Nicardipine Aguettant

Nicardipine Aguettant Dosage/Direction for Use

nicardipine

Manufacturer:

Laboratoire Aguettant

Distributor:

HK Medical Supplies
/
Health Express
Full Prescribing Info
Dosage/Direction for Use
Posology: The antihypertensive effect depends on the administered dose. The dosage to achieve the desired blood pressure can vary depending on the targeted blood pressure, the response of the patient, and the age or general condition of the patient.
Unless given via a central venous line, dilute the product to a concentration of 0.1-0.2 mg/ml before use (see Incompatibilities under Cautions for Usage for details on incompatible solutions).
Adults: Initial dose: Treatment should start with the continuous administration of nicardipine at a rate of 3-5 mg/hr for 15 minutes. Rates can be increased by increments of 0.5 or 1 mg every 15 minutes. The infusion rate should not exceed 15 mg/hr.
Maintenance dose: When the target pressure is reached, the dose should be reduced progressively, usually to between 2 and 4 mg/hr, to maintain therapeutic efficacy.
Transition to an oral antihypertensive agent: Discontinue nicardipine or reduce dosage while appropriate oral therapy is established. When an oral antihypertensive agent is initiated, consider the lag time before the onset of effects by the oral agent. Continue blood pressure monitoring until the desired effect is achieved.
It is possible to switch to oral nicardipine 20 mg tablets at a dosage of 60 mg/day in 3 daily doses, or to nicardipine 50 mg extended-release capsules, at a dosage of 100 mg/day, in 2 daily doses.
It should be noted that nicardipine 20 mg tablets and 50 mg extended-release capsules oral preparations are not available in Hong Kong market.
Elderly patients: Clinical studies on nicardipine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Elderly patients may be more sensitive to the effects of nicardipine because of impaired renal and/or hepatic function. It is recommended to provide a continuous infusion of nicardipine starting at a dose of 1 to 5 mg/hr, depending on the blood pressure and clinical situation. After 30 minutes, depending on the effect observed, the rate can be increased or decreased by increments of 0.5 mg/hr. The rate should not exceed 15 mg/hr.
Pregnancy: It is recommended to provide a continuous infusion of nicardipine starting at 1 to 5 mg/hr, depending on the blood pressure and clinical situation. After 30 minutes, depending on the effect observed, the rate can be increased or decreased by increments of 0.5 mg/hr.
Doses higher than 4 mg/hr are generally not exceeded in the treatment of pre-eclampsia. However, the rate should not exceed 15 mg/hr (see Precautions, Use in Pregnancy & Lactation, and Adverse Reactions).
Hepatic failure: Nicardipine should be used with particular caution in these patients. Since nicardipine is metabolised in the liver, it is recommended to use the same dose regimens as for elderly patients in patients with hepatic failure or reduced hepatic blood flow.
Renal failure: Nicardipine should be used with particular caution in these patients. In some patients with moderate renal failure, a significantly lower systemic clearance and higher area under the curve (AUC) have been observed. Therefore, it is recommended to use the same dose regimens as for elderly patients in patients with renal failure.
Paediatric population: The safety and efficacy of nicardipine in low birth weight infants, newborns, nursing infants, infants, and children have not been established.
Nicardipine should only be used for life-threatening hypertension in paediatric intensive care settings or post-operative contexts.
Initial dose: In case of emergency, a starting dose of 0.5 to 5 mcg/kg/min is recommended.
Maintenance dose: The maintenance dose of 1 to 4 mcg/kg/min is recommended.
Nicardipine should be used with caution in children with renal failure. In this case, only the lowest dosage should be used.
Method of administration: Nicardipine must only be administered by continuous intravenous infusion.
Nicardipine must only be administered by specialists in a well-controlled medical environment, such as hospitals and intensive care units, with continuous monitoring of blood pressure. The rate of administration should be precisely controlled using an electronic syringe driver or a volumetric pump. The blood pressure and heart rate should be monitored at least every 5 minutes during infusion, then until stabilisation of vital signs and at least 12 hours after the end of nicardipine administration.
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