Nicardipine – A Potent Calcium Channel Blocker for Hypertension & Emergencies

 

Learn about Nicardipine – a calcium channel blocker used for hypertension and angina. Explore its uses, dosage, side effects, interactions, and brand names in this detailed blog.

Table of Contents:

1. Introduction  

2. Mechanism of Action  

3. Pharmacokinetics & Pharmacodynamics  

4. Indications  

5. Drug of Choice  

6. Contraindications  

7. Side Effects  

8. Drug Interactions  

9. Dosage  

10. Brand Names & Price  

11. Conclusion

1. Introduction:

Nicardipine is a dihydropyridine calcium channel blocker (CCB) primarily used in the management of hypertension, angina, and hypertensive emergencies. Its selective vasodilatory effect on arterial smooth muscle makes it effective for rapid blood pressure control.

2. Mechanism of Action:

Nicardipine inhibits the influx of calcium ions into vascular smooth muscle and myocardium during depolarization, leading to arterial vasodilation and reduced systemic vascular resistance.

3. Pharmacokinetics & Pharmacodynamics:

  

- *Absorption:* Rapid (oral bioavailability ~35%)  

- *Onset:* IV – within minutes  

- *Half-life:* ~8 hours (oral), ~14 minutes (IV)  

- *Metabolism:* Hepatic (CYP450)  

- *Excretion:* Renal & fecal  

4. Indications: 

- Hypertension (chronic and emergency)

- Angina pectoris  

- Subarachnoid hemorrhage (to control vasospasm – off-label)  

- Perioperative blood pressure control

5. Drug of Choice: 

- Hypertensive emergencies (IV form)  

- Perioperative hypertension  

- Acute stroke with elevated BP (select scenarios)

6. Contraindications: 

  

- Aortic stenosis  

- Advanced hepatic impairment (use with caution)  

- Hypersensitivity to nicardipine or related drugs

7. Side Effects:

- Headache  

- Flushing  

- Tachycardia  

- Peripheral edema  

- Dizziness  

- Nausea

8. Drug Interactions:

- *Beta-blockers*: May increase cardiac depression  

- *CYP3A4 inhibitors*: Increase nicardipine levels  

- *Fentanyl*: May potentiate hypotensive effects  

- *Other antihypertensives*: Additive BP-lowering effect

9. Dosage:

- *Oral (Hypertension):* 20–40 mg three times daily  

- *IV (Hypertensive Emergency):* Start with 5 mg/hr, titrate every 5–15 minutes up to 15 mg/hr  

10. Brand Names & Price: 

  

- *Brand Names:* Cardene®️, Nicardia®️  

- *Price:*  

  - Oral: 15–50/month (varies)  

  - IV: 100–300 per vial (hospital use)

Conclusion:

Nicardipine stands out as a fast-acting and effective option in the management of both acute and chronic hypertension. With proper dosing and monitoring, it is a reliable agent for emergency settings and controlled blood pressure management.