Cordipin HL tablets 40mg, No. 20

- Ischemic heart disease: prevention of attacks of stable angina pectoris.

- Arterial hypertension.

Inside, after eating. The tablets of the drug CordipinЃ CL must be swallowed whole with a glass of water, the tablets must not be broken or chewed. The dosage regimen of the drug KordipinЃ CL is individual. The usual dose of the drug CordipinЃ CL, prolonged-release film-coated tablets, both at the beginning of therapy and during ongoing treatment, is 1 tablet 40 mg taken once a day. The maximum recommended dose is 2 tablets (80 mg) per day in 1 or 2 divided doses.
If the patient has forgotten to take the next dose of the drug CordipinЃ CL, the next time he is taken, he should not double the dose of the drug.

1 extended-release film-coated tablet. contains:

Core:
Active ingredient: Nifedipine 40.00 mg
Excipients: microcrystalline cellulose, cellulose, lactose, hypromellose, magnesium stearate, colloidal silicon dioxide
Film sheath: hypromellose, macrogol-6000, macrogol-400, iron dye red oxide (E172), titanium dioxide (E171), talc

- Hypersensitivity to nifedipine or other dihydropyridine derivatives or to any other component of the drug.

- Cardiogenic shock.

- Porphyria.

- Severe stenosis of the aortic valve.

- Chronic heart failure (in the stage of decompensation).

- Severe arterial hypotension (systolic blood pressure below 90 mm Hg. Art.).

- Acute period of myocardial infarction (during the first 4 weeks).

- Pregnancy (up to 20 weeks), breastfeeding period.

- Age up to 18 years (efficacy and safety have not been established).

- Simultaneous use with rifampicin (due to the inability to achieve effective levels of nifedipine in blood plasma due to enzyme induction).

- Lactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome (CordipinЃ CL contains lactose).

With caution
Severe stenosis of the aortic orifice or mitral valve, hypertrophic obstructive cardiomyopathy, severe bradycardia and tachycardia, sick sinus syndrome, malignant arterial hypertension, myocardial infarction with left ventricular failure, chronic heart failure, unstable angina pectoris, or concurrent obstruction of the gastrointestinal tract (GIT). pregnancy (after 20 weeks), mild or moderate arterial hypotension, severe cerebrovascular accident, impaired liver and / or kidney function, hemodialysis (risk of arterial hypotension). use in elderly patients.

Trade name: CordipinЃ CL

International non-proprietary name: nifedipine

Dosage form: sustained-release film-coated tablets

Composition
1 tablet with prolonged release, film-coated. contains:

Core:
Active ingredient: Nifedipine 40.00 mg
Excipients: microcrystalline cellulose, cellulose, lactose, hypromellose, magnesium stearate, colloidal silicon dioxide
Film sheath: hypromellose, macrogol-6000, macrogol-400, iron dye red oxide (E172), titanium dioxide (E171), talc

Description
Round, biconvex, beveled, reddish-brown film-coated tablets.
Fracture view: a rough yellow mass with a reddish-brown cyst membrane.

Pharmacotherapeutic group: blocker of 'slow' calcium channels

Pharmacological properties
Pharmacodynamics
CordipinЃ CL is a drug from the group of blockers of 'slow' calcium channels.
Nifedipine blocks the flow of calcium ions through the membrane of cardiac muscle cells and vascular smooth muscle. The blockade of the intake and accumulation of calcium ions inside cells leads to the expansion of peripheral and coronary vessels, reduces the total peripheral vascular resistance (OPSR), reduces the afterload on the heart, reduces coronary blood flow and reduces myocardial oxygen demand. Mainly at the beginning of therapy, heart rate and cardiac output may decrease as a result of activation of the baroreceptor reflex. With prolonged therapy with nifedipine, the heart rate and cardiac output return to those values ??that they had before the start of therapy. In patients with arterial hypertension, a more pronounced decrease in blood pressure is observed.

Pharmacokinetics
The release of nifedipine from the tablets of the drug CordipinЃ CL is very slow, almost linear, that is, the release occurs at a constant level. Nifedipine released from tablets is rapidly and almost completely absorbed. The lower value of the equilibrium concentration level is reached after taking the first dose of the drug Cordipin CL (after 24 hours). With an already reached equilibrium state, the maximum concentration of the drug is reached 5 ± 2.7 hours after ingestion. The effect of the drug lasts 24 hours, so a single appointment per day is sufficient. The binding of nifedipine to blood plasma proteins is 94-99%. Nifedipine is almost completely metabolized. The half-life (T1 / 2) of the drug is 14.9 ± 6.0 hours, less than 1% of the drug dose is excreted in the urine unchanged.70-80% of the dose taken is excreted in the urine as metabolites. Excretion of nifedipine may be slowed down by impaired renal function.

Indications for use

- Ischemic heart disease: prevention of attacks of stable angina pectoris.

- Arterial hypertension.

Contraindications

- Hypersensitivity to nifedipine or other dihydropyridine derivatives or to any other component of the drug.

- Cardiogenic shock.

- Porphyria.

- Severe stenosis of the aortic valve.

- Chronic heart failure (in the stage of decompensation).

- Severe arterial hypotension (systolic blood pressure below 90 mm Hg. Art.).

- Acute period of myocardial infarction (during the first 4 weeks).

- Pregnancy (up to 20 weeks), breastfeeding period.

- Age up to 18 years (efficacy and safety have not been established).

- Simultaneous use with rifampicin (due to the inability to achieve effective levels of nifedipine in blood plasma due to enzyme induction).

- Lactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome (CordipinЃ CL contains lactose).

With caution
Severe stenosis of the aortic orifice or mitral valve, hypertrophic obstructive cardiomyopathy, severe bradycardia and tachycardia, sick sinus syndrome, malignant arterial hypertension, myocardial infarction with left ventricular failure, chronic heart failure, unstable angina pectoris, or concurrent obstruction of the gastrointestinal tract (GIT). pregnancy (after 20 weeks), mild or moderate arterial hypotension, severe cerebrovascular accident, impaired liver and / or kidney function, hemodialysis (risk of arterial hypotension). use in elderly patients.

Application during pregnancy and during breastfeeding
Pregnancy
Nifedipine should not be used during pregnancy, unless the clinical condition of a woman requires treatment with nifedipine.
Nifedipine should be a backup for women with severe hypertension who do not respond to standard therapy.
There are no adequate controlled studies in pregnant women. The available information is insufficient to rule out the possibility of side effects posing a risk to the fetus and newborn. In animal studies, it has been shown that nifedipine has embryotoxicity, fetotoxicity and teratogenicity.
Based on clinical data, no specific prenatal risk was identified. However, there has been an increase in the incidence of perinatal asphyxia, caesarean section, and preterm birth and intrauterine growth retardation. The relationship of these reports with existing hypertension, its treatment, or the specific effect of the drug is unclear.
Breastfeeding period
Nifedipine is excreted into breast milk. The concentration of nifedipine in breast milk is comparable to its concentration in the maternal serum. When using immediate-release dosage forms, it is recommended to refrain from breastfeeding or expressing milk for 3-4 hours after taking the drug to reduce the effect of nifedipine on the baby.
Fertility
In isolated cases during in vitro fertilization, the use of calcium channel blockers, including nifedipine, was associated with reversible biochemical changes in the sperm head, which could lead to impaired sperm function. In case of unsuccessful attempts at in vitro fertilization and when other causes of infertility are excluded, the likelihood of the effect on sperm of the use of calcium channel blockers, including nifedipine, should be considered.

Method of administration and dosage
Inside, after a meal. The tablets of the drug CordipinЃ CL must be swallowed whole with a glass of water, the tablets must not be broken or chewed. The dosage regimen of the drug KordipinЃ CL is individual. The usual dose of the drug CordipinЃ CL, prolonged-release film-coated tablets, both at the beginning of therapy and during ongoing treatment, is 1 tablet 40 mg taken once a day. The maximum recommended dose is 2 tablets (80 mg) per day in 1 or 2 divided doses.
If the patient has forgotten to take the next dose of the drug CordipinЃ CL, the next time he is taken, he should not double the dose of the drug.

Side effect

From the side of the cardiovascular system: often: peripheral edema;
infrequently: tachycardia, palpitations, excessive decrease in blood pressure, fainting;
rarely: in some patients, especially at the beginning of treatment, angina attacks may occur, which requires discontinuation of the drug. Isolated cases of myocardial infarction are described.
From the side of the central nervous system: often: headache;
infrequently: sleep disturbance, vertigo, migraine, tremor, dizziness;
rarely: increased fatigue, weakness; frequency unknown: drowsiness, hypesthesia.
From the digestive system:
infrequently: dryness of the oral mucosa, dyspepsia (nausea, diarrhea or constipation), gastrointestinal and abdominal pain, nausea, flatulence;
rarely: gingival hyperplasia (bleeding, soreness, swelling), with prolonged use, impaired liver function (intrahepatic cholestasis, increased activity of 'hepatic' transaminases);
frequency unknown: vomiting, insufficiency of the gastroesophageal sphincter, jaundice.
From the side of the hematopoietic organs: the
frequency is unknown: agranulocytosis, leukopenia.
Allergic reactions:
infrequently: allergic edema / angioedema (including laryngeal edema), erythema;
rarely: pruritus, exanthema, exfoliative dermatitis, photodermatitis, urticaria;
very rare: autoimmune hepatitis;
frequency unknown: anaphylactic / anaphylactoid reactions, toxic epidermal necrolysis. palpable purpura.
From the musculoskeletal system:
infrequently: joint swelling, muscle cramps;
rarely: arthralgia, myalgia.
From the urinary system:
infrequently: dysuria, increased daily urine output.
Others:
often: feeling unwell;
infrequently: nosebleeds, nasal congestion, erectile dysfunction, nonspecific pain, chills; rarely: shortness of breath, cough;
very rarely: visual impairment (including transient blindness at the maximum concentration of nifediine in the blood plasma), gynecomastia (in elderly patients, completely disappearing after discontinuation of the drug), hyperglycemia, galactorrhea. pulmonary edema, bronchospasm, weight gain;
frequency unknown: eye pain.

Overdose
Symptoms: causes peripheral vasodilation with severe and, possibly, prolonged systemic arterial hypotension: headache, facial flushing, prolonged marked decrease in blood pressure, depression of the sinus node, bradycardia and / or tachycardia, bradyarrhythmia. In severe poisoning, loss of consciousness, coma. Overdose
treatment consists in standard procedures for removing the drug from the body (prescribing activated charcoal, gastric lavage), restoring stable hemodynamic parameters, and carefully monitoring the activity of the heart, lungs and excretory system.
The antidote is calcium preparations, intravenous administration of a 10% solution of calcium chloride or calcium gluconate is shown, followed by switching to a long infusion.
Due to the high degree of binding to blood plasma proteins, hemodialysis is not effective.
It is recommended to monitor the concentration of blood glucose (insulin release may decrease) and electrolytes (potassium, calcium).
The clearance of nifedipine is increased in patients with liver failure.

Interaction with other drugs
The severity of the decrease in blood pressure increases with the simultaneous use of other antihypertensive drugs, beta-blockers, nitrates, cimetidine (to a lesser extent, ranitidine). inhalation anesthetics, diuretics and tricyclic antidepressants.
Drugs from the group of blockers of 'slow' calcium channels (BMCC) can further enhance the negative inotropic effect (lowering the force of heart contraction) of antiarrhythmic drugs such as amiodarone and quinidine. Nifedipine causes a decrease in the concentration of quinidine in the blood plasma; after discontinuation of nifedipine, a sharp increase in the concentration of quinidine may occur. Increases plasma concentrations of digoxin and theophylline, in connection with which the clinical effect and the concentration of digoxin and theophylline in blood plasma should be monitored.
Inducers of microsomal liver enzymes (rifampicin and others) reduce the concentration of nifedipine. With simultaneous use with nitrates, tachycardia increases. The antihypertensive effect is reduced by sympathomimetics, nonsteroidal anti-inflammatory drugs, estrogens, calcium preparations.
Nifedipine can displace drugs with a high degree of binding from the connection with proteins (including indirect anticoagulants - coumarin and indandione derivatives, anticonvulsants, nonsteroidal anti-inflammatory drugs, quinine, salicylates, sulfinpyrazone), as a result of which their concentration in blood plasma may increase ...
Nifedipine inhibits the excretion of vincristine from the body and can cause an increase in the side effects of vincristine; if necessary, the dose of vincristine is reduced. Lithium preparations can increase toxic effects (nausea, vomiting, diarrhea, ataxia, tremors, tinnitus). With the simultaneous appointment of cephalosporins (for example, cefixime) and nifedipine in probands, the bioavailability of cephalosporin increased by 70%. Grapefruit juice inhibits the metabolism of nifedipine in the body, and therefore their simultaneous intake is contraindicated.
Suppresses the metabolism of prazosin and other alpha-blockers. as a result, an increase in the antihypertensive effect is possible. Procainamide, quinidine and other drugs that cause prolongation of the QT interval increase the negative inotropic effect and may increase the risk of a significant prolongation of the QT interval.
Medicines affecting nifedipine
Nifedipine is metabolized by the isoenzyme CYP3A4 of the cytochrome P450 system, which is located in the intestinal and liver mucosa. Drugs that suppress or induce this enzyme system can affect the effect of 'primary passage' through the liver (after ingestion) or clearance of nifedipine.
The strength and duration of interaction should be taken into account while taking nifedipine with the following drugs:
Rifampicin
Rifampicin is a powerful inducer of the CYP3A4 isoenzyme. With simultaneous use with rifampicin, the bioavailability of nifedipine is significantly reduced, and. accordingly, its effectiveness decreases. Therefore, the simultaneous use of nifedipine with rifampicin is contraindicated.
With the simultaneous use of weak or moderate inhibitors of the isoenzyme CYP3A4, regular monitoring of blood pressure is required and, if necessary, a decrease in the dose of nifedipine.
Macrolide antibiotics (eg erythromycin)
Clinical studies on the interaction of nifedipine and macrolide antibiotics have not been conducted. Some macrolides are known to inhibit the CYP3A4 isoenzyme. Therefore, the possibility of an increase in the concentration of nifedipine in the blood plasma cannot be ruled out with the simultaneous use of nifedipine and macrolide antibiotics.
Azithromycin, an antibiotic of the macrolide group. does not inhibit the isoenzyme CYP3A4.
HIV protease inhibitors (eg, ritonavir) There have been no
clinical studies examining the interaction of nifedipine with HIV protease inhibitors. It is known that drugs of this class inhibit the CYP3A4 isoenzyme. In addition, it has been shown that drugs of this class inhibit the metabolism of nifedipine. mediated by the isoenzyme CYP3A4. under conditions in vitro... With simultaneous use with nifedipine, a significant increase in the concentration of nifedipine in blood plasma cannot be ruled out due to a decrease in the effect of 'primary passage' through the liver and a slowdown in excretion.
Antifungals of the azole group (for example, ketoconazole)
Clinical studies have not been conducted to study the interaction of nifedipine and antifungal agents of the azole group. It is known that drugs of this class inhibit CYP3A4 isofermsnt. With simultaneous use with nifedipine, a significant increase in the systemic bioavailability of nifedipine is possible due to a decrease in the effect of 'primary passage' through the liver.
Fluoxetine
Clinical studies to study the interaction of nifedipine and fluoxetine have not been conducted. It is known that fluoxetine in vitro inhibits the metabolism of nifedipine, mediated by the action of the isoenzyme CYP3A4. Therefore, the possibility of an increase in the concentration of nifedipine in the blood plasma cannot be ruled out with the simultaneous use of nifedipine and fluoxetine.
Cefazodone
Clinical studies on the interaction of nifedipine and nefazodone have not been conducted. It is known that nefazodone inhibits the metabolism of other drugs, mediated by the action of the isoenzyme CYP3A4. Therefore, the possibility of an increase in the concentration of nifedipine in the blood plasma cannot be ruled out with the simultaneous use of nifedipine and nefazodone.
Quinupristin / dalfopristin
The simultaneous use of quinupristin / dalfopristin can lead to an increase in the concentration of nifedipine in the blood plasma.
Valproic acid
Clinical studies on the interaction of nifedipine and valproic acid have not been conducted. Since valproic acid increases the concentration of nimodipine in the blood plasma, which is structurally similar to BMCC, the possibility of an increase in the concentration of nifedipine in the blood plasma and an increase in its effectiveness cannot be ruled out.
Cimetidine
Cimetidine inhibits the CYP3A4 isoenzyme and causes an increase in the concentration of nifedipine in the blood plasma, thereby enhancing its antihypertensive effect.
Other studies
Cisapride The
simultaneous use of cisapride and nifedipine can lead to an increase in the concentration of nifedipine in the blood plasma.
Antiepileptic drugs that induce the CYP3A4 isoenzyme (eg, phenytoin, carbamazepine, phenobarbital)
Phenytoin induces the CYP3A4 isoenzyme. With the simultaneous use of nifedipine and phenytoin, the bioavailability of nifedipine decreases and its effectiveness decreases. With the simultaneous use of this combination, it is necessary to monitor the clinical response to therapy with nifedipine and, if necessary, increase its dose. In the case of an increase in the dose of nifedipine with the simultaneous use of both drugs, after the abolition of phenytoin, the dose of nifedipine should be reduced.
Clinical studies to investigate the potential interaction of nifedipine and carbamazepine or phenobarbital have not been conducted. Since both drugs reduce the concentration of nimodipine in the blood plasma, which is structurally similar to IUDC, the possibility of a decrease in the concentration of nifedipine in the blood plasma and a decrease in its effectiveness cannot be ruled out.
The effect of nifedipine on other drugs
Drugs that lower blood pressure The
antihypertensive effect of nifedipine can be enhanced when used simultaneously with antihypertensive drugs, such as diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, other blockers of calcium adrenoblockers phosphodiesterase-5, alpha-methyldopa.
With the simultaneous use of nifedipine and beta-blockers, it is necessary to carefully monitor the patient's condition, since in some cases it is possible to aggravate the course of chronic heart failure.
Digoxin The
simultaneous use of nifedipine and digoxin can lead to a decrease in the clearance of digoxin and, therefore, to an increase in the concentration of digoxin in the blood plasma. The appearance of symptoms of glycoside overdose in the patient should be carefully monitored, and, if necessary, the dose of digoxin should be reduced, taking into account its concentration in the blood plasma.
Tacrolimus
Tacrolimus is metabolized with the participation of the isoenzyme CYP3A4. Recently published data indicate the possibility of reducing the dose of tacrolimus in some cases when used simultaneously with nifedipine.
With the simultaneous use of tacrolimus and nifedipine, the concentration of tacrolimus in the blood plasma should be monitored and, if necessary, its dose should be reduced.
Interaction of nifedipine with food intake
Grapefruit juice
Grapefruit juice inhibits the isoenzyme CYP3A4. The simultaneous use of nifedipine with grapefruit juice leads to an increase in the concentration of nifedipine in the blood plasma and its prolongation of action due to a decrease in the effect of 'primary passage' through the liver and a decrease in clearance. In this case, the antihypertensive effect may be enhanced. With regular consumption of grapefruit juice, this effect can persist for 3 days after the last drink of the juice. It is advised to avoid consuming grapefruit / grapefruit juice during treatment with nifedipine.
Other interactions
Nifedipine can cause a false increase in the concentration of vanilyl mandelic acid in urine when determined by the spectrophotometric method, but does not affect the measurement results when using the method of high performance liquid chromatography (HPLC).

ќсобые указании
ѕрекращать лечение препаратом  ордипинЃ ’Ћ рекомендуетс¤ постепенно.
—ледует иметь в виду, что в начале лечени¤ может возникнуть стенокарди¤, особенно после недавней резкой отмены бета-адреноблокаторов (последние следует отмен¤ть постепенно).
ќдновременное применение бета-адреноблокагоров необходимо проводить в услови¤х шинельного врачебного контрол¤, поскольку это может обусловить чрезмерное снижение ј?, а в некоторых случа¤х усугубление симптомов хронической сердечной недостаточности.
ѕрепарат  ордипинЃ ’Ћ не следует примен¤ть дл¤ купировани¤ приступов стенокардии и дл¤ вторичной профилактики сердечно-сосудистых осложнений у пациентов, перенесших инфаркт миокарда.
ѕри выраженной сердечной недостаточности препарат  ордипинЃ ’Ћ дозируют с большой осторожностью. ?иагностическими критери¤ми назначени¤ препарата  ордипинЃ ’Ћ при вазоспастической стенокардии ¤вл¤ютс¤: классическа¤ клиническа¤ картина, сопровождающа¤с¤ повышением сегмента ST. возникновение эргоновин-индуцированной стенокардии или спазма коронарных артерий, вы¤вление коронароспазма при ангиографии или вы¤вление ангиоспастического компонента без подтверждени¤ (например, при разном пороге напр¤жени¤ или при нестабильной стенокардии, когда данные электрокардиограммы свидетельствуют о преход¤щем ангиоспазме). ?л¤ пациентов с т¤желой обструктивной кардиомиопатией существует риск увеличени¤ частоты, т¤жести про¤влени¤ и продолжительности приступов стенокардии после приема нифедипина, в данном случае необходима отмена препарата.
” пациентов, наход¤щихс¤ на гемодиализе, с высоким ј? и необратимой недостаточностью почек с уменьшенным общим количеством крови препарат следует примен¤ть осторожно, может произойти резкое падение ј?.
«а пациентами с нарушением функции печени устанавливаетс¤ тщательное наблюдение и при необходимости снижают дозу препарата и/или используют другие лекарственные формы нифедипина. ?сли во врем¤ терапии пациенту требуетс¤ провести хирургическое вмешательство под общим наркозом, необходимо информировать врача-анестезиолога о характере проводимой терапии.
¬о врем¤ лечени¤ возможны положительные результаты при проведении пр¤мой реакции  умбса и лабораторных тестов на антинуклеарные антитела.
— осторожностью следует назначать одновременно с дизопирамидом и флекаинамидом вследствие возможного усилени¤ инотропного эффекта.
—ледует с осторожностью примен¤ть у пациентов с выраженным снижением ј? (систолическое ј? ниже 90 мм рт. ст.), с симптомами хронической сердечной недостаточности и при т¤желом стенозе усть¤ аорты.
Ќифедипин не следует примен¤ть во врем¤ беременности, за исключением ситуации, когда клиническое состо¤ние женщины требует лечени¤ нифедипином. Ќифедипин должен быть резервным средством дл¤ женщин с т¤желой артериальной гипертензией, не отвечающих на стандартную терапию.
Ќе рекомендуетс¤ применение нифедипина в период грудного вскармливани¤, т. к. нифедипин выдел¤етс¤ в грудное молоко человека, и вли¤ние на грудного ребенка при приеме внутрь небольших количеств нифедипина неизвестно.
Ќеобходимо тщательно контролировать ј? у беременных женщин при одновременном применении нифедипина с внутривенным введением магни¤ сульфата вследствие возможности чрезмерного снижени¤ ј?, что представл¤ет опасность как дл¤ матери, так и дл¤ плода.
Ќифедипин метаболизируетс¤ с помощью изофермента CYP3A4. Ћекарственные средства, подавл¤ющие или индуцирующие эту ферментную систему, могут оказывать вли¤ние на эффект Ђпервичного прохождени¤ї через печень или клиренс нифедипина.   лекарственным средствам, слабым или умеренным ингибиторам изофермента CYP3A4. повышающим концентрацию нифедипина в плазме крови, относ¤тс¤:

- макролиды (например, эритромицин),

- ингибиторы ¬»„-протеазы (например, ритонавир),

- противогрибковые средства группы азолов (например, кетоконазол),

- антидепрессанты нефазодон и флуоксетин,

- квинупристин/дальфопристин,

- вальпроева¤ кислота,

- циметидин.
ѕри одновременном применении препарата  ордипинЃ ’Ћ и данных препаратов необходимо контролировать ј? и при необходимости скорректировать дозу нифедипина.
—пециальна¤ информаци¤ по вспомогательным веществам
ѕрепарат  ордипинЃ ’Ћ содержит лактозу, поэтому не следует примен¤ть при следующих состо¤ни¤х: непереносимость лактозы, дефицит лактазы, синдром глюкозо-галактозной мальабсорбции.

¬ли¤ние на способность управл¤ть транспортными средствами, механизмами
” некоторых пациентов, особенно в начале лечени¤, препарат может вызывать головокружение, что снижает способность к управлению автомобилем или другими механизмами. ¬ дальнейшем степень ограничений определ¤ют в зависимости от индивидуальной переносимости препарата.

‘орма выпуска
“аблетки с пролонгированным высвобождением, покрытые пленочной оболочкой, 40 мг.
ѕо 10 таблеток в блистере из комбинированного материала ѕ¬’/ѕ¬?’-алюминиевой фольги.
ѕо 2 блистера вместе с инструкцией по применению помещают в пачку картонную.

”слови¤ хранени¤
ѕри температуре не выше 25 ?—, в оригинальной упаковке.
’ранить в недоступном дл¤ детей месте.

Shelf life is
5 years.
Do not use the drug after the expiration date.

Terms of dispensing
Prescription.