased risk of hypotension (severe lowering of blood pressure) due to decreased excretion from the body and increased serum concentrations.
Application of nitrendipine Actavis with food and drink:
The tablets should not be taken with grapefruit juice, as this may increase the effect of nitrendipine.

pregnancy
Before taking any medicine consult your doctor or pharmacist.
It should be conducted treatment with nitrendipin Actavis during pregnancy.

breastfeeding
Before taking any medicine, consult your doctor or pharmacist.
Small amounts of nitrendipine pass into breast milk. Therefore it is not recommended for use nitrendipine Actavis during breast-feeding. If the application is urgent need to stop breastfeeding.

Driving and using machines
Early treatment with nitrendipin Actavis in individual patients may be a temporary occurrence of fatigue and dizziness, which can affect the ability to drive and use machines.

Taking other medicines:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even if they have not been prescribed by your doctor.
The blood pressure lowering effect of nitrendipine is increased by concomitant use of other antihypertensive drugs, especially beta-blockers.
Nitrendipine increases plasma levels of digoxin. In a joint treatment is necessary to monitor the effects of overdose and, if necessary, adjust the dose of digoxin. Cimetidine increases plasma levels of nitrendipine. Concomitant use of prazosin hypotension may occur. Calcium channel blockers may enhance the effect of suppressing cardiac function of antiarrhythmic drugs (such as amiodarone and quinidine) and lead to disturbances in cardiac impulse conduction (sinus arrest and / or atrial ventricular block). Anticonvulsants, administered in conjunction with dihydropyridine calcium channel blockers, reduce their plasma concentrations, by enhancing hepatic metabolism.
The effect of peripheral muscle relaxants may be extended. NSAIDs may antagonize the effect of calcium channel blockers.
Rifampicin reduces plasma concentrations of calcium channel antagonists, by enhancing hepatic metabolism.
Tricyclic antidepressants enhance the antihypertensive effect of nitrendipine and the risk of orthostatic hypotension (sudden fall in blood pressure when standing up).


13. HOW TO TAKE nitrendipin Actavis
Always nitrendipine Actavis according to the instructions of lekuvagtsiya doctor.
On prescription! It is orally with sufficient fluid after a meal.
Treatment with nitrendipine Actavis should be tailored to individual needs and patient tolerance, the dosing regimen is determined and controlled by doctor
The usual dose is 20 mg (1 tablet) in the morning. If necessary, the daily dose was increased to a maximum of 40 mg (2 tablets) - one tablet in the morning and evening.
In elderly patients or those with chronic liver disease, treatment starts with a 10 mg daily (1/2 tablet) and, if necessary, dose increased to 20 mg daily, distributed in one or two doses.

children:
This product is not recommended for children. Their safety and efficacy have not been established.
If you have the impression that the effect of the application of nitrendipine Actavis is strong or too weak, talk to your doctor or pharmacist.
If you used a higher dose of nitrendipine Actavis than prescribed:
When taking a higher dose than prescribed, immediately contact a doctor!

Symptoms of overdose:
Intense flushing, headache, marked lowering of blood pressure, collapse, fast or slow heartbeat, a rare disorder in conducting cardiac impulse, which may progress to asystole (cardiac arrest). Therapeutic measures:
The measures are aimed at eliminating the medicinal product and stabilizing the cardiovascular parameters.
Upon acceptance of an overdose mouth is shown gastric lavage possibly combined with intestinal lavage. Upon administration of laxatives, it should be borne in mind that calcium channel blockers inhibit the intestinal muscles to the extent of stopping the intestinal peristalsis. The patient should be placed in the supine position with the high position of the feet. It is necessary to ensure maintenance of respiration and cardiac activity, and if necessary administration of symptomatic therapy (calcium gluconate, dopamine or dobutamine, epinephrine, norepinephrine, atropine, if necessary placing a temporary pacemaker). Haemodialysis is not suitable because nitrendipine can not dialyse. Suitable plasma.
Due to the risk of burdening the heart, the additional fluid administration and volume replacement should be done carefully, with constant monitoring of cardiovascular parameters.
If symptoms of overdose, immediately contact a doctor!
If you forget to nitrendipine Actavis
If you miss a dose, take it at the next regular intake without increasing the dose.

4. POSSIBLE SIDE EFFECTS
Like all medicines, nitrendipin Actavis can cause side effects.
They are mainly from the cardiovascular system and are associated with sadovorazshiryavashtiya effect of nitrendipine. Observed early in treatment, gradually disappear and do not require discontinuation of therapy. The most commonly observed headache, flushing, hot flushes, palpitations, palpitations, rarely swelling around the ankles and lower legs. Very rarely can cause chest pain and angina, which requires discontinuation of treatment. Possible nausea, abdominal pain, diarrhea; nervousness, depression; paresthesias, muscle cramps. Observed are extremely rare rash, urticaria, pruritus. In isolated cases, describes the following side effects during treatment with nitrendipine: myocardial infarction, muscle pain, tremors, mild transient changes in visual perception, expansion of the lining of the gums, breast enlargement in men with prolonged therapy, enhancing the level of liver enzymes. Most of these side effects are mild and reversible after discontinuation of therapy.
If you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

5. Storage
Keep out of reach of children. At temperatures below 25 ° C!
Do not use after the expiry date stated on the package! Shelf life: three (3) years from date of manufacture.