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| Clinical data | |
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| Trade names | Cardene |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a695032 |
| Routes of administration | Oral, intravenous |
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| Pharmacokinetic data | |
| Protein binding | >95% |
| Eliminationhalf-life | 8.6 hours |
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| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.054.466 |
| Chemical and physical data | |
| Formula | C26H29N3O6 |
| Molar mass | 479.533 g·mol−1 |
| 3D model (JSmol) | |
| Melting point | 136–138 °C (277–280 °F) |
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Nicardipine (Cardene) is amedication used to treatangina andhypertension, especially forhemorrhagic stroke patients.[1] It belongs to thedihydropyridine class ofcalcium channel blockers (CCBs). It is also used forRaynaud's phenomenon. It is available in by mouth and intravenous formulations. It has been used inpercutaneous coronary intervention.[2]
Its mechanism of action and clinical effects closely resemble those ofnifedipine and the other dihydropyridine calcium channel blockers (amlodipine,felodipine), except that nicardipine is more selective for cerebral and coronary blood vessels. It is primarily a peripheral arterial vasodilator, thus unlike the nitrovasodilators (nitroglycerin and nitroprusside), cardiac preload is minimally affected. It has the longest duration among parenteral CCBs.[3][4] As its use may lead to reflex tachycardia, it is advisable to use it in conjunction with abeta-blocker.[4][3] In the setting of a rupturedbrain aneurysm, nicardipine may be used (ifnimodipine is unavailable) to reduce blood pressure and as prevention or treatment againstcerebral vasospasm.[1]
It was patented in 1973 and approved for medical use in 1981.[5] Nicardipine was approved by the FDA in December 1988. The patent for both Cardene and Cardene SR expired in October 1995.[6]
Nicardipine is a calcium channel blocker used primarily for the management of hypertension and angina. It is particularly effective in the treatment of acute and severe hypertension, including hypertensive emergency.[7] This is due to the rapid onset and short half-life of this drug, which allows for precision in the control of blood pressure.
Nicardipine is also used commonly in the perioperative setting for blood pressure fluctuations during surgery.[8] Other scenarios for usage of Nicardipine include subarachnoid hemorrhage and hypertensive crisis of pregnancy.[9]
Nicardipine is associated to a wide range of side effects, due mainly to its vasodilatory effects. Common adverse effects include dizziness, fainting, flushing and peripheral edema.[10] This is a direct result to the relaxation of blood vessels and lower systemic vascular resistance.
Hypotension is another frequently observed side effect, particularly seen in scenarios when this medication is used intravenously for hypertensive emergencies.[11] Reflex tachycardia is a common compensatory response to vasodilation.[12] These side effects are usually mild and resolve following adjustment in dosage of the medication or discontinuation.
