Nicardipine (Cardene) is a

medication Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...

used to treat

angina Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of parti ...

and

hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...

, especially for

hemorrhagic stroke Stroke is a medical condition in which poor blood flow to a part of the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop ...

patients. It belongs to the

dihydropyridine 1,4-Dihydropyridine (DHP) is an organic compound with the formula CH2(CH=CH)2NH. The parent compound is uncommon, but derivatives of 1,4-dihydropyridine are important commercially and biologically. The pervasive cofactors NADH and NADPH are deriv ...

class of

calcium channel blocker Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium () through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as ...

s (CCBs). It is also used for

Raynaud's phenomenon Raynaud syndrome, also known as Raynaud's phenomenon, is a medical condition in which the spasm of small arteries causes episodes of reduced blood flow to end arterioles. Typically the fingers, and, less commonly, the toes, are involved. Rare ...

. It is available in by mouth and intravenous formulations. It has been used in

percutaneous coronary intervention Percutaneous coronary intervention (PCI) is a minimally invasive non-surgical procedure used to treat stenosis, narrowing of the coronary artery, coronary arteries of the heart found in coronary artery disease. The procedure is used to place and ...

. Its mechanism of action and clinical effects closely resemble those of

nifedipine Nifedipine ( ), sold under the brand name Procardia among others, is a calcium channel blocker medication used to manage angina, high blood pressure, Raynaud's phenomenon, and premature labor. It is one of the treatments of choice for Prinzme ...

and the other dihydropyridine calcium channel blockers (

amlodipine Amlodipine, sold under the brand name Norvasc among others, is a calcium channel blocker medication used to treat hypertension, high blood pressure, coronary artery disease (CAD) and variant angina (also called Prinzmetal angina or coronary ar ...

felodipine Felodipine is a medication of the calcium channel blocker type that is used to treat high blood pressure. It was patented in 1978, and approved for medical use in 1988. Medical uses Felodipine is used to treat high blood pressure and stable ...

), 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. As its use may lead to reflex tachycardia, it is advisable to use it in conjunction with a

beta-blocker Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms ( arrhythmia), and to protect the heart from a second heart attack after a first heart attack (secondary prevention) ...

. In the setting of a ruptured

brain aneurysm An intracranial aneurysm, also known as a cerebral aneurysm, is a cerebrovascular disorder characterized by a localized dilation or ballooning of a blood vessel in the brain due to a weakness in the vessel wall. These aneurysms can occur in an ...

, nicardipine may be used (if

nimodipine Nimodipine, sold under the brand name Nimotop among others, is a calcium channel blocker used in preventing vasospasm secondary to subarachnoid hemorrhage (a form of cerebral hemorrhage). It was originally developed within the calcium channel b ...

is unavailable) to reduce blood pressure and as prevention or treatment against

cerebral vasospasm Cerebral vasospasm is the prolonged, intense vasoconstriction of the larger conducting arteries in the subarachnoid space which is initially surrounded by a clot. Significant narrowing of the blood vessels in the brain develops gradually over the ...

. It was patented in 1973 and approved for medical use in 1981. Nicardipine was approved by the FDA in December 1988. The patent for both Cardene and Cardene SR expired in October 1995.

Medical uses

Hypertensive emergency

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. This is due to the rapid onset and short half-life of this drug, which allows for precision in the control of blood pressure.

Other

Nicardipine is also used commonly in the perioperative setting for blood pressure fluctuations during surgery. Other scenarios for usage of Nicardipine include subarachnoid hemorrhage and hypertensive crisis of pregnancy.

Side effects

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. 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. Reflex tachycardia is a common compensatory response to vasodilation. These side effects are usually mild and resolve following adjustment in dosage of the medication or discontinuation.

References

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Pharmacodynamics Pharmacodynamics (PD) is the study of the biochemistry, biochemical and physiology, physiologic effects of drugs (especially pharmaceutical drugs). The effects can include those manifested within animals (including humans), microorganisms, or comb ...

, titlestyle = background:#ccccff , list1 = {{Ion channel modulators {{GABA receptor modulators {{Glycine receptor modulators {{Xenobiotic-sensing receptor modulators Calcium channel blockers CYP2D6 inhibitors Dihydropyridines 3-Nitrophenyl compounds Drugs developed by Hoffmann-La Roche Carboxylate esters Amines Glycine receptor agonists Glycine receptor antagonists GABAA receptor negative allosteric modulators Methyl esters Benzyl compounds

Medical uses

Hypertensive emergency

Other

Side effects

See also

References