Nicardipine

General

• Type: Calcium Channel Blocker
• Dosage Forms: Capsule, Infusion solution, Injectable solution
• Common Trade Names: Cardene

Adult Dosing

Hypertension

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

Chronic Stable Angina

• 20-40 mg 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
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

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.

Sources

• Medscape