Department of Pharmacy

Department of Nursing

Critical Care

Generic Name :           Nicardipine HCl

Trade Name:               Cardene®

Action :             Calcium channel blocker (decreases MAP)

Indications:                  Uncontrolled or essential hypertension; angina, CNS vasospasm

Administration Guidelines:

Usual Adult IV Dosage :      2.5-5mg/hour titrated to patient response. Can increase rate every 15 minutes

Suggested Adult Maximum Dose:           15mg/h

Standard Concentration:        25mg/250ml; 50mg/250ml

** 0.9% NaCl preferred on BL12 ** stable in D5w or 0.9% NaCl

50mg/50ml via Harvard Microinfusion pump

EW Standard :        25mg/250ml; 50mg/250ml

** 0.9% NaCl preferred on BL12 ** stable in D5w or 0.9% NaCl

Special Considerations:

·    Onset = 5-30 minutes

·    Drug should be titrated to blood pressure parameters.  Reassessment should occur every 15 minutes.  Due to drug accumulation and potential hypotension, do not adjust rate more frequently than every 15 minutes unless directly supervised by the covering physician (every 5 minutes absolute max).

·    May need to reduce rate once at steady state (3-5 hours).

·    May increase intracranial pressure; invasive monitoring suggested in patients with neurovascular complications or intracranial hypertension.

Precautions and Side Effects :

·    Contraindicated in patients with known hypersensitivity to nicardipine or any of its constituents, aortic stenosis, severe hypotension, cardiogenic shock or ventricular tachycardia.

·    Pregnancy and Lactation Category: C

·    Cardiovascular:  reflex tachycardia, flushing, hypotension

·    Pulmonary:  pulmonary edema

·    Endocrine/metabolic:  increased AST & ALT values

·    CNS:  dizziness, somnolence, headache

·    Other:  increased albumin, BUN, alkaline phosphate, local venous irritation.