Nicabloc

Nicardipine HCl

Acute life-threatening HTN particularly 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. Post-op HTN.

Adult Continuous administration at rate 3-5 mg/hr for 15 min. May be increased by increments of 0.5 or 1 mg every 15 min. Max infusion rate: 15 mg/hr. Maintenance dose: When target pressure is reached, dose should be reduced progressively, usually between 2 & 4 mg/hr. Childn Initially 0.5-5 mcg/kg/min in case of emergency. Maintenance dose: 1-4 mcg/kg/min. Elderly, pregnancy, hepatic & renal impairment Initially 1-5 mg/hr, increased or decreased by increments of 0.5 mg/hr after 30 min. Max infusion rate: 15 mg/hr.

Hypersensitivity. Severe aortic stenosis, compensatory HTN ie, in case of an arteriovenous shunt or aortic coarctation, unstable angina, w/in 8 days after MI. Patients w/ rare hereditary problems of fructose intolerance.

May produce systemic hypotension & reflex tachycardia. Patients w/ CHF or pulmonary edema in patients receiving β-blockers; suspected coronary ischemia; pre-existing elevated ICP; acute cerebral infarction. Worsen portal vein HTN & portal-systemic collateral blood flow in index in cirrhotic patients. History of hepatic dysfunction or those w/ impaired hepatic function. Concomitant use w/ Mg sulphate; β-blockers in patients w/ decreased cardiac function. Infusion site reactions. Pregnancy. Not to be used during lactation. Infants or childn w/ renal impairment.

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

May enhance -ve inotropic effect of β-blockers & may cause heart failure in patient w/ latent or uncontrolled heart failure. May cause fatal ventricular fibrillation w/ dantrolene. Risk of pulmonary oedema or excessive decrease in BP w/ Mg sulphate. Decreased plasma conc w/ CYP 3A4 enzyme-inducing agents (eg, carbamazepine, phenobarb, phenytoin, fosphenytoin, primidone & rifampicin). Increased plasma conc w/ CYP3A4 enzyme-inhibiting agents (eg, cimetidine, itraconazole & grapefruit juice). Increased risk of edema w/ itraconazole. Elevated plasma levels of cyclosporine, tacrolimus & sirolimus; digoxin. Potentiate antihypertensive effect w/ baclofen, α-blockers, TCAs, neuroleptics, opioids, & amifostine. Decreased antihypertensive effect w/ IV corticosteroid & tetracosactide. Induced potential additive or synergistic hypotensive effect w/ inhalational anaesth (eg, isoflurane, sevoflurane, enflurane). Enhanced neuromuscular block w/ competitive neuromuscular blockers.

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.

Rx