BCWorld Pharm


Concise Prescribing Info
Nicardipine HCl
Malignant arterial HTN/hypertensive encephalopathy. Aortic dissection, when short acting β-blocker therapy is not suitable, or in combination w/ a β-blocker when β-blockade alone is not effective. Severe pre-eclampsia, when other IV antihypertensive agents are not recommended or are contraindicated. Post-op HTN.
Dosage/Direction for Use
Individualized dosage. Adult Initially 3-5 mg/hr for 15 min. May be increased by increments of 0.5 or 1 mg every 15 min. Max infusion rate: 15 mg/hr. Maintenance: When the target pressure is reached, the dose should be reduced progressively, usually between 2 & 4 mg/hr. Childn Initially 0.5-5 mcg/kg/min. Maintenance: 1-4 mcg/kg/min. Pregnancy & elderly Initially at 1-5 mg/hr depending on BP & clinical response. After 30 min, may be increased or decreased by increments of 0.5 mg/hr. Pre-eclampsia Max: 4 mg/hr at a rate of not exceeding 15 mg/hr.
Hypersensitivity. Severe aortic stenosis, compensatory HTN ie, in case of an arteriovenous shunt or aortic coarctation, unstable angina (w/in 8 days after MI), patients w/ fructose intolerance.
Special Precautions
Systemic hypotension & reflex tachycardia. Patients w/ CHF or pulmonary edema, particularly in patients receiving β-blockers; suspected coronary ischemia; history of hepatic dysfunction or those w/ impaired hepatic function; portal HTN; preexisting elevated intracranial pressure; acute cerebral infarction. Not recommended in ischemic stroke patients. Renal impairment or reduced hepatic blood flow. Concomitant use w/ β-blockers & Mg sulphate. Not recommended if bolus or IV administration not controlled by the use of an electronic syringe driver or a volumetric pump. Pregnancy. Do not use during lactation. Childn.
Adverse Reactions
Headache. Dizziness; lower limb edema, palpitations, hypotension; tachycardia; orthostatic hypotension, nausea, vomiting; flushing.
Drug Interactions
May enhance -ve inotropic effect of β-blockers & may cause heart failure in patient w/ latent or uncontrolled heart failure. Combination w/ dantrolene. Possible risk of pulmonary edema or excessive decrease in BP w/ Mg sulphate. Decreased plasma conc w/ CYP3A4 enzyme inducing agents (eg, carbamazepine, phenobarb, phenytoin, fosphenytoin, primidone & rifampicin). Increased plasma conc w/ CYP3A4 enzyme-inhibiting agents (eg, cimetidine, itraconazole & grapefruit juice). May elevate plasma cyclosporine/tacrolimus levels w/ cyclosporine, tacrolimus or sirolimus. May increase plasma levels of digoxin. Potentiate the antihypertensive effect w/ baclofen, α-blockers, TCAs, neuroleptics, opioids & amifostine. Decreased antihypertensive effect w/ IV corticosteroids & tetracosactide (except for hydrocortisone used as replacement therapy). Potential additive or synergistic hypotensive effect w/ inhalational anesth.
MIMS Class
ATC Classification
C08CA04 - nicardipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
Nicardin soln for inj 1 mg/mL
10 × 10's (P8,705.36/box)
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