Malignant hypertension, hypertensive encephalopathy, dissection of aorta, severe pre-eclampsia, postoperative hypertension

Active Ingredient: Nicardipine

Indication for Nicardipine

Population group: only adults (18 - 65 years old)

Nicardipine solution for injection is indicated for the treatment of acute life-threatening hypertension, particularly in the event of:

  • Malignant arterial hypertension/Hypertensive encephalopathy.
  • Aortic dissection, when short acting beta-blocker therapy is not suitable, or in combination with a beta-blocker when beta-blockade alone is not effective.
  • Nicardipine is also indicated for the treatment of post-operative hypertension.

For this indication, competent medicine agencies globally authorize below treatments:

2-5 mg/h

Route of admnistration

Intravenous

Defined daily dose

2 - 5 mg

Dosage regimen

From 2 To 5 mg once every day

Detailed description

Nicardipine should only be administered by specialists in well controlled environments, such as hospitals and intensive care units, with continuous monitoring of blood pressure. The speed of administration must be accurately controlled by the use of an electronic syringe driver or a volumetric pump. Blood pressure and heart rate must be monitored at least every 5 minutes during the infusion, and then until vital signs are stable, but at least for 12 hours after the end of the administration of nicardipine.

The antihypertensive effect will depend on the administered dose. The dosage regimen to achieve the desired blood pressure can vary depending on the targeted blood pressure, the response of the patient, and the age or status of the patient.

Unless given by a central venous line, dilute to a concentration of 0.1-0.2 mg/ml before use.

Adults

Initial dose: Treatment should start with the continuous administration of nicardipine at a rate of 3-5 mg/h for 15 minutes. Rates can be increased by increments of 0.5 or 1 mg every 15 minutes. The infusion rate should not exceed 15 mg/h.

Maintenance dose: When the target pressure is reached, the dose should be reduced progressively, usually to between 2 and 4 mg/h, to maintain the therapeutic efficacy.

Transition to an oral antihypertensive agent: discontinue nicardipine or titrate downward while appropriate oral therapy is established. When an oral antihypertensive agent is being instituted, consider the lag time of onset of the oral agent’s affect. Continue blood pressure monitoring until desired effect is achieved.

A switch can also be made to oral nicardipine 20mg capsules at dosage of 60 mg/day in 3 daily doses, or to nicardipine 50 mg extended-release tablets, at dosage of 100mg/day, in 2 daily doses.

Active ingredient

Nicardipine

Nicardipine is a second generation slow calcium channel inhibitor, and belongs to the phenyl-dihydropyridine group. Nicardipine has a greater selectivity for L-type calcium channels in vascular smooth muscle than cardiac myocytes. Nicardipine produces smooth muscle relaxation and marked peripheral vasodilatation.

Read more about Nicardipine

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