Indication
Cilnivas is indicated for the management of hypertension in adults.
Dosage & Administration
The recommended adult oral dosage of Cilnidipine is 5-10 mg once daily. The dosage can be increased up to 20 mg.
Use in the Pediatric:
The safety of Cilnidipine in pediatric patients has not been established.
Use in the Elderly:
Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).
Special Population
Insulin Sensitivity: Cilnidipine improves insulin sensitivity possibly due to its exerting a vasodilatory action without stimulating sympathetic nervous activity. The favorable effects of Cilnidipine on glucose metabolism are of clinical importance for the treatment of hypertensive patients with insulin resistance or diabetes mellitus. Hypertensive obese patients treated with 10 mg of Cilnidipine showed improved insulin resistance.
Reno-protective Effects: Several clinical studies have indicated that Cilnidipine, displays better renal protection compared to other antihypertensive drugs including diuretics and other dihydropyridine CCBs. The precise mechanisms by which Cilnidipine elicits its strong anti-proteinuric effects remain unclear, however effective podocyte protection may play an important role.
Uric Acid & Renin Suppression: Cilnidipine reduces serum uric acid and also influences urinary nitric oxide excretion. It also inhibit renin activity. Therefore, Cilnidipine may be useful for alleviating hypertensive renal disease accompanied by hyperuricemia.
Precautions
Hypotension, poor cardiac reserve, heart failure. Sudden withdrawal may exacerbate angina. Discontinue in patients who experience ischemic pain following administration.
Pregnancy & Lactation
Cilnidipine should not be administered in pregnant woman or woman having possibilities of being pregnant. It is also advisable to avoid the administration of Cilnidipine to nursing mothers. However, if the administration is indispensable, the patient should be instructed to discontinue lactation.
