What is the dosage of Nicardipine (Calcium Channel Blocker)?

From the Guidelines

Nicardipine should be administered intravenously for acute blood pressure management, with an initial dose of 5 mg/hour, which can be increased by 2.5 mg/hour every 5 minutes as needed, up to a maximum of 15 mg/hour, as recommended by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.

Key Considerations

• The dose of nicardipine can be adjusted every 5 minutes to achieve the target blood pressure, allowing for quick titration and minimizing the risk of overshoot.
• The maximum dose of nicardipine is 15 mg/hour, and it is essential to monitor patients for potential side effects, including headache, flushing, dizziness, and peripheral edema.
• Nicardipine is a calcium channel blocker that works by relaxing blood vessels, making it easier for the heart to pump blood, and is particularly useful in hypertensive emergencies due to its rapid onset and short half-life.

Important Notes

• Contraindications for nicardipine include advanced aortic stenosis, and no dose adjustment is needed for elderly patients 1.
• Patients with hepatic or renal impairment may require dose adjustments, and it is crucial to monitor them closely for potential side effects.
• The choice of antihypertensive agent in hypertensive emergencies depends on various factors, including the underlying cause of the hypertension, the presence of comorbidities, and the patient's clinical presentation, and nicardipine may be a better option than labetalol in achieving short-term blood pressure targets 1.

From the FDA Drug Label

Individualize dosage based upon the severity of hypertension and response of the patient during dosing In a drug-free patient, initiate therapy at 5 mg/hr. Increase the infusion rate by 2. 5 mg/hr to a maximum of 15 mg/hr until desired blood pressure reduction is achieved.

The recommended dosage of Nicardipine is to be individualized based on the severity of hypertension and patient response. The initial dose in a drug-free patient is 5 mg/hr, which can be increased by 2.5 mg/hr to a maximum of 15 mg/hr until the desired blood pressure reduction is achieved 2.

From the Research

Nicardipine Dosage

• The provided studies do not specify a particular dosage for nicardipine, but they do discuss its efficacy and safety in various clinical settings 3, 4.
• Nicardipine is used to treat hypertension, angina pectoris, and related cardiovascular disorders, with its dosage likely depending on the specific condition being treated and the patient's response to the medication 3.
• In one study, nicardipine was administered at a dose of 60 mg/day, titrated if necessary to 100 mg/day, in the treatment of isolated systolic hypertension in the elderly 4.

Efficacy and Safety

• Nicardipine has been shown to be effective in reducing blood pressure and improving symptoms in patients with hypertension and angina pectoris 3, 4.
• The medication has a relatively good safety profile, with common side effects including headache, flushing, and peripheral edema 3.
• Nicardipine has been compared to other antihypertensive medications, such as amlodipine, and has been found to be similarly effective in reducing blood pressure 4.

Comparison to Other Medications

• Nicardipine has been compared to other calcium channel blockers, such as clevidipine, and has been found to have similar efficacy and safety profiles 5.
• The choice of medication may depend on individual patient factors, such as the specific condition being treated and the presence of any comorbidities 6, 7.