II. Indications

  1. First-line management of Hypertensive Emergency (Hypertensive Crisis)
    1. Preferred over Labetalol, Nitroglycerin Drip, and Nitroprusside
    2. Use Esmolol in Hypertensive Crisis if Heart Rate control is needed (e.g. AAA or Aortic Dissection)

III. Mechanism

  1. Pure arterial vasodilation
  2. Decreases Blood Pressure
  3. Does not effect Heart Rate or Preload

IV. Dosing

  1. Start: 5 mg/hour
  2. Maximum: 15 mg/hour
  3. Titrate
    1. Increase by 2.5 mg/hour every 5-15 minutes until Blood Pressure goal reached or maximum reached (15 mg/hour)
    2. Once goal Blood Pressure achieved, titrate down towards 3 mg/hour as long as Blood Pressure is controlled

V. References

  1. Orman and Weingart in Majoewsky (2012) EM:RAP 12(2): 6-7

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Cost: Medications

nicardipine (on 5/18/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
NICARDIPINE 20 MG CAPSULE Generic $1.26 each
NICARDIPINE 30 MG CAPSULE Generic $2.18 each

Ontology: Nicardipine (C0028005)

Definition (NCI) A synthetic derivative of nitrophenyl-pyridine and potent calcium channel blocker, Nicardipine (Nifedipine Family) blocks calcium ions from certain cell walls and inhibits contraction of coronary and peripheral arteries, resulting in lowered oxygen requirements for heart muscle and decreased arterial contraction and spasm. It is used clinically as a cerebral and coronary vasodilator.
Definition (MSH) A potent calcium channel blockader with marked vasodilator action. It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. It has also been used in the treatment of asthma and enhances the action of specific antineoplastic agents.
Definition (CSP) 1,4-dihydro-2,6-dimethyl-4-nitrophenyl-3, 5-pyridine carboxylic acid methyl-2- methylphenylmethylaminoethyl ester; calcium channel blocker of the nifedipine family; used clinically as a cerebral and coronary vasodilator.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009529
SnomedCT 108526002, 372502001
LNC LP66957-9, MTHU028054
English Nicardipine, 3,5-Pyridinedicarboxylic acid, 1,4-dihydro-2,6-dimethyl-4-(3-nitrophenyl)-, methyl 2-(methyl(phenylmethyl)amino)ethyl ester, Nicardipine [Chemical/Ingredient], niCARdipine, nicardipine, NICARDIPINE, Nicardipine (product), Nicardipine (substance)
Swedish Nikardipin
Czech nikardipin
Finnish Nikardipiini
Russian NIKARDIPIN, НИКАРДИПИН
Japanese ニカルジピン
Spanish nicardipino (sustancia), nicardipino, nicardipino (producto), nicardipina, nicardipina (producto), nicardipina (sustancia), Nicardipino
Polish Nikardypina
French Nicardipine
German Nicardipin
Italian Nicardipina
Portuguese Nicardipino