Cardene Side Effects

Generic Name: nicardipine

Please note - some side effects for Cardene may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Cardene - for the Consumer

Cardene IV

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Cardene IV:

Diarrhea; dizziness; feeling of warmth (flushing); feet swelling; headache; nausea; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast or irregular heartbeat; increased chest pain; pain, redness, or swelling at the injection site; pounding in the chest; shortness of breath; swelling of the ankles or hands.

Cardene

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Cardene:

Diarrhea; dizziness; feeling of warmth (flushing); feet swelling; headache; nausea; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast or irregular heartbeat; increased chest pain; pounding in the chest; shortness of breath; swelling of the ankles or hands.

Cardene SR Sustained-Release Capsules

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Cardene SR Sustained-Release Capsules:

Diarrhea; dizziness; feeling of warmth (flushing); feet swelling; headache; nausea; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast or irregular heartbeat; increased chest pain; pounding in the chest; shortness of breath; swelling of the ankles or hands.

Side Effects by Body System

General

Side effects of nicardipine are generally mild and transient.

Cardiovascular

Cardiovascular side effects are the most common, and are related to the vasodilatory properties of nicardipine. Peripheral edema occurs in up to 28%, dizziness in 6% to 18%, flushing in 4% to 8%, hypotension in 5%, palpitations in 3%, tachycardia in 3%, and angina in 3% of patients. At least one case of profound sinus bradycardia has been reported following intravenous nicardipine.

Rare cases of angina pectoris associated with nicardipine have been reported. These cases may be due to a coronary artery "steal phenomenon" secondary to coronary vasodilation or increased myocardial oxygen demand secondary to increased heart rate.

Nervous system

The dose of nicardipine SR for a 74-year-old man with angina pectoris was increased over a 2-week period from 30 mg BID to 60 mg BID. One week later the patient suffered two episodes of severe generalized tonic and clonic muscular contractions. There was no loss of bladder control or loss of consciousness. The symptoms were controlled by IV diazepam. Diltiazem was substituted and his symptoms never recurred. The patient refused rechallenge. The authors of this case report speculated whether some calcium channel blockers adversely affect calcium-mediated neurotransmission.

Nervous system side effects are probably related to the vasodilatory properties of nicardipine, and include headache in 10% to 16% of patients. Rare neurologic side effects include paresthesias, anxiety and depression. A single case of severe dyskinesia has been associated with nicardipine SR.

Gastrointestinal

Gastrointestinal side effects include dyspepsia and vomiting in up to 5% of patients. Noncompliance due to nausea and vomiting has been reported.

Dermatologic

Dermatologic side effects are uncommon. Rash has been reported in up to 6% of patients.

Endocrine

A small study (9 patients) has shown that the use of nicardipine to control blood pressure in hypertensive patients with noninsulin-dependent diabetes mellitus is associated with progressively and significantly elevated hemoglobin A1C concentrations.

Rare cases of hyperglycemia associated with nicardipine are reported. This is thought to be due to inhibition of pancreatic beta islet cellular insulin production and secretion. The Japanese have used some calcium channel blockers to reverse the frequency and severity of hypoglycemic symptoms in patients with insulinoma.

A case of parotitis associated with nicardipine has been reported.

Endocrinologic side effects are rare, and include cases of hyperglycemia. One study has shown that nicardipine can cause deterioration in glucose metabolism in hypertensive patients with noninsulin-dependent diabetes mellitus.

Musculoskeletal

Musculoskeletal side effects are uncommon, and include myalgias and arthralgias.

A case of erythromelalgia (paroxysmal burning or throbbing of the skin) associated with nicardipine has been reported.

Respiratory

Respiratory side effects include at least one case of pulmonary edema.

At least one case of pulmonary edema during tocolytic therapy with nicardipine has been reported. The patient developed pulmonary edema 3 days after starting intravenous nicardipine (2 mg/hr). Symptoms included dyspnea, orthopnea, cough, and tachycardia which rapidly responded to diuretic and oxygen therapy.

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