{"id":51897,"date":"2023-09-20T09:26:33","date_gmt":"2023-09-20T09:26:33","guid":{"rendered":"https:\/\/medsname.com\/nicardia-retard\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"nicardia-retard","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/nicardia-retard\/","title":{"rendered":"Nicardia 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 R\u0103spuns rapid \u2014 Ce este Nicardia Retard?<\/h3>\n<p style=\"margin:0;\"><strong>Nicardia Retard<\/strong> este un <strong>10\/20\/30 mg comprimate retard de nifedipin\u0103<\/strong> de la J B Chemicals \u2014 un blocant al canalelor de calciu dihidropiridinic de prima genera\u021bie (CCB). Introdus \u00een 1981 (Bayer sub denumirea <strong>Adalat \/ Procardia<\/strong>) \u2014 primul BCC dihidropiridin\u0103. Nifedipina cu eliberare imediat\u0103 de scurt\u0103 ac\u021biune a st\u00e2rnit controverse \u00een anii 1990 dup\u0103 rapoarte de infarct miocardic \u0219i cre\u0219tere a mortalit\u0103\u021bii cu formul\u0103ri sublinguale\/de ac\u021biune rapid\u0103; practica modern\u0103 utilizeaz\u0103 <strong>formul\u0103ri cu eliberare prelungit\u0103 (Retard, MR, CC, XL, OROS)<\/strong> exclusiv pentru hipertensiunea cronic\u0103. Timpul de \u00eenjum\u0103t\u0103\u021bire plasmatic\u0103 la eliberare imediat\u0103 ~2-5 ore; Retard\/MR\/CC\/XL ~20-24 de ore. <strong>Utiliza\u021bi EXCLUSIV nifedipin\u0103 cu eliberare prelungit\u0103 (Retard, MR, CC, XL, OROS, GITS) pentru hipertensiunea cronic\u0103.<\/strong> Nifedipina sublingual\u0103 sau zdrobit\u0103 cu eliberare imediat\u0103 este contraindicat\u0103 pentru controlul cronic al tensiunii arteriale \u2014 provoac\u0103 sc\u0103deri rapide ale TA cu activare simpatic\u0103 reflex\u0103, tahicardie \u0219i, \u00een unele studii, infarct miocardic sau mortalitate. Formul\u0103rile cu eliberare prelungit\u0103 (ER) evit\u0103 aceste probleme prin oferirea unui profil plasmatic uniform pe 24 de ore. Doz\u0103 tipic\u0103 pentru hipertensiune: <strong>Retard 20 mg de dou\u0103 ori pe zi SAU CC\/XL 30 mg o dat\u0103 pe zi<\/strong>; \u021bint\u0103 Retard 20-30 mg de dou\u0103 ori pe zi SAU CC\/XL 30-60 mg o dat\u0103 pe zi. Efecte secundare principale: edem periferic (la nivelul gleznelor), ro\u0219ea\u021b\u0103, cefalee datorit\u0103 vasodilata\u021biei, tahicardie reflex\u0103 (amortizat\u0103 de semivia\u021ba lung\u0103 a amlodipinei; frecvent\u0103 cu nifedipina IR). Sigur de combinat cu beta-blocante, inhibitori ACE, BRA \u0219i tiazide (spre deosebire de CCB non-DHP). Sarcina: nifedipina MR este sigur\u0103 \u00een sarcin\u0103 \u0219i adesea de prim\u0103 inten\u021bie; amlodipina este o op\u021biune rezonabil\u0103 secundar\u0103.<\/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>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Nicardia Retard?<\/h2>\n<p>Nicardia Retard este un comprimat retard de nifedipin\u0103 10\/20\/30 mg retard de la J B Chemicals, furnizat \u00een cutii de 30-180 de comprimate. Introdus \u00een 1981 (Bayer sub denumirea <strong>Adalat \/ Procardia<\/strong>) \u2014 primul BCC dihidropiridin\u0103. Nifedipina cu eliberare imediat\u0103 de scurt\u0103 ac\u021biune a st\u00e2rnit controverse \u00een anii 1990 dup\u0103 rapoarte de infarct miocardic \u0219i cre\u0219tere a mortalit\u0103\u021bii cu formul\u0103ri sublinguale\/de ac\u021biune rapid\u0103; practica modern\u0103 utilizeaz\u0103 <strong>formul\u0103ri cu eliberare prelungit\u0103 (Retard, MR, CC, XL, OROS)<\/strong> formul\u0103ri exclusive pentru hipertensiunea cronic\u0103.<\/p>\n<p>Nifedipina apar\u021bine clasei <strong>blocan\u021bilor dihidropiridinici ai canalelor de calciu<\/strong> diferit\u0103 de non-dihidropiridinele (<a href=\"https:\/\/medsbase.com\/ro\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/calaptin-40\/\">verapamil<\/a>) prin ac\u021biunea sa <strong>selectiv\u0103 asupra mu\u0219chilor netezi vasculari, cu un efect cardiac direct minim<\/strong>. Acest profil de selectivitate este important din punct de vedere clinic: DHPs pot fi combinate \u00een siguran\u021b\u0103 cu beta-blocante (combina\u021bia este standard \u00een angina pectoris), \u00een timp ce non-DHPs nu pot (risc adi\u021bional de bradicardie\/bloc cardiac).<\/p>\n<h2 class=\"wp-block-heading\">Cum ac\u021bioneaz\u0103 nifedipina<\/h2>\n<p>Blocatorii canalelor de calciu se leag\u0103 de canalele de calciu tip L dependente de voltaj \u0219i reduc intrarea de calciu \u00een celul\u0103 \u00een timpul depolariz\u0103rii. \u00cen <strong>mu\u0219chiul neted arterial<\/strong>, reducerea intr\u0103rii de calciu \u00eenseamn\u0103 o interac\u021biune actin-miozin\u0103 mai mic\u0103 \u0219i <strong>vasodilata\u021bie arterial\u0103 direct\u0103<\/strong> \u2014 sc\u0103z\u00e2nd rezisten\u021ba vascular\u0103 sistemic\u0103 \u0219i tensiunea arterial\u0103.<\/p>\n<p>Dihidropiridinele sunt de ~10 ori mai potente pe mu\u0219chiul neted vascular dec\u00e2t pe mu\u0219chiul cardiac \u2014 astfel, efectul clinic dominant este vasodilata\u021bia, cu o suprimare minim\u0103 direct\u0103 a contractilit\u0103\u021bii sau conduc\u021biei cardiace. Baroreflexul corpului poate declan\u0219a o u\u0219oar\u0103 tahicardie reflex\u0103 dup\u0103 vasodilata\u021bia cu debut rapid; aceasta este problema cu nifedipina cu ac\u021biune scurt\u0103 care a condus la controversa din anii 1990 \u2014 formul\u0103rile moderne ER o elimin\u0103 prin debutul lent \u0219i uniform.<\/p>\n<p>Debutul efectului clinic: Retard 1-4 ore; efect complet asupra TA la 1-2 s\u0103pt\u0103m\u00e2ni.<\/p>\n<h2 class=\"wp-block-heading\">Utiliz\u0103ri aprobate \u0219i bazate pe dovezi<\/h2>\n<ul>\n<li><strong>Hipertensiune arterial\u0103<\/strong> \u2014 Doar formularea Retard \/ CC \/ XL<\/li>\n<li><strong>Hipertensiune arterial\u0103 \u00een sarcin\u0103<\/strong> \u2014 Retard\/MR este de prim\u0103 sau a doua inten\u021bie al\u0103turi de <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a> \u0219i metildopa<\/li>\n<li><strong>Tocoliz\u0103 \u00een na\u0219terea prematur\u0103<\/strong> (off-label dar utilizat pe scar\u0103 larg\u0103) \u2014 relaxeaz\u0103 mu\u0219chiul neted uterin<\/li>\n<li><strong>Angin\u0103 Prinzmetal\/vasospastic\u0103<\/strong><\/li>\n<li><strong>Fenomenul Raynaud<\/strong><\/li>\n<li><strong>Angin\u0103 cronic\u0103 stabil\u0103<\/strong> \u2014 adesea combinat cu un beta-blocant (beta-blocantul atenueaz\u0103 tahicardia reflex\u0103)<\/li>\n<\/ul>\n<p><strong>Dovezile din studiile pivotale:<\/strong> <strong>INSIGHT (2000)<\/strong> \u2014 nifedipina GITS nu a fost inferioar\u0103 co-amilozidei \u00een ceea ce prive\u0219te evenimentele cardiovasculare la pacien\u021bii cu HTA. <strong>ACTION (2004)<\/strong> \u2014 nifedipina GITS ad\u0103ugat\u0103 la terapia standard pentru angin\u0103 a redus necesitatea de proceduri coronariene.<\/p>\n<h2 class=\"wp-block-heading\">Dozaj Nicardia Retard<\/h2>\n<p><strong>Hipertensiune arterial\u0103:<\/strong><\/p>\n<ul>\n<li><strong>Doza ini\u021bial\u0103:<\/strong> Retard 20 mg de dou\u0103 ori pe zi SAU CC\/XL 30 mg o dat\u0103 pe zi<\/li>\n<li><strong>Doza \u021bint\u0103:<\/strong> Retard 20-30 mg de dou\u0103 ori pe zi SAU CC\/XL 30-60 mg o dat\u0103 pe zi<\/li>\n<li><strong>Maximum:<\/strong> Retard 60 mg de dou\u0103 ori pe zi SAU CC\/XL 90 mg o dat\u0103 pe zi<\/li>\n<li>Titra\u021bi la fiecare 1-2 s\u0103pt\u0103m\u00e2ni \u00een func\u021bie de r\u0103spunsul tensiunii arteriale \u0219i tolerabilitate (\u00een special edem)<\/li>\n<\/ul>\n<p><strong>Angin\u0103:<\/strong> Retard 20-40 mg de dou\u0103 ori pe zi<\/p>\n<p><strong>Administrare:<\/strong> o dat\u0103 pe zi (sau de dou\u0103 ori pe zi pentru formul\u0103rile IR de nifedipin\u0103). \u00cenghi\u021bi\u021bi comprimatul \u00eentreg \u2014 nu-l zdrobi\u021bi sau nu-l desp\u0103r\u021bi\u021bi formul\u0103rile cu eliberare prelungit\u0103 (administreaz\u0103 o doz\u0103 IR cu risc de hipotensiune). Lua\u021bi cu sau f\u0103r\u0103 m\u00e2ncare.<\/p>\n<p><strong>\u00centrerupere:<\/strong> nu exist\u0103 un sindrom de sevraj specific; poate fi oprit\u0103 f\u0103r\u0103 reducere treptat\u0103. Tensiunea arterial\u0103 se va \u00eentoarce la nivelurile pre-tratament \u00een 1-2 s\u0103pt\u0103m\u00e2ni.<\/p>\n<h2 class=\"wp-block-heading\">Efecte Secundare<\/h2>\n<p><strong>Frecvente (&gt;5%, \u00een mare parte u\u0219oare \u0219i tranzitorii):<\/strong><\/p>\n<ul>\n<li><strong>Edem periferic (glezn\u0103)<\/strong> \u2014 Edem periferic (la nivelul gleznelor) \u2014 mecanism similar cu cel al amlodipinei; mai frecvent la doze mari de nifedipin\u0103. Hiperplazia gingival\u0103 este o complica\u021bie recunoscut\u0103 pe termen lung (10-15% dup\u0103 2+ ani); men\u021bine\u021bi o igien\u0103 oral\u0103 meticuloas\u0103 \u0219i programa\u021bi vizite dentare regulate.<\/li>\n<li>Rubor (febre facial\u0103 \u0219i a p\u0103r\u021bii superioare a corpului)<\/li>\n<li>Cefalee (\u00een special la \u00eenceputul terapiei; de obicei se atenueaz\u0103 \u00een 2-4 s\u0103pt\u0103m\u00e2ni)<\/li>\n<li>Tahicardie reflex\u0103 (palpita\u021bii) \u2014 mai pu\u021bin frecvent\u0103 la formul\u0103rile cu eliberare prelungit\u0103<\/li>\n<li>Ame\u021beli, hipotensiune postural\u0103<\/li>\n<li>Oboseal\u0103<\/li>\n<li>Constipa\u021bie u\u0219oar\u0103 (mai pu\u021bin frecvent\u0103 dec\u00e2t la CCB non-DHP)<\/li>\n<\/ul>\n<p><strong>Mai pu\u021bin frecvente:<\/strong><\/p>\n<ul>\n<li><strong>Hiperplazie gingival\u0103<\/strong> (cre\u0219tere excesiv\u0103 a gingiilor) \u2014 10-15% dintre utilizatorii pe termen lung; practica\u021bi o igien\u0103 oral\u0103 meticuloas\u0103 \u0219i programa\u021bi controale dentare la fiecare 6 luni<\/li>\n<li>Erup\u021bie cutanat\u0103, prurit<\/li>\n<li>Grea\u021b\u0103, disconfort abdominal<\/li>\n<li>Disfunc\u021bie erectil\u0103 (rar\u0103)<\/li>\n<li>Cre\u0219teri ale enzimelor hepatice (de obicei u\u0219oare, reversibile)<\/li>\n<li>Rapoarte rare de fotosensibilitate<\/li>\n<\/ul>\n<p><strong>Avertisment istoric:<\/strong> capsulele de nifedipin\u0103 cu ac\u021biune rapid\u0103 (eliberare imediat\u0103), \u00een special atunci c\u00e2nd sunt utilizate sublingual pentru \u201curgen\u021b\u0103 hipertensiv\u0103\u201d, au fost asociate cu infarct miocardic \u0219i cre\u0219tere a mortalit\u0103\u021bii \u00een anii 1990 (Psaty 1995). Practica modern\u0103 utilizeaz\u0103 exclusiv formul\u0103rile cu eliberare prelungit\u0103 (Retard\/MR\/CC\/XL\/OROS) pentru hipertensiunea arterial\u0103 cronic\u0103. Nu zdrobi\u021bi sau deschide\u021bi niciodat\u0103 o capsul\u0103 cu eliberare prelungit\u0103 pentru a ob\u021bine o doz\u0103 cu eliberare imediat\u0103.<\/p>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii \u0219i precau\u021bii<\/h2>\n<ul>\n<li>Hipersensibilitate cunoscut\u0103 la nifedipin\u0103 sau clasa dihidropiridinic\u0103<\/li>\n<li>\u0218oc cardiogen<\/li>\n<li>Stenoaz\u0103 aortic\u0103 sever\u0103 (poate provoca hipotensiune critic\u0103)<\/li>\n<li>Angin\u0103 instabil\u0103 sau infarct miocardic \u00een ultima lun\u0103 (DHP-uri \u00een afar\u0103 de amlodipin\u0103)<\/li>\n<li>Cardiomiopatie hipertrofic\u0103 obstructiv\u0103 (reduce gradientul de ejectie dinamic)<\/li>\n<li>Insuficien\u021b\u0103 hepatic\u0103 sever\u0103 (toate DHP-urile sunt metabolizate hepatic)<\/li>\n<\/ul>\n<p><strong>Sarcina:<\/strong> nifedipina MR este <strong>sigur\u0103 \u00een sarcin\u0103<\/strong> \u0219i este de prim\u0103 sau a doua linie pentru hipertensiunea gesta\u021bional\u0103 \u0219i preeclampsie, al\u0103turi de <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a> \u0219i metildopa. De asemenea, utilizat\u0103 off-label pentru toc\u00f3liza \u00een cazul travaliului prematur.<\/p>\n<p><strong>Al\u0103ptarea:<\/strong> cantit\u0103\u021bi mici \u00een laptele matern; considerat\u0103 \u00een general acceptabil\u0103 cu monitorizarea sugarului.<\/p>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Suc de grapefruit<\/strong> \u2014 inhib\u0103 metabolismul CYP3A4; poate cre\u0219te nivelul plasmatic al amlodipinei \u0219i \u00een special al nifedipinei\/nimodipinei de 2-3 ori. Evita\u021bi \u00een zilele de tratament sau folosi\u021bi consecvent dac\u0103 este cazul.<\/li>\n<li><strong>Inhibitori puternici ai CYP3A4<\/strong> (ketoconazol, itraconazol, claritromicin\u0103, ritonavir, cobicistat) \u2014 cresc nivelurile plasmatice ale BCC; reduce\u021bi doza sau evita\u021bi<\/li>\n<li><strong>Inductori puternici ai CYP3A4<\/strong> (rifampicin\u0103, fenitoin\u0103, carbamazepin\u0103, iarba Sf\u00e2ntului Ioan) \u2014 reduc nivelurile plasmatice ale BCC; poate fi necesar\u0103 cre\u0219terea dozei<\/li>\n<li><strong>Simvastatin\u0103<\/strong> \u2014 amlodipina cre\u0219te moderat expunerea la simvastatin\u0103; limita\u021bi simvastatina la 20 mg\/zi \u00een combina\u021bie<\/li>\n<li><strong>Beta-blocante<\/strong> \u2014 DHP-urile se combin\u0103 <strong>\u00een siguran\u021b\u0103<\/strong> cu beta-blocante (combina\u021bia este standard \u00een angina pectoral\u0103 \u2014 beta-blocantul atenueaz\u0103 tahicardia reflex\u0103, iar BCC ofer\u0103 vasodilata\u021bie). Distinct de BCC non-DHP (diltiazem, verapamil) care NU trebuie combinate cu beta-blocante.<\/li>\n<li><strong>Alte antihipertensive<\/strong> \u2014 \u00een general complementare; monitoriza\u021bi TA<\/li>\n<li><strong>Sildenafil \/ tadalafil<\/strong> (inhibitori PDE5 pentru disfunc\u021bie erectil\u0103) \u2014 hipotensiune aditiv\u0103; precau\u021bie mai ales la doze mari de BCC<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Clasa Blocatoarelor de Canale de Calciu pe scurt<\/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;\">BCC<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Clas\u0103<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Nis\u0103<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">Amlodipin\u0103 (Amlode, Amlip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (genera\u021bia a 3-a)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">BCC de referin\u021b\u0103; o dat\u0103 pe zi pentru HTA + angin\u0103; dovezi din studiul ASCOT<\/td>\n<\/tr>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/depin\/\">Nifedipin\u0103 (Depin, Nicardia Retard, Cardipin)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (genera\u021bia 1-a)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sigur \u00een sarcin\u0103 cu formulare cu eliberare modificat\u0103; tocoliz\u0103; trebuie utilizate formulare cu eliberare prelungit\u0103 pentru HTA cronic\u0103<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/nimodip-nimodipine\/\">Nimodipin\u0103 (Nimodip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (cerebrovascular)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevenirea vasospasmului \u00een hemoragia subarahnoidian\u0103 \u2014 NU pentru hipertensiune arterial\u0103 de rutin\u0103<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/dilzem\/\">Diltiazem (Dilzem, Dilzem CD)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (benzotiazepin\u0103)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Hipertensiune + controlul frecven\u021bei cardiace + angin\u0103; efect cardiac moderat<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/calaptin-40\/\">Verapamil (Calaptin 40, Calaptin SR)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (fenilalchilamin\u0103)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Cel mai puternic efect cardiac; tahicardie supraventricular\u0103, controlul frecven\u021bei \u00een fibrila\u021bia atrial\u0103, cefalee \u00een cluster<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>DHP vs non-DHP \u2014 de ce conteaz\u0103:<\/strong> DHP-urile (amlodipina, nifedipina) ac\u021bioneaz\u0103 selectiv pe mu\u0219chiul neted arterial cu efect cardiac minimal \u2014 pot fi combinate \u00een siguran\u021b\u0103 cu beta-blocante. Non-DHP-urile (diltiazemul, verapamilul) \u00eencetinesc conduc\u021bia nodal\u0103 AV \u0219i reduc contractilitatea cardiac\u0103 \u2014 <strong>NU combina\u021bi cu beta-blocante<\/strong> (risc aditiv de bradicardie, bloc cardiac, insuficien\u021b\u0103 cardiac\u0103 acut\u0103). Dac\u0103 pacientul dumneavoastr\u0103 ia deja un beta-blocant, utiliza\u021bi un DHP.<\/p>\n<h2 class=\"wp-block-heading\">Depozitare<\/h2>\n<p>P\u0103stra\u021bi Nicardia Retard la temperaturi sub 25\u00b0C. Proteja\u021bi de lumin\u0103. Depozita\u021bi \u00een afara reach-ului copiilor.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">De ce mi s-au umflat gleznele dup\u0103 ce am luat Nicardia Retard?<\/h3>\n<p><strong>Edemul periferic este un efect de clas\u0103 al dihidropiridinelor<\/strong>, cauzat de dilatarea arteriolelor precapilare care cre\u0219te presiunea hidrostatic\u0103 \u00een venulele membrelor inferioare. Acesta este <strong>NU este reten\u021bie de lichide<\/strong> \u0219i NU r\u0103spunde la diuretice. Op\u021biuni de management: (1) reduce\u021bi doza de CCB; (2) <strong>ad\u0103uga\u021bi un inhibitor ACE sau ARB<\/strong> care echilibreaz\u0103 vasodilata\u021bia pre- \u0219i postcapilar\u0103 \u0219i elimin\u0103 mecanismul edemului (adesea solu\u021bia preferat\u0103); (3) trece\u021bi la un CCB non-DHP (diltiazem, verapamil) dac\u0103 efectele secundare legate de frecven\u021b\u0103 sunt acceptabile; (4) ridicarea picioarelor \u0219i folosirea ciorapilor de compresie ca m\u0103suri adjuncte.<\/p>\n<h3 class=\"wp-block-heading\">C\u00e2t timp \u00eei ia Nicardia Retard s\u0103 scad\u0103 tensiunea arterial\u0103?<\/h3>\n<p>Nifedipin\u0103 ER\/Retard: sc\u0103dere observabil\u0103 a tensiunii arteriale \u00een 1-4 ore; efect complet la 1-2 s\u0103pt\u0103m\u00e2ni.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Nicardia Retard \u00eempreun\u0103 cu un beta-blocant?<\/h3>\n<p><strong>Da \u2014 DHP-urile se pot combina \u00een siguran\u021b\u0103 cu beta-blocantele.<\/strong> Aceast\u0103 combina\u021bie este standard \u00een angina pectoral\u0103: DHP-ul vasodilateaz\u0103 \u0219i reduce cerin\u021ba de oxigen miocardic; beta-blocantul atenueaz\u0103 tahicardia reflex\u0103. Aceasta este diferit\u0103 de CCB-urile non-DHP (<a href=\"https:\/\/medsbase.com\/ro\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/calaptin-40\/\">verapamil<\/a>) care NU trebuie combinat cu beta-blocante din cauza riscului aditiv de bradicardie \u0219i bloc cardiac.<\/p>\n<h3 class=\"wp-block-heading\">Pot m\u00e2nca grapefruit dac\u0103 iau Nicardia Retard?<\/h3>\n<p>Grapefruitul (sucul \u0219i fructul proasp\u0103t) inhib\u0103 metabolismul CYP3A4 \u0219i poate cre\u0219te nivelul plasmatic al nifedipinei de 2-3 ori, cresc\u00e2nd riscul de hipotensiune, ame\u021beli \u0219i edem. Cel mai bine: evita\u021bi grapefruitul\/sucul \u00een timpul tratamentului cu BCC (blocante ale canalelor de calciu), sau consuma\u021bi-l constant (doza este ajustat\u0103 \u00een func\u021bie de r\u0103spunsul tensional; consumul sporadic de grapefruit perturb\u0103 acest echilibru).<\/p>\n<h3 class=\"wp-block-heading\">Este Nicardia Retard sigur \u00een timpul sarcinii?<\/h3>\n<p><strong>Nifedipina MR este sigur\u0103 \u00een sarcin\u0103<\/strong> \u0219i este antihipertensiv de prim\u0103 sau a doua linie \u00een sarcin\u0103 al\u0103turi de <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a> \u0219i metildopa. De asemenea, este utilizat\u0103 off-label pentru a am\u00e2na na\u0219terea prematur\u0103 (tocoliz\u0103).<\/p>\n<h3 class=\"wp-block-heading\">Pot combina Nicardia Retard cu alte medicamente pentru tensiune?<\/h3>\n<p>Da \u2014 BCC de tip DHP se combin\u0103 bine cu <strong>Inhibitori ACE<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/ramcor\/\">ramipril<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/lispro\/\">lisinopril<\/a>), <strong>BRA<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/olmin\/\">olmesartan<\/a>), <strong>beta-blocante<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/betablock-xl\/\">metoprolol<\/a>), \u0219i <strong>diuretice tiazidice<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/aquazide\/\">HCTZ<\/a>). Combina\u021bia ACEi\/ARB + CCB este deosebit de util\u0103 deoarece elimin\u0103 efectul secundar de edem la nivelul gleznelor.<\/p>\n<h3 class=\"wp-block-heading\">De ce nu ar trebui s\u0103 folosesc nifedipina cu eliberare imediat\u0103 pentru HTA cronic\u0103?<\/h3>\n<p>Nifedipina cu ac\u021biune scurt\u0103 (eliberare imediat\u0103) provoac\u0103 <strong>sc\u0103deri rapide ale tensiunii cu activare simpatic\u0103 reflex\u0103<\/strong> \u2014 tahicardie \u0219i o cre\u0219tere a tonusului simpatic care, \u00een unele studii observa\u021bionale din anii 1990, a fost asociat\u0103 cu infarct miocardic \u0219i cre\u0219tere a mortalit\u0103\u021bii. Formulele cu eliberare prelungit\u0103 (Retard, MR, CC, XL, OROS) administreaz\u0103 aceea\u0219i doz\u0103 zilnic\u0103 total\u0103 pe parcursul a 24 de ore, cu un profil plasmatic constant, \u0219i nu prezint\u0103 aceast\u0103 problem\u0103. <strong>Utiliza\u021bi \u00eentotdeauna nifedipin\u0103 cu eliberare prelungit\u0103 pentru hipertensiune arterial\u0103 cronic\u0103<\/strong>, niciodat\u0103 capsule cu eliberare imediat\u0103.<\/p>\n<h3 class=\"wp-block-heading\">Unde pot cump\u0103ra Nicardia Retard online?<\/h3>\n<p>Pute\u021bi cump\u0103ra Nicardia Retard (nifedipin\u0103 10\/20\/30 mg retard, 30-180 comprimate) de la MedsBase cu ambalaj discret \u0219i livrare la nivel mondial.<\/p>\n<h2 class=\"wp-block-heading\">Antihipertensive \u00eenrudite pe MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/amlip\/\">Amlip \u2014 Amlodipin\u0103 2,5\/5 mg (DHP CCB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">Amlode \u2014 Amlodipin\u0103 5\/10 mg (DHP CCB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/calaptin-sr\/\">Calaptin SR \u2014 Verapamil SR 120\/240 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/dilzem-cd\/\">Dilzem CD \u2014 Diltiazem CD 120\/180 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/losar\/\">Losar \u2014 Losartan (alternativ\u0103 ARB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/nimodip-nimodipine\/\">Nimodip \u2014 Nimodipin\u0103 (hemoragie subarahnoidian\u0103)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/high-blood-pressure-medication\/\"><strong>R\u0103sfoi\u021bi toate medicamentele pentru hipertensiune arterial\u0103<\/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 Dezaprobare medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui medic calificat. Hipertensiunea, insuficien\u021ba cardiac\u0103 \u0219i aritmiile necesit\u0103 diagnostic, monitorizare \u0219i individualizarea dozei de c\u0103tre un medic \u2014 utiliza\u021bi \u00eentotdeauna beta-blocante sub \u00eendrumare medical\u0103.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Alternative conexe<\/h3>\n<p>Alte produse din <strong>Afec\u021biuni cronice<\/strong> pe care clien\u021bii le vizualizeaz\u0103 de asemenea:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/pirox-dt\/\">Pirox DT<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/nebicard\/\">Nebicard<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/methycobal-injection\/\">Injectie Methycobal<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/glimith\/\">Glimith<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/keytruda\/\">Keytruda<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Nicardia Retard este nifedipin\u0103 retard 10\/20\/30 mg comprimate cu eliberare prelungit\u0103 de la J B Chemicals \u2014 formularea sigur\u0103 \u00een timpul sarcinii a nifedipinei. Antihipertensiv de prim\u0103 sau a doua linie \u00een hipertensiunea gesta\u021bional\u0103 \u0219i preeclampsie, al\u0103turi de labetalol \u0219i metildopa. De asemenea, pentru HTN cronic, angin\u0103 stabil\u0103 \u0219i vasospastic\u0103, Raynaud. \u00cenghi\u021bi\u021bi \u00eentregi; NU zdrobi\u021bi sau desp\u0103r\u021bi\u021bi.<\/p>","protected":false},"featured_media":51898,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3428,3390],"class_list":{"0":"post-51897","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-nicardia-retard","11":"product_tag-nifedipine","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/51897","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=51897"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/51898"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=51897"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=51897"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=51897"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=51897"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}