Difference between revisions of "Nicardipine"

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==General==
 
==General==
*Type: [[Calcium Channel Blocker]]
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*Type: [[Calcium Channel Blocker]], dihydropyridine
 
*Dosage Forms: Capsule, Infusion solution, Injectable solution
 
*Dosage Forms: Capsule, Infusion solution, Injectable solution
 
*Common Trade Names: [[Cardene]]
 
*Common Trade Names: [[Cardene]]
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===[[Hypertension]]===
 
===[[Hypertension]]===
 
*PO: 20-40mg q8hr, or 30-60mg (extended release) q12hr
 
*PO: 20-40mg q8hr, or 30-60mg (extended release) q12hr
*IV: 5mg/hr by slow infusion (50 ml/hr), titrate to maximum of 30mg/hr, then maintenance of 2.0 - 15.5mg/hr
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*IV: 5mg/hr by slow infusion (50ml/hr), titrate to maximum of 30mg/hr, then maintenance of 2.0 - 15.5mg/hr
*IV bolus dose of 2mg, then continuous infusion achieves same control of HTN as starting infusion without bolus<ref>Tao P, Zheng DY, Yu XJ. Effects of intravenous nicardipine in Chinese patients with hypertensive emergencies. Curr Ther Res Clin Exp 1998 Mar; 59: 188-95.</ref>
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*IV bolus dose of 2mg, then continuous infusion achieves same control of hypertension as starting infusion without bolus<ref>Tao P, Zheng DY, Yu XJ. Effects of intravenous nicardipine in Chinese patients with hypertensive emergencies. Curr Ther Res Clin Exp 1998 Mar; 59: 188-95.</ref>
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===[[Intracranial hemorrhage]]===
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*Start at 5mg/hr
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**Increase q5min by 2.5mg until the target blood pressure is achieved
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**Then, immediately titrate down to maintenance infusion of 3mg/hr
  
 
===Chronic [[Stable Angina]]===
 
===Chronic [[Stable Angina]]===
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*Renal Dosing
 
*Renal Dosing
 
**Adult
 
**Adult
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*** PO: 20 mg TID (immediate release) or 30 mg BID (sustained release) with slow titration
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*** IV: not defined, slow titration
 
**Pediatric
 
**Pediatric
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*** IV: not defined, slow titration
 
*Hepatic Dosing
 
*Hepatic Dosing
 
**Adult
 
**Adult
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*** PO: 20 mg BID (immediate release) with slow titration
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*** IV: not defined, slow titration
 
**Pediatric
 
**Pediatric
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*** IV: not defined, slow titration
  
 
==Contraindications==
 
==Contraindications==
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==See Also==
 
==See Also==
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*[[Subarachnoid hemorrhage]]
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*[[Hemorrhagic stroke]]
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*[[Hypertensive emergency]]
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*[[Clevidipine]]
  
 
==References==
 
==References==
 
<references/>
 
<references/>
 
[[Category:Pharmacology]]
 
[[Category:Pharmacology]]
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[[Category:Cardiology]]
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Nicardipine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Latest revision as of 03:51, 6 March 2021

General

Adult Dosing

Hypertension

  • PO: 20-40mg q8hr, or 30-60mg (extended release) q12hr
  • IV: 5mg/hr by slow infusion (50ml/hr), titrate to maximum of 30mg/hr, then maintenance of 2.0 - 15.5mg/hr
  • IV bolus dose of 2mg, then continuous infusion achieves same control of hypertension as starting infusion without bolus[1]

Intracranial hemorrhage

  • Start at 5mg/hr
    • Increase q5min by 2.5mg until the target blood pressure is achieved
    • Then, immediately titrate down to maintenance infusion of 3mg/hr

Chronic Stable Angina

  • 20-40mg PO q8hr
  • Allow 3 days between dose increase

Pediatric Dosing

Hypertension

  • 0.5-3 mcg/kg/min IV
  • Not approved by FDA; limited date available

Special Populations

  • Pregnancy Rating: Category C
  • Lactation: Unknown wether drug is excreted in breast milk; avoid use
  • Renal Dosing
    • Adult
      • PO: 20 mg TID (immediate release) or 30 mg BID (sustained release) with slow titration
      • IV: not defined, slow titration
    • Pediatric
      • IV: not defined, slow titration
  • Hepatic Dosing
    • Adult
      • PO: 20 mg BID (immediate release) with slow titration
      • IV: not defined, slow titration
    • Pediatric
      • IV: not defined, slow titration

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 2-4 hr
  • Metabolism: Metabolized in liver b CYP3A4 (first pass)
  • Excretion: urine (60%), feces (35%)
  • Mechanism of Action:
    • inhibits trasmembrane influx of extracellular calcium ions across membranes of myocardial cells and vascular smooth muscle cells without changing serum calcium concentrations; this inhibit cardiac and vascular smooth muscle contractions, thereby dilating maincoronary and systemic arteries.

See Also

References

  1. Tao P, Zheng DY, Yu XJ. Effects of intravenous nicardipine in Chinese patients with hypertensive emergencies. Curr Ther Res Clin Exp 1998 Mar; 59: 188-95.

Nicardipine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.