Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: nicardipine
BRAND NAME: Cardene, Cardene SR
DRUG CLASS AND MECHANISM: Nicardipine belongs to a class of blood pressure
reducing medications called calcium channel blockers
(CCBs). Other medications in this
class include diltiazem (Cardizem), amlodipine (Norvasc), felodipine (Plendil),
verapamil (Calan, Isoptin), clevidipine (Cleviprex), and nifedipine (Adalat,
Procardia). These medications block the movement of calcium into the smooth
muscle cells surrounding the arteries of the body. Since calcium promotes
contraction of muscle, blocking calcium entry into the muscle cells relaxes the
arterial muscles and causes the arteries to become larger. This lowers blood
pressure, which reduces the work that the heart must do to pump blood to the
body. Reducing the work of the heart lessens the heart muscle's demand for
oxygen and thereby helps prevent angina (heart pain) in patients with
coronary
artery disease. Unlike verapamil or diltiazem, nicardipine has little effect on
heart muscle or on electrical conduction within the heart. The FDA approved
nicardipine in December 1988.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
- Capsules: 20 and 30 mg.
- Capsules (sustained release): 30, 45,
and 60 mg.
- Injection: 0.1, 0.2, and 2.5 mg/ml.
STORAGE: Nicardipine should be stored at room temperature, 15 to 30 C (59 to
86 F), and protected from light.
PRESCRIBED FOR: Oral nicardipine is used alone or in combination with other
drugs for the treatment of high blood pressure. Conventional capsules (not
sustained release) also are used for the treatment of angina (heart pain).
Nicardipine injections are used for short-term treatment of blood pressure when
oral medications are not possible or desirable.
DOSING: The recommended dose of nicardipine is 20-40 mg three times daily
with conventional capsules or 30-60 mg twice daily with sustained release
capsules. Intravenous infusion rates can range between 0.1 and 15 mg/hr.
DRUG INTERACTIONS: Rifampin, phenobarbital, phenytoin, oxcarbazepine
(suspension oral Trileptal;
oral Trileptal) and
carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) may reduce blood levels of nicardipine by increasing its
metabolism in the liver. Therapy should be monitored and drug doses should be
adjusted accordingly.
Co-administration of nicardipine and cyclosporine results in increased
cyclosporine blood levels. Cyclosporine blood levels should be monitored and its
dosage reduced when taking nicardipine.
PREGNANCY: There are no adequate studies of nicardipine in pregnant women;
Nicardipine has been used to treat the high blood pressure of preeclampsia
during the third trimester of pregnancy.
NURSING MOTHERS: Animal studies show that nicardipine is secreted in
breast milk. Nicardipine should be avoided by nursing mothers.
SIDE EFFECTS: Side effects of nicardipine include an increased heart rate due
to the drop in blood pressure. Other side effects include swelling of the feet
(edema), dizziness,
headaches,
flushing, palpitations, and nausea. Nicardipine
sometimes can cause an increase in the frequency and duration of angina. The
reason for this side effect is not clearly understood. Excessively
low blood
pressure can occur in rare instances, especially during initiation of treatment
or following adjustments of dosage.
Reference: FDA Prescribing Information
Last Editorial Review: 9/2/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- High Blood Pressure - Learn about high blood pressure symptoms like headache, dizziness, shortness of breath, blurred vision and more. Causes, and normal blood pressure information is included.
- Calcium Channel Blockers - Establishes the medication calcium channel blockers (CCBs), which are drugs used for treating high blood pressure, angina, and abnormal heart rhythms like atrial fibrillation.
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