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ნიფედიპრესი / NIFEDIPRESS | მედიკამენტები | vidal.ge
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იხილეთ აფთიაქების ჩამონათვალი

ნიფედიპრესი / NIFEDIPRESS
შემადგენლობა 

პრეპარატი ნიფედიპრესი MR 10მგ (NIFEDIPRESS MR 10mg) აქტიური ნივთიერების სახით შეიცავს ნიფედიპინს.

ჩვენებები
სტენოკარდიის შეტევების პროფილაქტიკა, არტერიული ჰიპერტენზია, ჰიპერტონული კრიზები, რეინოს დაავადება.

მიღების წესები და დოზები
ინდივიდუალური. საწყისი დოზა შეადგენს 10მგ-ს 3-4-ჯერ დღეში. აუცილებლობის შემთხვევაში დოზას ზრდიან 20მგ-მდე 3-4-ჯერ დღეში. 
დასაშვებია მედიკამენტის მიღება საკვებთან ერთად ან მის გარეშე. ტაბლეტის დაღეჭვა ან გატეხვა არ შეიძლება. არ შეიძლება ნიფედიპრესის მიღება გრეიფრუტის წვენთან ერთად.

გვერდითი მოვლენები
გულ-სისხლძარღვთა სისტემის მხრივ: კანის ჰიპერემია, სითბოს შეგრძნება, ტაქიკარდია, არტერიული ჰიპოტენზია, პერიფერიული შეშუპება, იშვიათად - ბრადიკარდია, პარკუჭოვანი ტაქიკარდია, ასისტოლია.
საჭმლის მომნელებელი სისტემის მხრივ: გულისრევა, გულძმარვა, დიარეა, იშვიათად – ღვიძლის ფუნქციის გაუარესება, ერთეულ შემთხვევებში – ღრძილების ჰიპერპლაზია. მაღალი დოზით ხანგრძლივი გამოყენებისას შესაძლოა დისპეფსიური სიმპტომები, ღვიძლის ტრანსამინაზების აქტივობის გაზრდა.
ცნს-ისა და პერიფერიული ნერვული სისტემის მხრივ: თავის ტკივილი. მაღალი დოზით ხანგრძლივი გამოყენებისას შესაძლოა პარესტეზია, კუნთების ტკივილი, ტრემორი, მხედველობის მსუბუქი დარღვევები, ძილის დარღვევები.
სისხლმბადი სისტემის მხრივ: ერთეულ შემთხვევებში – ლეიკოპენია, თრომბოციტოპენია.
შარდგამომყოფი სისტემის მხრივ: დღეღამური დიურეზის გაზრდა. მაღალი დოზით ხანგრძლივი გამოყენებისას შესაძლოა თირკმლის ფუნქციის დარღვევა.
ენდოკრინული სისტემის მხრივ: ცალკეულ შემთხვევებში – გინეკომასტია.
ალერგიული რეაქციები: გამონაყარი კანზე.

უკუჩვენება
არტერიული ჰიპოტენზია, კოლაფსი, კარდიოგენული შოკი, გულის უკმარისობის მძიმე ფორმა, აორტული სტენოზი მძიმე ფორმით, მომატებული მგრძნობელობა ნიფედიპინის მიმართ.

ორსულობა და ლაქტაცია
ორსულობა-ლაქტაციის დროს პრეპარატის გამოყენება არ არის რეკომენდებული.

განსაკუთრებული მითითებები
მიოკარდიუმის მწვავე ინფარქტის, თავის ტვინის სისხლის მიმოქცევის მძიმე დარღვევების, შაქრიანი დიაბეტის, ღვიძლისა და თირკმლის ფუნქციის დარღვევეის, ავთვისებიანი არტერიული ჰიპერტენზიის და ჰიპოვოლემიის დროს, ასევე ჰემოდიალიზზე მყოფ პაციენტებში ნიფედიპრესის გამოიყენება შესაძლოა მხოლოდ კლინიკის პირობებში ექიმის მკაცრი მეთვალყურეობის ქვეშ. პაციენტებში ღვიძლისა და/ან თირკმლის ფუნქციის დარღვევებით პრეპარატის დანიშვნა მაღალი დოზით არ არის დასაშვები.
ნიფედიპრესით მკურნალობის ფონზე მკერდის ძვლის უკან ტკივილის გაჩენისას პრეპარატის მიღება უნდა შეწყდეს. ნიფედიპრესის მოხსნა უნდა მოხდეს თანდათანობით, რადგან უეცარი შეწყვეტისას შესაძლოა განვითარდეს მოხსნის სინდრომი.
ნიფედიპრესით კურსობრივი მკურნალობის პერიოდში ალკოჰოლის მიღება დასაშვები არ არის რათა არ მოხდეს არტერიული წნევის გადაჭარბებული ვარდნა. 
ნიფედიპრესით მკურნალობის დასაწყისში ავტოსატრანსპორტო საშუალებების მართვა და პოტენციურად საშიში სხვა სახის საქმიანობა, რომელიც საჭიროებს სწრაფ ფსიქომოტორულ რეაქციებს, უნდა შეიზღუდოს. შემდგომი მკურნალობის პერიოდში შეზღუდვის ხარისხი განისაზღვრება ნიფედიპრესის ინდივიდუალური ამტანობით. ანტიჰიპერტენზიულ საშუალებებთან, დიურეტიკებთან, ფენოთიაზინის წარმოებულებთან ერთდროული გამოყენებისას ძლიერდება ნიფედიპრესის ანტიჰიპერტენზიული მოქმედება.
ანტიქოლინერგულ საშუალებებთან ერთდროული გამოყენებისას შესაძლოა მეხსიერებისა და ყურადღების დარღვევა ასაკოვან პაციენტებში. 
ბეტა-ადრენობლოკატორებთან ერთდროული გამოყენებისას შესაძლოა გამოხატული არტერიული ჰიპოტენზიის განვითარება, ცალკეულ შემთხვევებში – გულის უკმარისობის განვითარება.
ნიტრატებთან ერთდროული გამოყენებისას იზრდება ნიფედიპრესის ანტიანგინალური ეფექტი.
კალციუმის პრეპარატებთან ერთდროული გამოყენებისას ნიფედიპრესის ეფექტურობა მცირდება ანტაგონისტური მოქმედების გამო.
დიგოქსინთან ერთდროული გამოყენებისას ნელდება ამ უკანასკნელის გამოყოფა ორგანიზმიდან და შესაბამისად იზრდება მისი კონცენტრაცია სისხლის პლაზმაში.
დილთიაზემთან ერთდროული გამოყენებისას ძლიერდება ანტიჰიპერტენზიული მოქმედება.
თეოფილინთან ერთდროული გამოყენებისას შესაძლოა შეიცვალოს თეოფილინის კონცენტრაცია სისხლის პლაზმაში.
რიფამპიცინი ახდენს ღვიძლის ფერმენტების აქტივობის ინდუცირებას, რის გამო ნიფედიპრესის მეტაბოლიზმი ჩქარდება და მისი ეფექტურობა მცირდება.
ფენობარბიტალთან, ფენიტოინთან, კარბამაზეპინთან ერთდროული გამოყენებისას მცირდება ნიფედიპრესის კონცენტრაცის სისხლის პლაზმაში.
არსებობს მონაცემები სისხლის პლაზმაში ნიფედიპრესის კონცენტრაციის გაზრდის შესახებ ფლუკონაზოლთან, იტრაკონაზოლთან მისი ერთდროული გამოყენებისას.
ფლუოქსეტინთან ერთდროული გამოყენებისას შესაძლოა ნიფედიპრესის გვერდითი მოქმედების გაძლიერება.
ციმეტიდინი, და უფრო ნაკლებად რანიტიდინი, იწვევენ ნიფედიპრესის კონცენტრაციის გაზრდას სისხლის პლაზმაში, შესაბამისად მისი ანტიჰიპერტენზიული მოქმედების გაძლიერებას.
ეთანოლმა შესაძლოა გამოიწვიოს ნიფედიპრესის მოქმედების გაძლიერება, რაც იწვევს თავბრუსხვევას და სხვა არასასურველ რეაქციებს.

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