Nicardipine Availability as an Oral Medication
Yes, nicardipine is available as an oral medication in capsule form, with dosages of 20 mg and 30 mg. 1
Oral Nicardipine Details
Nicardipine is a dihydropyridine calcium channel blocker that comes in both intravenous and oral formulations. The oral form has the following characteristics:
- Available strengths: 20 mg and 30 mg capsules 1
- Usual dosing range: 20-40 mg three times daily 2
- Duration of action: Short (compared to other calcium channel blockers) 2
- Pharmacokinetics:
- Completely absorbed following oral administration
- Subject to first-pass metabolism with bioavailability of about 35%
- Peak plasma levels occur within 30 minutes to 2 hours (mean 1 hour) 1
Clinical Use of Oral Nicardipine
Oral nicardipine is primarily used for:
- Hypertension management: Effective for mild to moderate hypertension 3
- Angina pectoris: Used for stable effort angina and rest angina due to coronary artery spasm 3
The JNC 7 guidelines list nicardipine as one of the available calcium channel blockers for hypertension management, with a usual dose of 20-40 mg three times daily 2.
Transition from IV to Oral Therapy
Research has shown that patients can be successfully transitioned from intravenous to oral nicardipine therapy:
- Oral therapy can be initiated approximately 1 hour before discontinuation of IV treatment
- Starting oral dose is typically 40 mg
- Maintenance dose is usually 40 mg three times daily, which can be adjusted based on blood pressure response 4
Side Effects of Oral Nicardipine
Common side effects include:
Important Clinical Considerations
- Nicardipine has less negative inotropic effect compared to some other calcium channel blockers 3
- Food may decrease the bioavailability of oral nicardipine by 20-30%, though clinical trials establishing efficacy were conducted without regard to meal timing 1
- Nicardipine inhibits certain cytochrome P450 enzymes (including CYP3A4, CYP2D6, CYP2C8, and CYP2C19), which may lead to drug interactions 1
Comparison to Other Calcium Channel Blockers
Unlike immediate-release nifedipine (which should be avoided due to risk of abrupt blood pressure drops), oral nicardipine has a more predictable effect profile when used appropriately 5.
Nicardipine's pharmacokinetics are non-linear due to saturable hepatic first-pass metabolism, meaning increasing doses result in disproportionate increases in plasma levels 1.
In conclusion, nicardipine is indeed available in oral form and represents a viable option for patients requiring calcium channel blocker therapy for hypertension or angina when appropriate.