Clevidipine Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: IV infusion of 1 to 2 mg/hour (2 to 4 mL/hour)

Dose titration: Dose may be doubled at short (90 second) intervals initially. As blood pressure approaches goal, increase in doses should be less than doubling and intervals between dose adjustments should increase to every 5 to 10 minutes. An increase of approximately 1 to 2 mg/hour generally produces an additional 2 to 4 mmHg decrease in systolic pressure.

Maintenance dose: The desired therapeutic response for most patients occurs at doses of 4 to 6 mg/hour (8 to 12 mL/hour). Patients with severe hypertension may require doses up to 32 mg/hour (64 mL/hour).

Maximum dose: Most patients were treated with maximum doses of 16 mg/hour (32 mL/hour) or less; however, there is limited short-term experience with doses up to 32 mg/hour (64 mL/hour). Due to lipid load restrictions, no more than 1000 mL (or an average of 21 mg/hour) of clevidipine infusion is recommended per 24 hour period. There is little experience with infusion durations beyond 72 hours at any dose.

Patients transitioned to an oral antihypertensive agent: Clevidipine should be discontinued or titrated downward while appropriate oral treatment is established.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Dose Adjustments

The dose of clevidipine should be decreased if systemic hypotension or reflex tachycardia occurs.

Precautions

Clevidipine is contraindicated in patients with soybean, soy product, egg, or egg product allergies; in patients with defective lipid metabolism, including pathologic hyperlipemia, lipoid nephrosis, or acute pancreatitis (if accompanied by hyperlipidemia); and in patients with severe aortic stenosis (afterload reduction can be expected to decrease myocardial oxygen delivery).

Blood pressure and heart rate should be monitored constantly during infusion, and then until vital signs are stable. Patients not transitioned to another antihypertensive treatment following prolonged clevidipine infusions should be monitored for at least 8 hours after the infusion is stopped in case of rebound hypertension.

Continued blood pressure monitoring is recommended for patients transitioned to an oral antihypertensive agent until the desired effect is reached.

Dihydropyridine calcium channel blockers may produce negative inotropic effects and worsen heart failure. Heart failure patients should be carefully monitored.

Clevidipine contains about 0.2 g of lipid per mL (2.0 kcal). Patients with significant lipid metabolism disorders may require lipid intake restrictions and a decrease in concurrently administered lipids may be necessary to compensate for the amount infused as part of the clevidipine formulation.

Safety and efficacy have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Dosage should be individualized depending on the desired blood pressure and the patient's response.

Once the stopper of the vial is punctured, clevidipine should be used within 12 hours and any unused portion should be discarded.

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