Cardene iv

What is Cardene iv?

• Cardene iv (nicardipine hydrochloride) is a calcium channel blocker used for the short-term treatment of hypertension when oral therapy is not feasible.

Nicardipine

Nicardipine molecule ball

What are the uses of this medicine?

• Cardene® I.V. (nicardipine hydrochloride) Premixed Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable.
• For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits.

How does this medicine work?

• Nicardipine (nye kar' di peen) belongs to the dihydropyridine class of calcium channel blockers and is used in the treatment of both angina pectoris and hypertension.
• Like other calcium channel blockers, nicardipine acts by blocking the influx of calcium ions into vascular smooth muscle and cardiac cells during depolarization.
• This inhibition of calcium flux results in a vasodilation and decrease in cardiac work and oxygen consumption.

Who Should Not Use this medicine ?

This medicine cannot be used in patients:

• with advanced aortic stenosis

What drug interactions can this medicine cause?

• Oral or intravenous nicardipine may increase cyclosporine and tacrolimus plasma levels. Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended when co-administering Cardene I.V. Premixed Injection.
• Cimetidine increases oral nicardipine plasma levels. Frequently monitor response in patients receiving both drugs.
• Titrate slowly when using Cardene I.V. Premixed Injection in combination with a beta-blocker in heart failure patients.

Is this medicine FDA approved?

• Nicardipine was approved in the United States in 1988 and in remains in wide use.

How should this medicine be used?

Recommended dosage: When substituting for oral nicardipine therapy, use the intravenous infusion rate from the table below:

Oral Cardene Dose	Equivalent I.V. Infusion Rate (0.1 mg/mL)	Equivalent I.V. Infusion Rate (0.2 mg/mL)
20 mg q8h	0.5 mg/hr = 5 mL/hr	0.5 mg/hr = 2.5 mL/hr
30 mg q8h	1.2 mg/hr = 12 mL/hr	1.2 mg/hr = 6 mL/hr
40 mg q8h	2.2 mg/hr = 22 mL/hr	2.2 mg/hr = 11 mL/hr

• In a patient not receiving oral nicardipine, initiate therapy at 5 mg/hr.
• Increase the infusion rate by 2.5 mg/hr every 5 minutes (for rapid titration) to 15 minutes (for gradual titration) up to a maximum of 15 mg/hr until desired blood pressure reduction is achieved.
• If unacceptable hypotension or tachycardia occurs, discontinue the infusion.
• When blood pressure and heart rate stabilize, restart the infusion at low doses such as 3-5 mg/hr.

Administration:

• For Intravenous Use.
• No further dilution is required.
• Administer Cardene I.V. by a central line or through a large peripheral vein.
• Change the infusion site every 12 hours if administered via peripheral vein.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form: As Injection:

• 200 mL nicardipine (0.1 mg/mL) in either dextrose (4.8%) or sodium chloride (0.86%) in a single use, ready-to-use, iso-osmotic solution in a GALAXY container.
• 200 mL nicardipine (0.2 mg/mL) in sodium chloride (0.83%) in a single use, ready-to-use, iso-osmotic solution in a GALAXY container

This medicine is available in fallowing brand namesː

• Cardene I.V.

What side effects can this medication cause?

The most common side effects of this medicine include:

• headache
• hypotension
• tachycardia
• nausea/vomiting

What special precautions should I follow?

• Closely monitor response in patients with angina, heart failure, impaired hepatic function, or renal impairment.
• To reduce the possibility of venous thrombosis, phlebitis, and vascular impairment, do not use small veins, such as those on the dorsum of the hand or wrist. Exercise extreme care to avoid intra-arterial administration or extravasation.
• To minimize the risk of peripheral venous irritation, change the site of infusion of Cardene I.V. Premixed Injection every 12 hours.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• hypotension
• bradycardia
• palpitations
• flushing
• drowsiness
• confusion
• slurred speech

Lethal overdose may cause systemic hypotension, bradycardia (following initial tachycardia) and progressive atrioventricular conduction block.

Management of overdosage:

• For treatment of overdosage, implement standard measures including monitoring of cardiac and respiratory functions.
• Position the patient so as to avoid cerebral anoxia.
• Use vasopressors for patients exhibiting profound hypotension.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• There are no adequate and well-controlled studies of nicardipine use in pregnant women.
• Cardene I.V. should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Can this medicine be used in children?

• Safety and efficacy in patients under the age of 18 have not been established.

What are the active and inactive ingredients in this medicine?

Active Ingredient:

• NICARDIPINE HYDROCHLORIDE

Inactive Ingredients:

• DEXTROSE MONOHYDRATE
• CITRIC ACID MONOHYDRATE
• SORBITOL

Who manufactures and distributes this medicine?

Manufactured by:

• Baxter Healthcare Corporation
• Deerfield, IL USA

Marketed by: Chiesi USA, Inc. Cary, NC USA

What should I know about storage and disposal of this medication?

• Store at controlled room temperature 20º to 25ºC (68º to 77ºF), refer to USP Controlled Room Temperature.
• Protect from freezing.
• Avoid excessive heat.
• Protect from light, store in carton until ready to use.

• Dailymed label info on Cardene iv
• FDA Cardene iv

Pharmacodynamics