Nicardipine

Provider Level

RN/Paramedic

Class

Calcium channel blocker, Antihypertensive

Mechanism of Action

Inhibits the transmembrane influx of calcium ions into cardiac muscle and vascular smooth muscle without altering serum calcium concentrations. It selectively relaxes vascular smooth muscle, decreasing peripheral vascular resistance and lowering blood pressure.

Indications

Management of hypertensive emergencies including acute ischemic stroke with severely elevated blood pressure.

Contraindications

Advanced aortic stenosis, severe hypotension, cardiogenic shock, hypersensitivity to the drug.

Routes

IV

Onset / Duration

Onset: 5 to 15 minutes. Duration: 1 to 4 hours after discontinuation of infusion.

Adverse Effects

Hypotension, headache, reflex tachycardia, flushing, nausea, vomiting, dizziness.

Precautions & Interactions

Continuous blood pressure monitoring is required. Rapid decreases in blood pressure should be avoided to prevent cerebral or myocardial ischemia. Use caution in patients with heart failure, hepatic impairment, or renal impairment.

Special Considerations

Requires an IV infusion pump for precise administration. Ensure peripheral IV lines are flushed adequately as the medication can cause venous irritation. Authorized provider levels: RN/Paramedic.