Manidipine


Generic Medicine Info
Indications and Dosage
Oral
Hypertension
Adult: Initially, 5-10 mg once daily, may increase dose after 2-4 weeks according to patient response and tolerability. Max: 20 mg daily. Dosage and treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initiate at lower doses and titrate according to response. Usual maintenance dose: 10 mg daily.
Renal Impairment
CrCl (mL/min) Dosage
<10 Contraindicated.
Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Hepatic Impairment
Mild: Max: 10 mg daily. Moderate to severe: Contraindicated. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Administration
Should be taken with food. Take after breakfast.
Contraindications
Unstable angina or within 4 weeks of MI, untreated CHF. Severe renal (CrCl <10 mL/min) and moderate to severe hepatic impairment.
Special Precautions
Patient with left ventricular failure, left ventricular outflow tract obstruction, isolated right heart failure or sick sinus syndrome in the absence of a pacemaker. Avoid abrupt withdrawal. Mild hepatic impairment. Elderly.
Adverse Reactions
Significant: Angina, MI, excessive hypotension.
Cardiac disorders: Palpitations, tachycardia.
Gastrointestinal disorders: Nausea, vomiting, constipation, dry mouth, digestive disorders.
General disorders and administration site conditions: Oedema, asthenia.
Investigations: Increased ALT/AST, LDH, GGT, alkaline phosphatase, BUN, and creatinine.
Nervous system disorders: Headache, dizziness, vertigo, paraesthesia.
Respiratory, thoracic and mediastinal disorders: Dyspnoea.
Skin and subcutaneous tissue disorders: Rash, eczema.
Vascular disorders: Hot flushes.
Patient Counseling Information
This drug may cause dizziness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor blood pressure, heart rate, LFTs, and renal function at baseline and as necessary.
Overdosage
Symptoms: Excessive peripheral vasodilatation, severe hypotension, reflex tachycardia. Management: Symptomatic and supportive treatment. If recent ingestion, perform gastric lavage, administer activated charcoal and/or cathartics. Give dopamine, Ca chloride, isoproterenol hydrochloride, metaraminol bitartrate, or norepinephrine bitartrate to treat hypotension. Administer atropine, Ca chloride, isoproterenol hydrochloride, or norepinephrine bitartrate to treat bradycardia and AV block; may perform cardiac pacing. Perform cardiac monitoring (for at least 24 hours).
Drug Interactions
Enhanced antihypertensive effect with diuretics, β-blockers, and other antihypertensive agents. Increased antihypertensive effect and increased risk of orthostatic hypotension with TCAs, antipsychotics, and α-blockers (e.g. alfuzosin, tamsulosin). Decreased antihypertensive effect with corticosteroids and tetracosactide.
Food Interaction
Increased absorption with food. Increased hypotensive effect with alcohol. Increased serum concentration and hypotensive effect with grapefruit juice.
Action
Description:
Mechanism of Action: Manidipine, a 3rd generation dihydropyridine Ca channel blocker, inhibits Ca ion influx via voltage-dependent L-type and T-type Ca channels causing peripheral vasodilation and a reduction in blood pressure.
Onset: 15-60 minutes.
Duration: 24 hours.
Pharmacokinetics:
Absorption: Rapidly absorbed. Food increases absorption. Time to peak plasma concentration: 1-4 hours.
Distribution: Widely distributed to the tissues. Plasma protein binding: 99%.
Metabolism: Extensively metabolised in the liver. Undergoes first-pass metabolism by the CYP450 isoenzymes via dehydrogenation and oxidation.
Excretion: Mainly via faeces (63%); urine (31%). Elimination half-life: 3.9-7.95 hours.
Chemical Structure

Chemical Structure Image
Manidipine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4008, Manidipine. https://pubchem.ncbi.nlm.nih.gov/compound/Manidipine. Accessed Oct. 24, 2023.

Storage
Store below 30°C. Protect from light.
MIMS Class
Calcium Antagonists
ATC Classification
C08CA11 - manidipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
References
Anon. Manidipine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/04/2023.

Buckingham R (ed). Manidipine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/04/2023.

Cardiplot 10, 20 Tablets (Berlin Pharmaceutical Industry Co., Ltd.). MIMS Thailand. http://mims.com/thailand. Accessed 05/04/2023.

Cardiplot 20 Tablets (Berlin Pharmaceutical Industry Co., Ltd.). MIMS Thailand. http://mims.com/thailand. Accessed 05/04/2023.

Monet Tablet (Millimed Co., Ltd.). MIMS Thailand. http://mims.com/thailand. Accessed 09/10/2023.

Disclaimer: This information is independently developed by MIMS based on Manidipine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com
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