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nicardipine

Pronunciation

Generic Name: nicardipine (nye KAR di peen)
Brand Name: Cardene, Cardene SR, Cardene IV

What is nicardipine?

Nicardipine is in a class of drugs called calcium channel blockers. Nicardipine relaxes (widens) your blood vessels, which makes it easier for the heart to pump and reduces its workload.

Nicardipine is used to treat hypertension (high blood pressure) and angina (chest pain).

Nicardipine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about nicardipine?

Do not stop taking nicardipine without first talking to your doctor, even if you begin to feel better. If you stop taking the medication, your condition could become worse.

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Do not crush, chew, or break the extended-release (SR) capsules. Swallow them whole. They are specially formulated to release the medication slowly in the body.

What should I discuss with my healthcare provider before taking nicardipine?

Before taking nicardipine, tell your doctor if you have

  • kidney disease;

  • liver disease; or

  • another disease of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, low blood pressure, or coronary artery disease.

You may not be able to take nicardipine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Nicardipine is in the FDA pregnancy category C. This means that it is not known whether nicardipine will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Nicardipine passes into breast milk and may affect a nursing infant. Do not take nicardipine without first talking to your doctor if you are breast-feeding a baby.

If you are over 65 years of age, you may be more likely to experience side effects from nicardipine. Your doctor may prescribe a lower dose of this medication.

How should I take nicardipine?

Take nicardipine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Do not crush, break, or chew the extended-release (SR) capsules. Swallow them whole. They are specially formulated to release the medication slowly in the body.

Do not stop taking nicardipine without first talking to your doctor, even if you begin to feel better. If you stop taking the medication, your condition could become worse.

Grapefruit and grapefruit juice may interact with nicardipine. The interaction could have potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Store nicardipine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a nicardipine overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

What should I avoid while taking nicardipine?

Grapefruit and grapefruit juice may interact with nicardipine. The interaction could have potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Follow any recommendations your doctor makes about diet or exercise.

Use caution when you stand or sit up from a lying position, especially if you wake up during the night. You may become dizzy when changing positions.

Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness or dizziness while taking nicardipine.

Nicardipine side effects

If you experience any of the following serious side effects, stop taking nicardipine and contact your doctor immediately or seek emergency medical treatment:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • unusually fast or slow heartbeats;

  • fainting or severe dizziness;

  • abnormal behavior or psychosis;

  • chest pain or worsening angina;

  • jaundice (yellowing of the skin or eyes); or

  • swelling of the legs or ankles.

Other, less serious side effects may be more likely to occur. Continue to take nicardipine and talk to your doctor if you experience

  • unusual headache, fatigue, or tiredness;

  • dizziness;

  • flushing;

  • rash;

  • insomnia;

  • vivid or abnormal dreams;

  • increased urination;

  • dry mouth;

  • nausea or constipation; or

  • nervousness or tremor.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Nicardipine dosing information

Usual Adult Dose for Hypertension:

Oral:
Immediate release:
Initial dose: 20 mg orally 3 times a day
Maintenance dose: 20 to 40 mg orally 3 times a day

Sustained release:
Initial dose: 30 mg orally twice a day
Maintenance dose: 30 to 60 mg orally twice a day

IV infusion:
As substitute for oral therapy:
The following IV infusion rates are required to produce an average plasma level corresponding to a given oral dose at steady state:
20 mg orally every 8 hours is equivalent to 0.5 mg/hour via IV infusion
30 mg orally every 8 hours is equivalent to 1.2 mg/hour via IV infusion
40 mg orally every 8 hours is equivalent to 2.2 mg/hour via IV infusion

For initiation of therapy in patient not receiving oral nicardipine:
Initial dose: 5 mg/hour by IV infusion
The infusion rate may be increased by 2.5 mg/hour every 5 to 15 minutes (rapid and gradual titration, respectively) up to a maximum of 15 mg/hour, until desired blood pressure reduction is achieved. The infusion rate should be decreased to 3 mg/hour following achievement of the blood pressure goal using rapid titration.

Maintenance dose: The rate of infusion should be adjusted as needed to maintain desired response.

If oral nicardipine is to be used after IV nicardipine, the first dose should be administered 1 hour prior to discontinuation of the IV infusion.

Usual Adult Dose for Angina Pectoris Prophylaxis:

Oral:
Immediate release:
Initial dose: 20 mg orally 3 times a day
Maintenance dose: 20 to 40 mg orally 3 times a day

Sustained release:
Initial dose: 30 mg orally twice a day
Maintenance dose: 30 to 60 mg orally twice a day

IV infusion:
The following IV infusion rates are required to produce an average plasma level corresponding to a given oral dose at steady state:
20 mg orally every 8 hours is equivalent to 0.5 mg/hr IV infusion
30 mg orally every 8 hours is equivalent to 1.2 mg/hr IV infusion
40 mg orally every 8 hours is equivalent to 2.2 mg/hr IV infusion

Initiation of therapy: 5 mg/hour by IV infusion
May increase by 2.5 mg/hour every 5 to 15 minutes up to a maximum of 15 mg/hour

Usual Adult Dose for Congestive Heart Failure:

Oral:
Immediate release:
Initial dose: 20 mg orally 3 times a day
Maintenance dose: 20 to 40 mg orally 3 times a day

Sustained release:
Initial dose: 30 mg orally twice a day
Maintenance dose: 30 to 60 mg orally twice a day

IV infusion:
The following IV infusion rates are required to produce an average plasma level corresponding to a given oral dose at steady state:
20 mg orally every 8 hours is equivalent to 0.5 mg/hr IV infusion
30 mg orally every 8 hours is equivalent to 1.2 mg/hr IV infusion
40 mg orally every 8 hours is equivalent to 2.2 mg/hr IV infusion

Initiation of therapy: 5 mg/hour by IV infusion
May increase by 2.5 mg/hour every 5 to 15 minutes up to a maximum of 15 mg/hour

What other drugs will affect nicardipine?

Before taking nicardipine, tell your doctor if you are taking any of the following drugs:

  • another heart medication to treat the same or another condition;

  • cimetidine (Tagamet, Tagamet HB); or

  • cyclosporine (Sandimmune, Neoral).

You may not be able to take nicardipine, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with nicardipine or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

  • Your pharmacist can provide more information about nicardipine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.02. Revision Date: 2010-12-15, 5:01:39 PM.

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