How do you dilute nicardipine (calcium channel blocker) for intravenous administration?

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Nicardipine Dilution for Intravenous Administration

Nicardipine must be diluted to a concentration of 0.1 mg/mL before intravenous infusion: add each 25 mg vial to 240 mL of compatible IV fluid to yield 250 mL total volume. 1

Dilution Protocol for Single-Dose Vials

  • Each 25 mg vial requires dilution with 240 mL of compatible IV fluid, resulting in 250 mL at a final concentration of 0.1 mg/mL 1
  • The diluted solution remains stable for 24 hours at controlled room temperature in polyvinyl chloride containers 1

Compatible IV Fluids

The following solutions are compatible with nicardipine for dilution 1:

  • Dextrose 5% Injection, USP
  • Dextrose 5% and Sodium Chloride 0.45% Injection, USP
  • Dextrose 5% and Sodium Chloride 0.9% Injection, USP
  • Dextrose 5% with 40 mEq Potassium, USP
  • Sodium Chloride 0.45% Injection, USP
  • Sodium Chloride 0.9% Injection, USP

Incompatible Solutions

Never mix nicardipine with Sodium Bicarbonate 5% Injection, USP or Lactated Ringer's Injection, USP 1

Pre-Mixed Flexible Containers

  • Nicardipine Hydrochloride in 0.9% Sodium Chloride Injection premixed bags do not require dilution 1
  • Inspect the bag for leaks by squeezing firmly before use; discard if the seal is not intact 1
  • Do not add supplementary medications to premixed bags 1
  • Protect from light until ready to use 1

Critical Safety Checks Before Administration

  • Visually inspect for particulate matter, precipitate, or crystallization before use 1
  • Do not use if particulate matter is present or if the container appears damaged 1
  • Never use plastic containers in series connections due to air embolism risk 1

Administration Route Considerations

  • Administer by slow continuous infusion via a central line or large peripheral vein 1
  • Change the infusion site every 12 hours if using a peripheral vein to prevent phlebitis 1, 2
  • Central line administration is preferred to avoid superficial thrombophlebitis, which occurred in pediatric patients receiving peripheral infusions 2

Standard Dosing After Dilution

  • Start at 5 mg/hr IV infusion and titrate by 2.5 mg/hr every 5-15 minutes to a maximum of 15 mg/hr 3, 4, 1
  • Onset of action occurs within 5-15 minutes, with blood pressure beginning to fall within minutes of infusion 3, 1

References

Research

Nicardipine is a safe and effective agent in pediatric hypertensive emergencies.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2000

Guideline

Nicardipine Administration Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Nicardipine IV Infusion Protocol for Hypertensive Emergency

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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