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Cardene IV Premixed
Calcium channel blocker (dihydropyridine)
Short-term treatment of HTN when oral therapy is not feasible or not desirable.
Short-term treatment when PO therapy is not feasible or not desirable
Patients Not Receiving Oral Nicardipine: Initial: 5mg/hr (50mL/hr) IV infusionTitrate: May increase by 2.5mg/hr (25mL/hr) every 5 min (for rapid titration) to 15 min (for gradual titration) if desired BP reduction is not achievedMax: 15mg/hr (150mL/hr)Decrease infusion rate to 3mg/hr (30mL/hr) after BP goal achieved with rapid titrationIV Dosage as a Substitute for Oral Nicardipine Therapy:20mg q8h=0.5mg/hr30mg q8h=1.2mg/hr40mg q8h=2.2mg/hrTransition to Oral Antihypertensives: Switch to Oral Nicardipine: Give 1st dose 1 hr prior to discontinuation of infusionSwitch to Oral Antihypertensive Other than Nicardipine: Initiate therapy upon discontinuation of IV nicardipine
Renal ImpairmentTitrate gradually
Hepatic ImpairmentImpaired Function/Reduced Hepatic Blood Flow: Consider lower dosages
ElderlyUse low initial doses
Other Important ModificationsHeart Failure: Titrate gradually Premixed:Impending Hypotension/Tachycardia: D/C then restart at 3-5mg/hr when BP has stabilized and adjust to maintain desired BP
Premixed SolnDo not combine Cardene I.V. Premixed Inj w/ any product in the same IV line or premixed containerNo further dilution is requiredAmpulesAdministered by slow continuous infusion at a concentration of 0.1mg/mLEach ampul (25mg) should be diluted w/ 240mL of compatible IV fluid (yielding 250mL of sol at a concentration of 0.1 mg/mLIV CompatilibilitiesCompatible and stable in glass or polyvinyl chloride containers for 24 hrs at controlled room temperature w/: D5 Inj; D5 and NaCl 0.45% Inj; D5 and NaCl 0.9% Inj; D5 w/ 40 mEq Potassium; NaCl 0.45% Inj, NaCl 0.9% Inj
IV IncompatibilitiesSodium Bicarbonate (5%) Inj, USP or Lactated Ringer's Inj, USP
Inj: 2.5mg/mL [10mL], 0.1mg/mL [200mL], 0.2mg/mL [200mL]
Advanced aortic stenosis.
May induce or exacerbate angina in coronary artery disease (CAD) patients. Caution with heart failure (HF) or significant left ventricular dysfunction. To reduce possibility of venous thrombosis, phlebitis, local irritation, swelling, extravasation, and occurrence of vascular impairment, administer through large peripheral or central veins; change IV site q12h to minimize risk of peripheral venous irritation. May occasionally produce symptomatic hypotension or tachycardia. Avoid systemic hypotension when administering in sustained acute cerebral infarction or hemorrhage. Caution in hepatic/renal impairment, reduced hepatic blood flow, and in elderly.
Headache, hypotension, tachycardia, N/V.
Titrate slowly with β-blockers in HF or significant left ventricular dysfunction due to possible negative inotropic effects. Increased nicardipine levels when oral nicardipine is given with cimetidine; frequently monitor response. Elevated cyclosporine levels reported with oral nicardipine; closely monitor cyclosporine levels and reduce its dose accordingly.
Category C, not for use in nursing.
Calcium channel blocker (dihydropyridine); inhibits transmembrane influx of Ca2+ ions into cardiac muscle and smooth muscles without changing serum Ca2+ concentrations.
Distribution: Vd=8.3L/kg; plasma protein binding (>95%); found in breast milk. Metabolism: Liver (extensive). Elimination: Urine (49%), feces (43%); T1/2=14.4 hrs.
Assess for advanced aortic stenosis, HF, CAD, left ventricular dysfunction, sustained acute cerebral infarction or hemorrhage, hepatic/renal impairment, pregnancy/nursing status, and possible drug interactions.
Monitor for symptomatic hypotension, tachycardia, induction or exacerbation of angina, and other adverse reactions. Monitor BP and HR during administration. Closely monitor responses with impaired liver function or reduced hepatic blood flow.
Advise to seek medical attention if adverse reactions occur.
20-25°C (68-77°F). Avoid excessive heat. Protect from light. Diluted Sol: Stable at room temperature for 24 hrs. Premixed: Protect from freezing.