Nicardipine Hydrochloride (10 brand names, 3 dosage forms, 3 routes)
Available dosage forms: INJECTABLE, CAPSULE, CAPSULE, EXTENDED RELEASE.
Routes of administration: INJECTION, INTRAVENOUS, ORAL.
Brand Names
- CARDENE
- CARDENE IN 0.83% SODIUM CHLORIDE IN PLASTIC CONTAINER
- CARDENE IN 0.86% SODIUM CHLORIDE IN PLASTIC CONTAINER
- CARDENE IN 4.8% DEXTROSE IN PLASTIC CONTAINER
- CARDENE IN 5.0% DEXTROSE IN PLASTIC CONTAINER
- CARDENE SR
- NICARDIPINE HYDROCHLORIDE
- NICARDIPINE HYDROCHLORIDE IN 0.83% SODIUM CHLORIDE
- NICARDIPINE HYDROCHLORIDE IN 0.86% SODIUM CHLORIDE
- NICARDIPINE HYDROCHLORIDE IN 0.9% SODIUM CHLORIDE
Mechanism of Action
Nicardipine inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle without changing serum calcium concentrations. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. The effects of nicardipine are more selective to vascular smooth muscle than cardiac muscle. In animal models, nicardipine produced relaxation of coronary vascular smooth muscle at drug levels which cause little or no negative inotropic effect.
Overdosage
Several overdosages with orally administered nicardipine have been reported. One adult patient allegedly ingested 600 mg of nicardipine immediate release capsules, and another patient, 2160 mg of the sustained release formulation of nicardipine. Symptoms included marked hypotension, bradycardia, palpitations, flushing, drowsiness, confusion and slurred speech. All symptoms resolved without sequelae. An overdosage occurred in a one-year-old child who ingested half of the powder in a 30 mg nicardipine standard capsule. The child remained asymptomatic.Based on results obtained in laboratory animals, lethal overdose may cause systemic hypotension, bradycardia (following initial tachycardia) and progressive atrioventricular conduction block. Reversible hepatic function abnormalities and sporadic focal hepatic necrosis were noted in some animal species receiving very large doses of nicardipine.For treatment of overdosage, standard measures including monitoring of cardiac and respiratory functions should be implemented. The patient should be positioned to avoid cerebral anoxia. Frequent blood pressure determinations are essential. Vasopressors are clinically indicated for patients exhibiting profound hypotension. Intravenous calcium gluconate may help reverse the effects of calcium entry blockade.