What is Nicardipine?
Nicardipine is an intravenous blood pressure medication that works by relaxing blood vessels, used specifically when you need to lower dangerously high blood pressure quickly in a hospital setting. 1
How It Works (Simple Version)
- Nicardipine blocks calcium from entering the muscle cells in your blood vessel walls, which makes the vessels relax and widen—like loosening a tight belt 1
- When blood vessels widen, blood pressure drops because blood has more room to flow 1
- It works mainly on blood vessels, not on the heart muscle itself, which makes it safer than some other blood pressure medicines 1
When Doctors Use It
Nicardipine is given through an IV (a tube in your vein) only in hospitals when blood pressure is dangerously high and needs to come down quickly. 2, 3
Specific situations include:
- Before stroke treatment: When blood pressure is too high (over 185/110) to safely give clot-busting medicine for stroke 2
- During and after stroke treatment: To keep blood pressure controlled while receiving stroke medications 2
- Severe high blood pressure emergencies: When organs like the brain, heart, or kidneys are being damaged by extremely high blood pressure 2, 3
- Pregnancy complications: When pregnant women develop dangerously high blood pressure (preeclampsia/eclampsia) 2, 3
- During surgery: To control blood pressure spikes during operations 3
- Kidney problems with high blood pressure: When kidneys are failing and blood pressure is very high 3
How Doctors Give It
- Starts at a low drip rate (5 mg per hour) through the IV 2, 3
- Increased slowly every 5-15 minutes until blood pressure reaches the safe target 2, 3
- Maximum dose is 15 mg per hour 2, 3
- Nurses check blood pressure every 15 minutes at first to make sure it doesn't drop too fast 2
Why Not Just Take a Pill?
When blood pressure is dangerously high and damaging organs, doctors need precise, minute-by-minute control that only IV medications can provide. 3
- Pills take 30-60 minutes to start working and can't be turned off if blood pressure drops too much 3
- IV nicardipine works in about 5-15 minutes and can be stopped immediately if needed 2, 4
- Doctors can adjust the dose up or down instantly based on blood pressure readings 4
Important Safety Points
- Must be given in an intensive care unit or emergency room where blood pressure can be monitored constantly 5
- Cannot be given through small hand or wrist veins because it irritates the vein—needs a larger vein or central line 1
- IV site should be changed every 12 hours to prevent vein inflammation 1
- Not for routine high blood pressure that can be treated with pills at home 3
Common Side Effects
- Headache (very common) 4, 6
- Flushing or feeling warm 4, 6
- Faster heartbeat (about 10 beats per minute faster) 1, 4
- Vein irritation at the IV site if left in too long 4
The Simple Rule
If your blood pressure is so high that it's an emergency requiring hospitalization, nicardipine is one of the safest and most controllable IV medications doctors can use to bring it down gradually without causing harm. 2, 3, 7