Chemical formula: C₂₇H₂₉N₃O₆ Molecular mass: 491.544 g/mol PubChem compound: 443869
Barnidipine interacts in the following cases:
In a specific interaction study alcohol led to an increase of barnidipine plasma levels (40%), which increase may be considered clinically not relevant. As with all vasodilating and antihypertensive agents, caution should be exercised when alcohol is taken concomitantly as it may potentiate their effect.
Although barnidipine kinetics was not significantly altered by administration with grapefruit juice, a modest effect was observed.
Care should be taken with concomitant use of mild CYP3A4 inhibitors or inducers. In case of concomitant use of CYP3A4 inhibitors it is discouraged to increase the dosage of barnidipine to 20 mg.
Barnidipine should be used with caution in patients with mild to moderate renal impairment (creatinine clearance between 10 and 80 ml/min).
The concurrent administration of barnidipine and other antihypertensive drugs may result in an additional antihypertensive effect.
In vitro data show that cyclosporin may inhibit the metabolism of barnidipine.
Concurrent dosing of cimetidine in a specific interaction study led on average to a doubling of barnidipine plasma levels. Care should therefore be exercised when using barnidipine concomitantly with cimetidine.
A higher dose of barnidipine may be necessary when barnidipine is administered concomitantly with enzyme inducing drugs, such as phenytoin, carbamazepine and rifampicin. Should a patient stop using an enzyme inducing drug, lowering the dosage of barnidipine should be considered.
Caution is recommended also when barnidipine is administered to patients with sick sinus (if a pacemaker is not in situ).
As with all other dihydropyridines, Vasexten should be used with caution in patients with left ventricular dysfunction, in patients suffering from obstruction of the outflow channel of the left ventricle and patients with isolated right-sided cardiac decompensation, e.g. cor pulmonale. Barnidipine has not been studied in NYHA class III or IV patients.
No clinical experience with barnidipine in pregnancy or lactation is present. Animal studies do not indicate direct harmful effects with respect to pregnancy, embryonal/foetal or postnatal development. Only indirect effects are observed. The class of dihydropyridines has shown the potential to prolong delivery and parturition, which was not observed with barnidipine. As a consequence, barnidipine could be used in pregnancy only if the benefit justifies the potential risk to the fetus.
The results of animal tests have shown that barnidipine (or its metabolites) is excreted in human milk. Therefore, breast feeding is not advised during use of barnidipine.
No studies on the effects on the ability to drive and use machines have been performed barnidipine. However, caution should be exercised because dizziness/vertigo may occur during antihypertensive treatment.
| System organ class | 10 mg dosage | 20 mg dosage |
|---|---|---|
| Immune system disorders | ||
| Anaphylactoid reaction | Not known (frequency cannot be estimated from the available data) | Not known (frequency cannot be estimated from the available data) |
| Nervous system disorders | ||
| Headache | Common (≥1/100 to <1/10) | Very common (≥1/10) |
| Dizziness/vertigo | Common (≥1/100 to <1/10) | Common (≥1/100 to <1/10) |
| Cardiac disorders | ||
| Palpitations | Common (≥1/100 to <1/10) | Common (≥1/100 to <1/10) |
| Tachycardia, sinus tachycardia, heart rate increased | Not known (frequency cannot be estimated from the available data) | Not known (frequency cannot be estimated from the available data) |
| Vascular disorders | ||
| Flushing | Common (≥1/100 to <1/10) | Very common (≥1/10) |
| Hepato-biliary disorders | ||
| Liver function test abnormal | Not known (frequency cannot be estimated from the available data) | Not known (frequency cannot be estimated from the available data) |
| Skin and subcutaneous tissue disorders | ||
| Rash | Not known (frequency cannot be estimated from the available data) | Not known (frequency cannot be estimated from the available data) |
| General and administration site conditions | ||
| Peripheral oedema | Common (≥1/100 to <1/10) | Very common (≥1/10) |
The symptoms tend to diminish or disappear during treatment (within one month for peripheral oedema and two weeks for flushing, headache and palpitations).
Although never observed, the following adverse event may be of interest, as it is in the use of other dihydropyridines: gingival hyperplasia.
Some dihydropyridines may rarely lead to precordial pain or angina pectoris. Very rarely patients with preexisting angina pectoris may experience increased frequency, duration or severity of these attacks. Isolated cases of myocardial infarction may be observed.
© All content on this website, including data entry, data processing, decision support tools, "RxReasoner" logo and graphics, is the intellectual property of RxReasoner and is protected by copyright laws. Unauthorized reproduction or distribution of any part of this content without explicit written permission from RxReasoner is strictly prohibited. Any third-party content used on this site is acknowledged and utilized under fair use principles.
