What is the mg/hr dose of nicardipine (calcium channel blocker) for a post-craniotomy patient with subarachnoid hemorrhage and hypertension, if it's being administered at 100cc/hr?

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Last updated: January 21, 2026View editorial policy

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Nicardipine Concentration Calculation

At 100 cc/hr, you are administering 10 mg/hr of nicardipine, assuming the standard concentration of 0.1 mg/mL (10 mg in 100 mL).

Standard Nicardipine Concentration and Calculation

  • Nicardipine is typically prepared as 0.1 mg/mL concentration (10 mg diluted in 100 mL of compatible IV solution), which is the most common premixed formulation used in clinical practice 1, 2.

  • At 100 cc/hr (100 mL/hr) with standard 0.1 mg/mL concentration:

    • 100 mL/hr × 0.1 mg/mL = 10 mg/hr

Clinical Context for This Dose

  • This 10 mg/hr dose is within the therapeutic range recommended by the American Heart Association for hypertensive emergencies, which specifies a dosing range of 5-15 mg/hr 3, 1.

  • For post-craniotomy patients with subarachnoid hemorrhage, this represents a moderate-to-high maintenance dose that should provide effective blood pressure control 1, 2.

  • The American Heart Association recommends starting nicardipine at 5 mg/hr and titrating by 2.5 mg/hr every 5-15 minutes to a maximum of 15 mg/hr until desired blood pressure is achieved 3, 1, 2.

Critical Monitoring Requirements

  • Blood pressure should be monitored every 15 minutes during active titration and for the first 2 hours after reaching target dose 1, 2.

  • For post-thrombolytic stroke patients specifically, the American Heart Association recommends checking blood pressure every 15 minutes for 2 hours, then every 30 minutes for 6 hours, then hourly for 16 hours 1, 2.

  • In subarachnoid hemorrhage patients, research demonstrates that nicardipine at approximately 10 mg/hr effectively prevents vasospasm while maintaining adequate cerebral perfusion 4, 5.

Important Caveats

  • Always verify the actual concentration of your institution's nicardipine preparation, as concentrations can vary (some institutions use 0.2 mg/mL or other concentrations).

  • If using a different concentration, recalculate: mg/hr = infusion rate (mL/hr) × concentration (mg/mL).

  • The maximum recommended dose is 15 mg/hr regardless of clinical scenario, as this is the absolute ceiling supported by all major guidelines 1, 2.

References

Guideline

Nicardipine Administration Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Management of Severe Hypertension with Nicardipine

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 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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