Nicardipine hydrochloride

How it works

It blocks L-type calcium channels in vascular smooth muscle, producing arterial vasodilatation with relative vascular selectivity over the myocardium, thereby reducing peripheral resistance and blood pressure.

Prescribing in practice

• Intravenous use can cause excessive hypotension and reflex tachycardia and requires close blood-pressure monitoring with careful titration, usually via an infusion pump in a monitored environment.
• Like other dihydropyridines it may cause flushing, headache, peripheral oedema and palpitations.
• Avoid in advanced aortic stenosis, and consult the SPC for cautions, dilution and administration details.

Monitoring

Monitor blood pressure and heart rate closely, continuously during intravenous infusion and at the infusion site for irritation.

Counselling the patient

• Explain that the intravenous form is given in hospital with frequent blood-pressure checks.
• Advise that headache, flushing and ankle swelling are common and usually settle.

Evidence & guidelines

Nicardipine is an established dihydropyridine calcium-channel blocker; refer to current prescribing references for licensed indications.