Nicardipine Dilution with D5W
Yes, nicardipine can and should be diluted with D5W (Dextrose 5% in Water) for intravenous administration. This is explicitly approved and recommended in the FDA labeling as one of the compatible diluents for nicardipine infusion. 1
FDA-Approved Compatible Diluents
Nicardipine hydrochloride injection is compatible and stable in polyvinyl chloride containers for 24 hours at controlled room temperature when diluted with the following solutions: 1
- Dextrose (5%) Injection, USP (D5W)
- 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
Preparation Instructions
For single dose vials: Each 25 mg vial must be diluted with 240 mL of D5W (or other compatible IV fluid), resulting in 250 mL of solution at a concentration of 0.1 mg/mL. 1
For flexible containers: Pre-mixed nicardipine in 0.9% sodium chloride does not require dilution. 1
Critical Incompatibilities to Avoid
Nicardipine is NOT compatible with: 1
- Sodium Bicarbonate (5%) Injection, USP
- Lactated Ringer's Injection, USP
These solutions will cause precipitation or inactivation and must never be used as diluents for nicardipine. 1
Administration Guidelines
- Administer by slow continuous infusion via central line or large peripheral vein 1
- Change infusion site every 12 hours if using peripheral vein to prevent phlebitis 1
- Inspect solution for particulate matter, precipitate, or crystallization before use; discard if present 1
- Protect from light until ready to use 1
Stability Considerations
The diluted nicardipine solution in D5W remains stable for 24 hours at controlled room temperature, providing adequate time for clinical use. 1 Research confirms that nicardipine demonstrates effective blood pressure control when properly diluted and administered, with rapid onset of action (within minutes) and predictable offset after discontinuation. 2, 3