{"id":51671,"date":"2023-09-20T09:24:00","date_gmt":"2023-09-20T09:24:00","guid":{"rendered":"https:\/\/medsname.com\/depin-retard\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"depin-retard","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/depin-retard\/","title":{"rendered":"Depin Retard"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 co je Depin Retard?<\/h3>\n<p style=\"margin:0;\"><strong>Depin Retard<\/strong> je <strong>20 mg tableta nifedipinu<\/strong> od Zydus Cadila \u2014 prvn\u00ed generace blok\u00e1toru kalciov\u00fdch kan\u00e1l\u016f (CCB). <strong>Adalat \/ Procardia<\/strong>) \u2014 p\u016fvodn\u00ed dihydropyridinov\u00fd CCB. Kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00ed nifedipin s rychl\u00fdm uvol\u0148ov\u00e1n\u00edm zp\u016fsobil v 90. letech kontroverzi kv\u016fli zpr\u00e1v\u00e1m o zv\u00fd\u0161en\u00ed rizika infarktu a mortality p\u0159i sublingv\u00e1ln\u00edm\/p\u0159\u00edli\u0161 rychl\u00e9m pod\u00e1n\u00ed; modern\u00ed praxe pou\u017e\u00edv\u00e1 <strong>prodlou\u017een\u00e9 uvol\u0148ov\u00e1n\u00ed (Retard, MR, CC, XL, OROS)<\/strong> formulace v\u00fdhradn\u011b pro chronickou hypertenzi. Polo\u010das v plazm\u011b IR ~2-5 hodin; Retard \/ MR \/ CC \/ XL ~20-24 hodin. <strong>Pou\u017e\u00edvejte V\u00ddHRADN\u011a nifedipin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (Retard, MR, CC, XL, OROS, GITS) pro chronickou hypertenzi.<\/strong> Sublingv\u00e1ln\u00ed nebo drcen\u00fd nifedipin s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm je kontraindikov\u00e1n pro chronickou kontrolu krevn\u00edho tlaku \u2014 zp\u016fsobuje rychl\u00e9 poklesy TK s reflexn\u00ed sympatickou aktivac\u00ed, tachykardi\u00ed a v n\u011bkter\u00fdch studi\u00edch IM nebo mortalitu. ER formulace t\u011bmto probl\u00e9m\u016fm p\u0159edch\u00e1zej\u00ed d\u00edky plynul\u00e9mu 24hodinov\u00e9mu profilu v plazm\u011b. Typick\u00e1 d\u00e1vka p\u0159i hypertenzi: <strong>Retard 20 mg dvakr\u00e1t denn\u011b NEBO CC\/XL 30 mg jednou denn\u011b<\/strong>; c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed Retard 20-30 mg dvakr\u00e1t denn\u011b NEBO CC\/XL 30-60 mg jednou denn\u011b. Hlavn\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: otoky kotn\u00edk\u016f (perifern\u00ed ed\u00e9my), n\u00e1valy horka, bolesti hlavy z vazodilatace, reflexn\u00ed tachykardie (tlumen\u00e1 dlouh\u00fdm polo\u010dasem amlodipinu; \u010dast\u00e9 u IR nifedipinu). Bezpe\u010dn\u00e9 kombinov\u00e1n\u00ed s betablok\u00e1tory, ACE inhibitory, ARB a thiazidy (na rozd\u00edl od ne-DHP blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f). T\u011bhotenstv\u00ed: nifedipin MR je v t\u011bhotenstv\u00ed bezpe\u010dn\u00fd a \u010dasto prvn\u00ed volbou; amlodipin je rozumnou druhou mo\u017enost\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Depin Retard?<\/h2>\n<p>Depin Retard je retardovan\u00e1 forma nifedipinu 20 mg od spole\u010dnosti Zydus Cadila, dod\u00e1van\u00e1 v balen\u00ed po 30-90 tablet\u00e1ch. Zaveden na trh 1981 (Bayer jako <strong>Adalat \/ Procardia<\/strong>) \u2014 p\u016fvodn\u00ed dihydropyridinov\u00fd CCB. Kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00ed nifedipin s rychl\u00fdm uvol\u0148ov\u00e1n\u00edm zp\u016fsobil v 90. letech kontroverzi kv\u016fli zpr\u00e1v\u00e1m o zv\u00fd\u0161en\u00ed rizika infarktu a mortality p\u0159i sublingv\u00e1ln\u00edm\/p\u0159\u00edli\u0161 rychl\u00e9m pod\u00e1n\u00ed; modern\u00ed praxe pou\u017e\u00edv\u00e1 <strong>prodlou\u017een\u00e9 uvol\u0148ov\u00e1n\u00ed (Retard, MR, CC, XL, OROS)<\/strong> formulace v\u00fdhradn\u011b pro chronickou hypertenzi.<\/p>\n<p>Nifedipin pat\u0159\u00ed do skupiny <strong>dihydropyridinov\u00fdch blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/strong> , kter\u00e1 se odli\u0161uje od nedihydropyridin\u016f (<a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">verapamil<\/a>) sv\u00fdm <strong>selektivn\u00ed \u00fa\u010dinek na c\u00e9vn\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm srde\u010dn\u00edm \u00fa\u010dinkem<\/strong>. Tento selektivn\u00ed profil je klinicky v\u00fdznamn\u00fd: DHP lze bezpe\u010dn\u011b kombinovat s beta-blok\u00e1tory (kombinace je standardn\u00ed u anginy pectoris), zat\u00edmco ne-DHP nikoli (riziko aditivn\u00ed bradykardie\/blok\u00e1dy srdce).<\/p>\n<h2 class=\"wp-block-heading\">Jak nifedipin p\u016fsob\u00ed<\/h2>\n<p>Blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se v\u00e1\u017eou na L-typ nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch kalciov\u00fdch kan\u00e1l\u016f a sni\u017euj\u00ed vstup v\u00e1pn\u00edku do bu\u0148ky b\u011bhem depolarizace. V <strong>hladk\u00e9m svalstvu tepen<\/strong>, znamen\u00e1 sn\u00ed\u017een\u00fd vstup v\u00e1pn\u00edku m\u00e9n\u011b interakce aktin-myozin a <strong>p\u0159\u00edmou vazodilataci tepen<\/strong> \u2014 sn\u00ed\u017een\u00ed syst\u00e9mov\u00e9 c\u00e9vn\u00ed rezistence a krevn\u00edho tlaku.<\/p>\n<p>Dihydropyridiny jsou ~10x \u00fa\u010dinn\u011bj\u0161\u00ed na c\u00e9vn\u00ed hladk\u00e9 svalstvo ne\u017e na srde\u010dn\u00ed sval \u2014 dominantn\u00edm klinick\u00fdm \u00fa\u010dinkem je tedy vazodilatace s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm potla\u010den\u00edm srde\u010dn\u00ed kontraktility nebo veden\u00ed. Baroreflex t\u011bla m\u016f\u017ee po rychl\u00e9 vazodilataci vyvolat m\u00edrnou reflexn\u00ed tachykardii; to je probl\u00e9m kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00edho nifedipinu, kter\u00fd vedl ke kontroverzi v 90. letech \u2014 modern\u00ed ER formulace tomu p\u0159edch\u00e1zej\u00ed pomal\u00fdm plynul\u00fdm n\u00e1stupem.<\/p>\n<p>N\u00e1stup klinick\u00e9ho \u00fa\u010dinku: Retard 1-4 hodiny; pln\u00fd \u00fa\u010dinek na TK za 1-2 t\u00fddny.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Hypertenze<\/strong> \u2014 pouze Retard \/ CC \/ XL formulace<\/li>\n<li><strong>Hypertenze v t\u011bhotenstv\u00ed<\/strong> \u2014 Retard\/MR je prvn\u00ed nebo druh\u00e1 volba vedle <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a> a methyldopa<\/li>\n<li><strong>Tokol\u00fdza u p\u0159ed\u010dasn\u00e9ho porodu<\/strong> (mimo schv\u00e1len\u00e9 indikace, ale \u0161iroce pou\u017e\u00edvan\u00e9) \u2014 uvol\u0148uje hladk\u00e9 svalstvo d\u011blohy<\/li>\n<li><strong>Prinzmetalova\/vasospastick\u00e1 angina<\/strong><\/li>\n<li><strong>Raynaud\u016fv fenom\u00e9n<\/strong><\/li>\n<li><strong>Chronick\u00e1 stabiln\u00ed angina<\/strong> \u2014 \u010dasto kombinov\u00e1no s betablok\u00e1torem (betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii)<\/li>\n<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> <strong>INSIGHT (2000)<\/strong> \u2014 nifedipin GITS nebyl hor\u0161\u00ed ne\u017e ko-amilozid u kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod u hypertenze. <strong>ACTION (2004)<\/strong> \u2014 p\u0159id\u00e1n\u00ed nifedipinu GITS ke standardn\u00ed terapii anginy pectoris sn\u00ed\u017eilo pot\u0159ebu koron\u00e1rn\u00edch v\u00fdkon\u016f.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Depin Retard<\/h2>\n<p><strong>Hypertenze:<\/strong><\/p>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> Retard 20 mg dvakr\u00e1t denn\u011b NEBO CC\/XL 30 mg jednou denn\u011b<\/li>\n<li><strong>C\u00edlov\u00e1 d\u00e1vka:<\/strong> Retard 20-30 mg dvakr\u00e1t denn\u011b NEBO CC\/XL 30-60 mg jednou denn\u011b<\/li>\n<li><strong>Maxim\u00e1ln\u00ed d\u00e1vka:<\/strong> Retard 60 mg dvakr\u00e1t denn\u011b NEBO CC\/XL 90 mg jednou denn\u011b<\/li>\n<li>Titrujte ka\u017ed\u00fdch 1-2 t\u00fddny na z\u00e1klad\u011b odpov\u011bdi krevn\u00edho tlaku a sn\u00e1\u0161enlivosti (zejm\u00e9na otok\u016f)<\/li>\n<\/ul>\n<p><strong>Angina pectoris:<\/strong> Retard 20-40 mg dvakr\u00e1t denn\u011b<\/p>\n<p><strong>Pod\u00e1v\u00e1n\u00ed:<\/strong> jednou denn\u011b (nebo dvakr\u00e1t denn\u011b u IR formulac\u00ed nifedipinu). Polykejte cel\u00e9 \u2014 NEROZDRCUJTE ani NED\u011aLTE tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (dod\u00e1v\u00e1 IR d\u00e1vku s rizikem hypotenze). U\u017e\u00edvejte s j\u00eddlem nebo bez j\u00eddla.<\/p>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> \u017e\u00e1dn\u00fd specifick\u00fd abstinen\u010dn\u00ed syndrom; lze vysadit bez postupn\u00e9ho sni\u017eov\u00e1n\u00ed d\u00e1vky. Krevn\u00ed tlak se vr\u00e1t\u00ed na p\u0159edl\u00e9\u010debn\u00e9 hodnoty b\u011bhem 1-2 t\u00fddn\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;5%, v\u011bt\u0161inou m\u00edrn\u00e9 a p\u0159echodn\u00e9):<\/strong><\/p>\n<ul>\n<li><strong>Perifern\u00ed (kotn\u00edkov\u00e9) otoky<\/strong> \u2014 Perifern\u00ed (kotn\u00edkov\u00fd) ed\u00e9m \u2014 podobn\u00fd mechanismus jako u amlodipinu; \u010dast\u011bj\u0161\u00ed u nifedipinu ve vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch. Hyperplazie d\u00e1sn\u00ed je zn\u00e1m\u00e1 dlouhodob\u00e1 komplikace (10-15 % po 2+ letech); dodr\u017eujte d\u016fslednou \u00fastn\u00ed hygienu a pl\u00e1nujte zubn\u00ed prohl\u00eddky.<\/li>\n<li>N\u00e1valy horka (teplo v obli\u010deji a horn\u00ed \u010d\u00e1sti t\u011bla)<\/li>\n<li>Bolest hlavy (zejm\u00e9na na za\u010d\u00e1tku terapie; obvykle se p\u0159izp\u016fsob\u00ed b\u011bhem 2-4 t\u00fddn\u016f)<\/li>\n<li>Reflexn\u00ed tachykardie (palpitace) \u2014 m\u00e9n\u011b \u010dast\u00e1 u dlouhodob\u011b p\u016fsob\u00edc\u00edch forem<\/li>\n<li>Z\u00e1vrat\u011b, ortostatick\u00e1 hypotenze<\/li>\n<li>\u00danava<\/li>\n<li>M\u00edrn\u00e1 z\u00e1cpa (m\u00e9n\u011b ne\u017e u ne-DHP)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Hyperplazie d\u00e1sn\u00ed<\/strong> (nadm\u011brn\u00fd r\u016fst d\u00e1sn\u00ed) \u2014 u 10-15 % dlouhodob\u00fdch u\u017eivatel\u016f; dodr\u017eujte d\u016fslednou \u00fastn\u00ed hygienu a pl\u00e1nujte zubn\u00ed prohl\u00eddky ka\u017ed\u00fdch 6 m\u011bs\u00edc\u016f<\/li>\n<li>Vyr\u00e1\u017eka, sv\u011bd\u011bn\u00ed<\/li>\n<li>Nevolnost, b\u0159i\u0161n\u00ed dyskomfort<\/li>\n<li>Erektiln\u00ed dysfunkce (vz\u00e1cn\u011b)<\/li>\n<li>Zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f (obvykle m\u00edrn\u00e9, reverzibiln\u00ed)<\/li>\n<li>Vz\u00e1cn\u00e9 hl\u00e1\u0161en\u00e9 p\u0159\u00edpady fotosenzitivity<\/li>\n<\/ul>\n<p><strong>Historick\u00e9 varov\u00e1n\u00ed:<\/strong> kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00ed (s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm) nifedipinov\u00e9 kapsle, zejm\u00e9na p\u0159i sublingv\u00e1ln\u00edm pod\u00e1n\u00ed pro \u201chypertenzn\u00ed urgentn\u00ed stav\u201d, byly v 90. letech spojov\u00e1ny s infarktem myokardu a zv\u00fd\u0161en\u00edm mortality (Psaty 1995). Modern\u00ed praxe v\u00fdhradn\u011b pou\u017e\u00edv\u00e1 ER (Retard\/MR\/CC\/XL\/OROS) formulace pro chronickou hypertenzi. Nikdy nedr\u0165te ani neotev\u00edrejte ER kapsli, abyste vytvo\u0159ili IR d\u00e1vku.<\/p>\n<h2 class=\"wp-block-heading\">Kontraindikace a upozorn\u011bn\u00ed<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na nifedipin nebo t\u0159\u00eddu dihydropyridin\u016f<\/li>\n<li>Kardiogenn\u00ed \u0161ok<\/li>\n<li>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za (m\u016f\u017ee zp\u016fsobit kritickou hypotenzi)<\/li>\n<li>Nestabiln\u00ed angina pectoris nebo infarkt myokardu do 1 m\u011bs\u00edce (DHP krom\u011b amlodipinu)<\/li>\n<li>Obstruk\u010dn\u00ed hypertrofick\u00e1 kardiomyopatie (dynamicky sni\u017euje v\u00fdtokov\u00fd gradient)<\/li>\n<li>T\u011b\u017ek\u00e9 po\u0161kozen\u00ed jater (v\u0161echny DHP jsou metabolizov\u00e1ny j\u00e1try)<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> nifedipin MR je <strong>bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed<\/strong> a je l\u00e9kem prvn\u00ed nebo druh\u00e9 volby pro gesta\u010dn\u00ed hypertenzi a preeklampsii spolu s <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a> a methyldopou. Pou\u017e\u00edv\u00e1 se tak\u00e9 off-label pro tokol\u00fdzu p\u0159i p\u0159ed\u010dasn\u00e9m porodu.<\/p>\n<p><strong>Kojen\u00ed:<\/strong> mal\u00e9 mno\u017estv\u00ed v mate\u0159sk\u00e9m ml\u00e9ce; obecn\u011b pova\u017eov\u00e1no za p\u0159ijateln\u00e9 s monitorov\u00e1n\u00edm kojence.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/strong> \u2014 inhibuje metabolismus CYP3A4; m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny amlodipinu a zejm\u00e9na nifedipinu\/nimodipinu 2\u20133\u00d7. Vyvarujte se u\u017e\u00edv\u00e1n\u00ed v l\u00e9\u010debn\u00e9 dny, nebo u\u017e\u00edvejte konzistentn\u011b, pokud v\u016fbec.<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (ketokonazol, itrakonazol, klarithromycin, ritonavir, kobicistat) \u2014 zvy\u0161uj\u00ed plazmatick\u00e9 hladiny BKK; sni\u017ete d\u00e1vku nebo se vyhn\u011bte<\/li>\n<li><strong>Siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1) \u2014 sni\u017euj\u00ed plazmatick\u00e9 hladiny BKK; m\u016f\u017ee b\u00fdt nutn\u00e9 zv\u00fd\u0161it d\u00e1vku<\/li>\n<li><strong>Simvastatin<\/strong> \u2014 amlodipin m\u00edrn\u011b zvy\u0161uje expozici simvastatinu; omezte simvastatin na 20 mg\/den p\u0159i kombinaci<\/li>\n<li><strong>Beta-blok\u00e1tory<\/strong> \u2014 DHP lze kombinovat <strong>bezpe\u010dn\u011b<\/strong> s betablok\u00e1tory (kombinace je standardem u anginy pectoris \u2014 betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii, BKK zaji\u0161\u0165uje vazodilataci). Na rozd\u00edl od ne-DHP BKK (diltiazem, verapamil), kter\u00e9 by se s betablok\u00e1tory NEM\u011aLY kombinovat.<\/li>\n<li><strong>Jin\u00e1 antihypertenziva<\/strong> \u2014 obecn\u011b komplement\u00e1rn\u00ed; monitorujte TK<\/li>\n<li><strong>Sildenafil \/ tadalafil<\/strong> (Inhibitory PDE5 pro erektiln\u00ed dysfunkci) \u2014 aditivn\u00ed hypotenze; opatrnost zejm\u00e9na p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch CCB<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">P\u0159ehled t\u0159\u00eddy blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">CCB<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">T\u0159\u00edda<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Niche<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlodipin (Amlode, Amlip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (3. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Referen\u010dn\u00ed DHP; jednou denn\u011b pro hypertenzi a anginu pectoris; d\u016fkazy ze studie ASCOT<\/td>\n<\/tr>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/depin\/\">Nifedipin (Depin, Nicardia Retard, Cardipin)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (1. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed MR; tokol\u00fdza; pro chronickou hypertenzi nutno pou\u017e\u00edt ER formulace<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/nimodip-nimodipine\/\">Nimodipin (Nimodip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (cerebrovaskul\u00e1rn\u00ed)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevence vazospazmu p\u0159i subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed \u2014 NEPOU\u017d\u00cdVAT pro b\u011b\u017enou hypertenzi<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Diltiazem (Dilzem, Dilzem CD)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (benzothiazepin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HTN + kontrola srde\u010dn\u00ed frekvence + angina; st\u0159edn\u00ed srde\u010dn\u00ed \u00fa\u010dinek<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">Verapamil (Calaptin 40, Calaptin SR)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (fenylalkylamin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Nejsiln\u011bj\u0161\u00ed srde\u010dn\u00ed \u00fa\u010dinek; SVT, kontrola frekvence p\u0159i AF, cluster headache<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>DHP vs non-DHP \u2014 pro\u010d na tom z\u00e1le\u017e\u00ed:<\/strong> DHP (amlodipin, nifedipin) selektivn\u011b p\u016fsob\u00ed na arteri\u00e1ln\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm srde\u010dn\u00edm \u00fa\u010dinkem \u2014 lze bezpe\u010dn\u011b kombinovat s betablok\u00e1tory. Non-DHP (diltiazem, verapamil) zpomaluj\u00ed AV nod\u00e1ln\u00ed veden\u00ed a sni\u017euj\u00ed srde\u010dn\u00ed kontraktilitu \u2014 <strong>NEKOMBINUJTE s betablok\u00e1tory<\/strong> (riziko aditivn\u00ed bradykardie, srde\u010dn\u00edho bloku a akutn\u00edho srde\u010dn\u00edho selh\u00e1n\u00ed). Pokud pacient ji\u017e u\u017e\u00edv\u00e1 betablok\u00e1tor, pou\u017eijte DHP.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Depin Retard p\u0159i teplot\u011b do 25\u00b0C. Chra\u0148te p\u0159ed sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d mi po u\u017e\u00edv\u00e1n\u00ed Depin Retard ot\u00e9kaj\u00ed kotn\u00edky?<\/h3>\n<p><strong>Perifern\u00ed ed\u00e9m je t\u0159\u00eddn\u00edm \u00fa\u010dinkem dihydropyridin\u016f<\/strong>, zp\u016fsoben\u00fdm prekapil\u00e1rn\u00ed arteriol\u00e1rn\u00ed dilatac\u00ed, kter\u00e1 zvy\u0161uje hydrostatick\u00fd tlak v venul\u00e1ch doln\u00edch kon\u010detin. NEN\u00cd to <strong>p\u0159et\u00ed\u017een\u00ed tekutinami<\/strong> a NEREAGUJE na diuretika. Mo\u017enosti \u0159e\u0161en\u00ed: (1) sn\u00ed\u017eit d\u00e1vku BKK; (2) <strong>p\u0159idejte ACE inhibitor nebo ARB<\/strong> kter\u00fd vyrovn\u00e1v\u00e1 pre- a postkapil\u00e1rn\u00ed vazodilataci a eliminuje mechanismus vzniku otok\u016f (\u010dasto preferovan\u00e9 \u0159e\u0161en\u00ed); (3) p\u0159ejd\u011bte na ne-DHP BKK (diltiazem, verapamil), pokud jsou p\u0159ijateln\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky souvisej\u00edc\u00ed s frekvenc\u00ed; (4) elevace nohou a kompresn\u00ed pun\u010dochy jako dopl\u0148kov\u00e1 opat\u0159en\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Za jak dlouho Depin Retard sn\u00ed\u017e\u00ed krevn\u00ed tlak?<\/h3>\n<p>ER\/Retard nifedipin: znateln\u00fd pokles TK b\u011bhem 1-4 hodin; pln\u00fd \u00fa\u010dinek za 1-2 t\u00fddny.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Depin Retard s betablok\u00e1tory?<\/h3>\n<p><strong>Ano \u2013 DHP lze bezpe\u010dn\u011b kombinovat s betablok\u00e1tory.<\/strong> Tato kombinace je standardem u anginy pectoris: DHP zp\u016fsobuje vazodilataci a sni\u017euje spot\u0159ebu kysl\u00edku myokardem; betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii. To se li\u0161\u00ed od ne-DHP BKK (,), kter\u00e9 by se s betablok\u00e1tory NEM\u011aLY kombinovat kv\u016fli riziku aditivn\u00ed bradykardie a srde\u010dn\u00edho bloku.<a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">verapamil<\/a>Mohu j\u00edst grapefruit p\u0159i u\u017e\u00edv\u00e1n\u00ed Amlopresu?.<\/p>\n<h3 class=\"wp-block-heading\">Mohu j\u00edst grapefruit p\u0159i u\u017e\u00edv\u00e1n\u00ed Depin Retard?<\/h3>\n<p>Grapefruit (\u0161\u0165\u00e1va i \u010derstv\u00e9 ovoce) inhibuje metabolismus CYP3A4 a m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny nifedipinu 2-3\u00d7, co\u017e zvy\u0161uje riziko hypotenze, z\u00e1vrat\u00ed a otok\u016f. Doporu\u010den\u00fd postup: vyhn\u011bte se grapefruitu\/\u0161\u0165\u00e1v\u011b p\u0159i u\u017e\u00edv\u00e1n\u00ed blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f, nebo konzumujte konzistentn\u011b (va\u0161e d\u00e1vka je titrov\u00e1na podle reakce TK; ob\u010dasn\u00e1 konzumace grapefruitu to naru\u0161uje).<\/p>\n<h3 class=\"wp-block-heading\">Je Depin Retard bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n<p><strong>Nifedipin MR je v t\u011bhotenstv\u00ed bezpe\u010dn\u00fd<\/strong> a je l\u00e9kem prvn\u00ed nebo druh\u00e9 volby p\u0159i hypertenzi v t\u011bhotenstv\u00ed spolu s <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a> a methyldopou. Pou\u017e\u00edv\u00e1 se tak\u00e9 off-label k odd\u00e1len\u00ed p\u0159ed\u010dasn\u00e9ho porodu (tokol\u00fdza).<\/p>\n<h3 class=\"wp-block-heading\">Mohu kombinovat Depin Retard s dal\u0161\u00edmi l\u00e9ky na tlak?<\/h3>\n<p>Ano \u2014 DHP blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se dob\u0159e kombinuj\u00ed s <strong>ACE inhibitory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">ramipril<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/lispro\/\">lisinoprilem<\/a>), <strong>sartany<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/olmin\/\">olmesartan<\/a>), <strong>beta-blok\u00e1tory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/betablock-xl\/\">metoprolol<\/a>), a <strong>thiazidov\u00fdmi diuretiky<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">HCTZ<\/a>). Kombinace ACE inhibitoru\/sartanu + blok\u00e1toru kalciov\u00fdch kan\u00e1l\u016f je obzvl\u00e1\u0161t\u011b u\u017eite\u010dn\u00e1, proto\u017ee eliminuje vedlej\u0161\u00ed \u00fa\u010dinek v podob\u011b otoku kotn\u00edk\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d bych nem\u011bl pou\u017e\u00edvat nifedipin s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm pro chronickou hypertenzi?<\/h3>\n<p>Kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00ed (s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm) nifedipin zp\u016fsobuje <strong>rychl\u00fd pokles TK s reflexn\u00ed sympatickou aktivac\u00ed<\/strong> \u2014 tachykardii a vzestup sympatick\u00e9ho tonu, kter\u00fd byl v n\u011bkter\u00fdch observa\u010dn\u00edch studi\u00edch z 90. let spojov\u00e1n s infarktem myokardu a zv\u00fd\u0161enou mortalitou. Formy s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (Retard, MR, CC, XL, OROS) dod\u00e1vaj\u00ed stejnou celkovou denn\u00ed d\u00e1vku b\u011bhem 24 hodin s plynul\u00fdm plazmatick\u00fdm profilem a tento probl\u00e9m nemaj\u00ed. <strong>Pro chronickou hypertenzi v\u017edy pou\u017e\u00edvejte nifedipin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong>, nikdy IR kapsle.<\/p>\n<h3 class=\"wp-block-heading\">Kde mohu koupit Depin Retard online?<\/h3>\n<p>Depin Retard (nifedipin 20 mg, 30-90 tablet) m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlode \u2014 Amlodipin 5\/10 mg (DHP blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">Calaptin 40 \u2014 Verapamil IR 40 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/concor\/\">Concor \u2014 beta-blok\u00e1tor bisoprolol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Dilzem \u2014 Diltiazem IR 30\/60 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">Nicardia Retard \u2014 Nifedipin retard 10\/20\/30 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nimodip-nimodipine\/\">Nimodip \u2014 Nimodipin (subarachnoid\u00e1ln\u00ed krv\u00e1cen\u00ed)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Depin Retard je prvn\u00ed generace blok\u00e1toru kalciov\u00fdch kan\u00e1l\u016f.<\/p>","protected":false},"featured_media":51672,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3391,3390],"class_list":{"0":"post-51671","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-depin-retard","11":"product_tag-nifedipine","13":"first","14":"outofstock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51671","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51671"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51672"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51671"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51671"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51671"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51671"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}