Nicardipine (Cardene)
📖 About
- 💊 Nicardipine is a dihydropyridine calcium channel blocker.
- Acts selectively on L-type calcium channels in vascular smooth muscle → vasodilation 🫀.
- Always check the BNF link here for up-to-date prescribing advice.
⚙️ Mode of Action
- Reduces systemic vascular resistance.
- Minimal direct effect on cardiac contractility or conduction compared with non-dihydropyridines.
🔗 Interactions
- See BNF (CYP3A4 interactions may be clinically significant).
⚠️ Cautions
- Uncontrolled heart failure or pulmonary oedema 🌊.
- Recent myocardial infarction ❤️.
📊 Nicardipine (Cardene) Dosing (BNF/local guidance must be checked)
| Indication | Dose / Range | Route |
|---|
| 🌡️ Hypertension / Angina |
20–30 mg PO three times daily |
PO |
| 🚨 Severe Hypertension (e.g. SBP >200 mmHg, DBP >120 mmHg) |
Start 3–5 mg/hour IV infusion over 15 min; titrate upwards depending on BP response |
IV infusion |
| 🤰 Preeclampsia (severe hypertension in pregnancy) |
Maintenance 2–4 mg/hour IV infusion |
IV infusion |
| 👴 Elderly patients |
Lower maintenance dose 1–5 mg/hour IV infusion |
IV infusion |
⚠️ IV nicardipine must only be given in a monitored setting (HDU/ITU/CCU) with continuous blood pressure monitoring.
⛔ Contraindications
- Severe aortic stenosis 🚫.
- Acute porphyrias.
💥 Side Effects
- Common: flushing, headache, dizziness, hypotension, palpitations, peripheral oedema, constipation, abdominal pain 🤢.
- Occasional: rash, drowsiness, nausea, vomiting, syncope.
- Reflex tachycardia may occur with marked vasodilation ⚡.
🚨 Overdose
- Symptoms: nausea, vomiting, agitation, dizziness, confusion, coma 🧠.
- Metabolic acidosis & hyperglycaemia may occur.
- Severe hypotension due to profound vasodilatation → requires urgent supportive care (fluids, vasopressors, ICU monitoring).
