Arterial hypertension, chronic stable angina (stress angina), vasospastic angina (Prinzmetal angina, variant angina).
FENIGYDIN PHARMACOLOGICAL PROPERTIES.
A calcium channel blocker, a dihydropyridine derivative. Inhibits the flow of calcium into cardiomyocytes and vascular smooth muscle cells. It has antianginal and antihypertensive effects. Reduces the tone of vascular smooth muscles. Expands the coronary and peripheral arteries, lowers the total peripheral vascular resistance, blood pressure, reduces afterload and myocardial oxygen demand.
Pharmacokinetics. When taken orally, Fenigidin is rapidly and almost completely (more than 90%) absorbed from the gastrointestinal tract. Bioavailability is approximately 50%. The maximum concentration in blood plasma is recorded 20-40 minutes after administration. The time of the onset of the clinical effect: 20 minutes – for oral administration, 5 minutes – for sublingual administration. The duration of the clinical effect is 4-6 hours. The half-life is 2-4 hours. It is excreted mainly in the urine in the form of inactive metabolites. There is no cumulative effect.
FENIGYDIN INDICATIONS FOR USE.
Prevention and treatment of angina attacks; arterial hypertension of various origins, hypertensive crisis.
FENIGYDIN DOSAGE AND APPLICATION
The drug is taken orally, without chewing, with a small amount of liquid, regardless of the meal. Simultaneous food intake slows down, but does not reduce the degree of absorption of the drug (some foods affect the bioavailability of the drug). The dose is set individually. The initial dose for adults is 10 mg (1 tablet), 3-4 times a day. If necessary, the dose is gradually increased to 20 mg, 3-4 times a day. The maximum daily dose is 120 mg. To relieve an attack of angina pectoris or hypertensive crisis, the drug is used sublingually: 1 tablet of 0.01 g is chewed and placed under the tongue; after a while (5-10 minutes), you can swallow the drug with a small amount of water, while it is recommended to be in the supine position for 30-60 minutes. The duration of treatment is determined by the doctor.
Side effects occur mainly at the beginning of treatment, are usually mild and temporary. More than 1% of patients may experience headache, flushing of the skin of the face and other parts of the body, accompanied by a burning sensation (erythema, erythromegaly), palpitations, swelling of the legs (associated with vasodilation), dizziness, increased fatigue, nausea, a feeling of heaviness in the stomach, diarrhea, constipation; in less than 1% of cases, shortness of breath, myalgia, tremor, hyperexcitability, paresthesia, tachycardia, arterial hypotension, skin rash and itching are possible; less than 0.1% of patients (in some elderly men, with prolonged therapy) may develop gynecomastia, which completely regresses after discontinuation of the drug; with long-term treatment, gingival hyperplasia is also possible, which completely disappears after discontinuation of the drug. Initial hyperglycemia, transient visual impairment, increased daily urine output (can be regarded as a positive effect with increased blood pressure), liver dysfunction (increased transaminase levels, intrahepatic cholestasis), exfoliative dermatitis, photosensitization, systemic allergic reactions, thrombocytopenic purpura, agulocytosis are extremely rare. these phenomena disappear after discontinuation of the drug. Due to a decrease in blood pressure, a collapse may develop. A sharp decrease in blood pressure due to vasodilation is possible in patients on dialysis, with malignant arterial hypertension and hypovolemia. When treating patients with stable angina pectoris within 1 hour after taking Fenigidine, chest pain may appear in the form of angina pectoris.
In some patients, usually at the beginning of treatment, an increase in the frequency, duration and severity of angina attacks may occur, which requires discontinuation of the drug.
Hypersensitivity to Fenigidin, cardiogenic shock, arterial hypotension, tachycardia, acute period of myocardial infarction (first 8 days), heart failure, pregnancy, childhood.
Since Phenigidine is excreted in breast milk, you should avoid its use during lactation or stop breastfeeding during treatment
Symptoms: headache, facial flushing, prolonged systemic hypotension, bradycardia, bradyarrhythmia. In severe poisoning, collapse, depression of the sinus node is possible. Treatment: administration of norepinephrine, intravenous administration of calcium chloride or calcium gluconate in atropine solution.
FEATURES OF APPLICATION.
Special care must be taken when prescribing the drug to patients with significantly reduced blood pressure (systolic pressure below 90 mm Hg), with severe heart failure or aortic stenosis.
In case of impaired liver function, it is necessary to ensure careful medical supervision of patients, if necessary, to reduce the dose of Fenigidine.
The drug can affect the psychophysical abilities of the body, weakening attention and slowing down responses, especially with the simultaneous use of alcohol.
Upothe consumption of grapefruit juice during treatment with Fenigidin can lead to an increase in the concentration of the drug in the blood plasma and an increase in its hypotensive effect.
Reception of Fenigidin can cause a false increase in the level of vanilla-mandelic acid in the urine during spectrophotometric examination; the results of determining this indicator by high pressure liquid chromatography are not distorted.