Nicardipine Hydrochloride(nye kar’ de peen)
Cardene, Cardene SR
PREGNANCY CATEGORY C
Drug Classes
Antianginal
Antihypertensive
Calcium channel blocker
Therapeutic Actions
Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; calcium is involved in the generation of the action potential in specialized automatic and conducting cells in the heart, in arterial smooth muscle, and in excitation-contraction coupling in cardiac muscle cells. Inhibition of calcium flow results in the depression of impulse formation in specialized cardiac pacemaker cells, in slowing of the velocity of conduction of the cardiac impulse, in the depression of myocardial contractility, and in the dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac energy consumption, and increased delivery of oxygen to myocardial cells.
Indications
Immediate-release only: Chronic stable (effort-related) angina. Use alone or with beta blockers
Immediate-release and SR: Management of essential hypertension alone or with other antihypertensives
IV: Short-term treatment of hypertension when oral use is not feasible
Contraindications and Cautions
Contraindicated with allergy to nicardipine, pregnancy, lactation, advanced aortic stenosis.
Use cautiously with impaired hepatic or renal function, sick sinus syndrome, heart block (second- or third-degree), HF.
Available Forms
Capsules—20, 30 mg; ER capsules—30, 45, 60 mg; injection—2.5 mg/mL; premixed bags—20 mg/200 mL, 40 mg/200 mL
Dosages
Adults
Oral
Angina: Immediate-release only—individualize dosage. Usual initial dose is 20 mg tid PO. Range, 20–40 mg tid PO. Allow at least 3 days before increasing dosage to ensure steady-state plasma levels.
Hypertension: Immediate-release—initial dose, 20 mg tid PO. Range, 20–40 mg tid. The maximum BP-lowering effect occurs in 1–2 hr. Adjust dosage based on BP response, allow at least 3 days before increasing dosage. SR—initial dose is 30 mg bid PO. Range, 30–60 mg bid.
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