Cardene

Generic name: Nicardipine

Drug class: Calcium channel blocker (dihydropyridine type)

Dosage form: Oral capsules (20 mg, 30 mg), extended-release oral capsules (30 mg, 45 mg, 60 mg), intravenous solution (20 mg/200 mL, 40 mg/200 mL)

Route of administration: Oral, intravenous

Dose:

• Hypertension (oral): 20–40 mg every 8 hours; extended-release: 30–60 mg every 12 hours
• Hypertension (intravenous): Initial infusion rate of 5 mg/hour; may be increased by 2.5 mg/hour every 15 minutes, not to exceed 15 mg/hour
• Chronic stable angina (oral): 20–40 mg every 8 hours; usual dosage range: 60–120 mg/day

Mechanism of action: Nicardipine inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle by blocking L-type calcium channels, leading to vasodilation of coronary and peripheral arteries, reduced peripheral vascular resistance, decreased afterload, and increased coronary blood flow.

Drug usage cases:

• Hypertension
• Chronic stable angina pectoris
• Variant angina (Prinzmetal’s angina)
• Hypertensive emergencies (intravenous use)

Drug contraindications:

• Hypersensitivity to nicardipine or any component of the formulation
• Advanced aortic stenosis

Side effects:

• Common: Swelling in the legs and ankles (edema), dizziness, headache, fast or abnormal heartbeat, flushing, fatigue
• Serious: Hypotension, chest pain, severe allergic reactions (difficulty breathing, swelling of the face or throat, hives), liver enzyme abnormalities

Warnings:

• Monitor blood pressure regularly during treatment
• Use caution in patients with heart failure or significant left ventricular dysfunction
• May cause reflex tachycardia; consider co-administration with a beta-blocker
• Use with caution in patients with hepatic or renal impairment

Use during pregnancy or breastfeeding: Nicardipine is classified as a pregnancy category C drug, indicating that risk to the fetus cannot be ruled out. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nicardipine is excreted in breast milk; caution should be exercised when administering to nursing mothers, and a decision should be made whether to discontinue nursing or the drug, considering the importance of the drug to the mother.