Nicardipine Aguettant

Nicardipine HCl

Acute life-threatening HTN, particularly in the event of malignant arterial HTN/hypertensive encephalopathy; aortic dissection, when short-acting β-blocker therapy is not suitable, or in combination w/ a β-blocker when β-blockade alone is not effective; severe pre-eclampsia, when other IV antihypertensive agents are not recommended or are contraindicated. Post-op HTN.

IV infusion Dose will depend on targeted BP, patient's response, & age or general status of the patient. Adult Initial dose: Continuous infusion at a rate of 3-5 mg/hr for 15 min; can be increased by increments of 0.5 or 1 mg every 15 min. Max: 15 mg/hr. Maintenance dose: Progressively reduce to 2-4 mg/hr when target pressure is reached. Paed patient In case of emergency, initial dose: 0.5-5 mcg/kg/min. Maintenance dose: 1-4 mcg/kg/min. Elderly, pregnant w/ pre-eclampsia, patient w/ hepatic &/or renal failure Continuous infusion starting at 1-5 mg/hr; can be increased or decreased by increments of 0.5 mg/hr after 30 min. Max: 15 mg/hr.

Hypersensitivity. Severe aortic stenosis. Compensatory HTN, in case of an arteriovenous shunt or aortic coarctation. Unstable angina. W/in 8 days after MI.

Administer w/ caution to avoid excessive fall in BP. Patients w/ congestive cardiac failure or pulmonary oedema, particularly when receiving concomitant β-blockers; suspected coronary ischaemia; portal HTN; pre-existing intracranial HTN; acute cerebral infarction; patients w/ decreased cardiac function concomitantly using a β-blocker. Concomitant use of Mg sulphate in pregnant women. Infusion site reactions w/ prolonged duration of administration & in peripheral veins. Not recommended in patients w/ hereditary fructose intolerance. May impair ability to drive or operate machinery. Patients w/ history of hepatic dysfunction; hepatic failure; renal failure. Pregnancy. Should not be used during breastfeeding. Elderly ≥65 yr. Infants or childn.

Headache. Dizziness; lower limb oedema, palpitations, hypotension, tachycardia; orthostatic hypotension; nausea, vomiting.

Potentially dangerous to combine w/ dantrolene. Increased adverse effects w/ idelalisib. Increased blood levels of immunosuppressants eg, ciclosporine, everolimus, sirolimus, tacrolimus, temsirolimus. Decreased plasma conc w/ CYP3A4 inducers (eg, carbamazepine, phenobarb, phenytoin, fosphenytoin, primidone, rifampicin). Increased plasma conc w/ potent CYP3A4 inhibitors (eg, cimetidine, clarithromycin, cobicistat, erythromycin, itraconazole, grapefruit juice, ketoconazole, nelfinavir, posaconazole, ritonavir, telaprevir, telithromycin, voriconazole). Potentiated antihypertensive effect w/ baclofen, urologic α-blockers (alfuzosin, doxazosin, prazosin, silodosin, tamsulosin, terazosin), α-blocking antihypertensive agents (doxazosin, prazosin, urapidil), TCAs (eg, imipramine), neuroleptics, opioids & amifostine. Increased risk of orthostatic hypotension w/ nitrate derivatives or related agents & other orthostatic hypotension-causing medicinal products. Potential additive or synergistic hypotensive effect w/ inhalational anaesth. Enhanced -ve inotropic effect of β-blockers in cardiac failure (bisoprolol, carvedilol, metoprolol, nebivolol). Possible risk of pulmonary oedema or excessive decrease in BP w/ Mg sulphate. Increased plasma levels of digoxin. Decreased antihypertensive effect w/ IV corticosteroids (glucocorticoids & mineralocorticoids) & tetracosactide (except for hydrocortisone used as replacement therapy in Addison's disease). May have additive effect on neuromuscular blocking; vecuronium infusion dose requirements could be reduced by concurrent use of nicardipine.

Calcium Antagonists

C08CA04 - nicardipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.

P₁S₁S₃