Nicardipine

DEA Class; Rx

Common Brand Names; Cardene IV, Cardene SR

• Calcium Channel Blockers; 
• Calcium Channel Blockers, Dihydropyridine

Indicated for the treatment of chronic stable angina.

Hypersensitivity to nicardipine or other calcium-channel blockers

Advanced aortic stenosis

• Headache (IV; 15%)
• Flushing (6-10%)
• Peripheral edema (PO; 6-8%)
• Pedal edema (PO; 6.8%)
• Headache (PO; 6.3%)
• Hypotension (IV; 6%)
• Exacerbation of angina (6%)
• Asthenia (PO; 3%)
• Nausea (PO; 1.6%)
• Ventricular extrasystoles (IV; 1%)
• Dizziness (1%)
• Rash (PO; 1%)
• Polyuria (IV; 1%)
• Asthenia (IV)
• Facial edema
• Hypotension (PO)
• Myalgia (PO)
• Syncope (IV)
• Tachycardia

May cause symptomatic hypotension or tachycardia; titrate slowly to avoid systemic hypotension and possible negative inotropic effects with congestive heart failure (CHF), angina, and left ventricular dysfunction (particularly during treatment initiation, after dose increase, or after withdrawal of beta blocker)

To reduce possibility of venous thrombosis, phlebitis, and vascular impairment, do not use small veins, such as those on dorsum of hand or wrist; avoid intraarterial administration or extravasation

Caution should be exercised when using the drug in congestive heart failure patients, particularly in combination with a beta-blocker; nicardipine gives no protection against dangers of abrupt beta-blocker withdrawal; any such withdrawal should be by gradual reduction of dose of beta-blocker, preferably over 8 to 10 days

Closely monitor response in patients with angina, congestive heart failure, impaired hepatic function, portal hypertension, and renal impairment and pheochromocytoma

Peripheral edema may occur

Exacerbation of angina or MI reported with dosage titration of dihydropyridine calcium-channel blockers

With acute cerebral infarction or hemorrhage, titrate slowly to avoid systemic hypotension

Use with caution in patients with hypertrophic cardiomyopathy and mild-to-moderate aortic stenosis

Use with caution in hepatic or renal impairment; lower doses may be required

Use with caution in hypertension associated with pheochromocytoma and portal hypertension when administering IV

Change infusion site every 12 hr to minimize risk of peripheral venous irritation

Blood pressure starts to fall within min of infusion; calcium channel blockers, may occasionally produce symptomatic hypotension; caution is advised to avoid systemic hypotension when administering drug to patients who have sustained acute cerebral infarction or hemorrhage

Extended-release form not recommended for angina

Pregnancy category: C

Lactation: Unknown whether drug is excreted in breast milk; avoid use