Nicardipine
General
- Type: Calcium Channel Blocker
- Dosage Forms: Capsule, Infusion solution, Injectable solution
- Common Trade Names: Cardene
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
- Adult
- Hepatic Dosing
- Adult
- PO: 20 mg BID (immediate release) with slow titration
- IV: not defined, slow titration
- Pediatric
- IV: not defined, slow titration
- Adult
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Headache (IV, 15%)
Common
- Flushing
- Peripheral Edema
- Pedal Edema
- Hypotension
- Exacerbation of angina
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
- ↑ 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.