Nicardipine Side Effects
Some side effects of nicardipine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to nicardipine: oral capsule, oral capsule extended release
Other dosage forms:
Along with its needed effects, nicardipine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking nicardipine:More common
- Arm, back, or jaw pain
- chest pain or discomfort
- chest tightness or heaviness
- fast or irregular heartbeat
- shortness of breath
- swelling of the legs
- Blurred vision
- cold hands and feet
- cold sweats
- cough or hoarseness
- difficulty swallowing
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- extra heartbeat
- fever or chills
- increase in frequency of urination
- lower back or side pain
- painful or difficult urination
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- skin rash
- unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur while taking nicardipine:Symptoms of overdose
- slurred speech
Some side effects of nicardipine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Feeling of warmth
- lack or loss of strength
- redness of the face, neck, arms and occasionally, upper chest
- Acid or sour stomach
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- difficulty in moving
- dry mouth
- joint pain
- muscle aching or cramping
- muscle pains or stiffness
- stomach discomfort, upset, or pain
- swollen joints
- Changes in vision
- continuing ringing or buzzing or other unexplained noise in ears
- decreased interest in sexual intercourse
- difficult or labored breathing
- fear or nervousness
- feeling of constant movement of self or surroundings
- feeling sad or empty
- hearing loss
- inability to have or keep an erection
- increase in body movements
- lack of appetite
- loss of interest or pleasure
- loss in sexual ability, desire, drive, or performance
- pain or tenderness around eyes and cheekbones
- runny nose
- sensation of spinning
- sore throat
- stuffy nose
- trouble concentrating
- trouble sleeping
For Healthcare Professionals
Applies to nicardipine: compounding powder, injectable solution, intravenous solution, oral capsule, oral capsule extended release
Side effects of nicardipine were generally mild and transient. Most were expected consequences of vasodilation. Therapy was discontinued in approximately 9% to 12% of patients, primarily due to hypotension, headache, and tachycardia.
Cardiovascular side effects have included hypotension (up to 8%), tachycardia (up to 5%), and angina pectoris. Atrioventricular block, ST segment depression, inverted T wave, deep vein thrombophlebitis, and at least one case of profound sinus bradycardia have been reported with intravenous nicardipine. Increased angina (5.6%), vasodilatation (4.7%), palpitations (up to 4.1%), postural hypotension (up to 0.9%), sustained tachycardia (0.8%), abnormal ECG (0.6%), chest pain, atypical chest pain, peripheral vascular disorder, and ventricular extrasystoles have been reported with oral nicardipine. Sinus node dysfunction, myocardial infarction, atrial fibrillation, exertional hypotension, pericarditis, heart block, cerebral ischemia, and ventricular tachycardia (any of which may be due to disease progression) have been observed in patients on chronic therapy with oral nicardipine. A case of erythromelalgia (paroxysmal burning or throbbing of the skin) associated with nicardipine has been reported.
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.
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 have included headache (up to 21%) and tinnitus. Hypertonia and ear disorder have been reported with intravenous nicardipine. Dizziness (up to 6.9%), somnolence (up to 1.4%), paresthesia (1%), syncope (0.8%), insomnia (0.6%), tremor (0.6%), vertigo, and hyperkinesia have been reported with oral nicardipine. A single case of severe dyskinesia has been associated with nicardipine SR.
Gastrointestinal side effects have included nausea/vomiting (up to 7%) and dyspepsia (up to 1.5%). Dry mouth (up to 1.4%), constipation (0.6%), and sore throat have been reported with oral nicardipine. A case of parotitis associated with nicardipine has been reported. Noncompliance due to nausea and vomiting has been reported.
Other side effects associated with intravenous nicardipine have included fever and neck pain. Pedal edema (up to 8%), asthenia (up to 5.8%), flushing (up to 9.7%), other edema (up to 1%), malaise (0.6%), pain (0.6%), infection, hot flashes, and face edema have been reported with oral nicardipine.
Dermatologic side effects associated with oral nicardipine have included rash (up to 6%) and increased sweating (0.6%).
Metabolic side effects associated with intravenous nicardipine have included hypophosphatemia and peripheral edema.
Musculoskeletal side effects associated with oral nicardipine have included myalgia (1%) and arthralgia.
Respiratory side effects associated with intravenous nicardipine have included respiratory disorder and at least one case of pulmonary edema. Dyspnea, rhinitis, and sinusitis have been reported with oral nicardipine.
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.
Psychiatric side effects have included confusion. Nervousness (0.6%), abnormal dreams (0.4%), depression, and anxiety have been reported with oral nicardipine.
Hypersensitivity side effects have included angioedema, wheezing, and rash in patients with suspected hypersensitivity reactions. Allergic reactions have been reported with oral nicardipine.
Genitourinary side effects have included increased urinary frequency. Nocturia (0.4%) and impotence have been reported with oral nicardipine.
Hematologic side effects associated with intravenous nicardipine have included thrombocytopenia.
Hepatic side effects associated with oral nicardipine have included abnormal liver chemistries.
Ocular side effects associated with intravenous nicardipine have included conjunctivitis. Abnormal vision and blurred vision have been reported with oral nicardipine.
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.
Endocrinologic side effects have rarely included cases of hyperglycemia. One study has shown that nicardipine can cause deterioration in glucose metabolism in hypertensive patients with noninsulin-dependent diabetes mellitus.
More nicardipine resources
- nicardipine Concise Consumer Information (Cerner Multum)
- nicardipine MedFacts Consumer Leaflet (Wolters Kluwer)
- nicardipine Advanced Consumer (Micromedex) - Includes Dosage Information
- Cardene Prescribing Information (FDA)
- Cardene MedFacts Consumer Leaflet (Wolters Kluwer)
- Cardene IV Advanced Consumer (Micromedex) - Includes Dosage Information
- Cardene SR Prescribing Information (FDA)
- Cardene SR sustained-release capsules MedFacts Consumer Leaflet (Wolters Kluwer)
- Nicardipine Prescribing Information (FDA)
- Nicardipine Monograph (AHFS DI)
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