Precautions
What is cardene used for?
Nicardipine (Cardene) capsules treat chest pain and high blood pressure. Nicardipine (Cardene) is also available as an intravenous (IV) infusion that is administered by a healthcare provider to treat high blood pressure if people cannot take the oral capsules.
What is the difference between Cardene and Cardizem?
Cardene is a dihydropyridine calcium channel blocker and Cardizem is a benzothiazepine calcium channel blocker.
Does cardene drip lower heart rate?
In general, no detrimental effects on the cardiac conduction system have been seen with Cardene I.V. During acute electrophysiologic studies, it increased heart rate and prolonged the corrected QT interval to a minor degree.
What does nicardipine do for the heart?
Nicardipine is a calcium channel blocker. It works by affecting the movement of calcium into the cells of the heart and blood vessels. As a result, nicardipine relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload .
What is the other name for Cardene?
Nicardipine is a prescription medication used to treat Hypertension and Chronic Stable Angina. Nicardipine is available under the following different brand names: Cardene IV, Cardene SR.
Why does nicardipine cause tachycardia?
Nicardipine-induced tachycardia is generally attributed to the involvement of the baroreflex. The effects of nicardipine on blood pressure (BP) and heart rate (HR) as well as on plasma catecholamine levels were studied in six conscious dogs made hypertensive by sinoaortic denervation.
What are the side effects of Cardene?
Dizziness, lightheadedness, headache, flushing, or swelling ankles/feet may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
What is the best drip for hypertension?
Nicardipine, nitroprusside, fenoldopam, nitroglycerin, enalaprilat, hydralazine, labetalol, esmolol, and phentolamine are i.v. antihypertensive agents recommended for use in hypertensive emergency by the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood ...
What drip is used for high blood pressure?
Combined alpha and beta-blockers are used as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure.
How long does IV nicardipine last?
Nicardipine hydrochloride 0.5 and 0.05 mg/mL in eight i.v. solutions was stable in glass containers for up to seven days. Drug concentrations slowly decreased in PVC containers.
Why is nicardipine used in stroke?
Nicardipine is recommended for elevated blood pressure after acute ischemic stroke or intracerebral haemorrhage and is effective in prevention of stroke. More recent investigations were focused on the treatment of cognitive deterioration of vascular origin.
How long does it take for nicardipine to work?
The onset of action is 1 to 2 minutes and the half-life is approximately 40 minutes. Nicardipine is metabolized in the liver. Nicardipine can be started at a dose of 0.5 to 1 mcg/kg per minute and titrated to a maximum infusion rate of 3 mcg/kg per minute.
How is nicardipine different from diltiazem?
The results suggest that diltiazem protects the ischemic heart by slight cardiac suppression and that nicardipine reduces afterload by marked vascular dilatation during anesthesia for coronary revascularization. Both Ca-channel blockers were demonstrated to be useful.
What is a substitute for Cardizem?
Norvasc, Toprol XL, Zestril, Cozaar, and hydrochlorothiazide are some diltiazem alternatives.
What is the difference between diltiazem and Cardizem?
Unlike other diltiazem once‐daily formulations, CARDIZEM® LA is a tablet formulation. Its pharmacokinetic profile differs from that of CARDIZEM® CD, another extended‐release formulation of diltiazem, in that GRD exhibits a smoother drug‐release profile with a “one‐peak” plasma concentration time curve.
Is diltiazem and Cardizem the same?
Diltiazem (Cardizem) is a calcium channel blocker that slows your heart rate and relaxes your blood vessels. This gets more oxygen to the heart so it doesn't have to work as hard to pump, which relieves chest pain.
What is Cardene I.V. used for?
Cardene I.V. is intended for intravenous use. Titrate dose to achieve the desired blood pressure reduction. Individualize dosage depending on the blood pressure to be obtained and the response of the patient.
How much cardene should I take for tachycardia?
Then, when blood pressure has stabilized, infusion of Cardene I.V. Premixed Injection may be restarted at low doses such as 30-50 mL/hr (3 - 5 mg/hr) for 20 mg in 200 mL or 15-25 mL/hr (3 - 5 mg/hr) for 40 mg in 200 mL and adjusted to maintain desired blood pressure.
How long does it take for blood pressure to decrease?
With constant infusion, blood pressure begins to fall within minutes. It reaches about 50% of its ultimate decrease in about 45 minutes.
Can you mix Cardene I.V. with other medications?
Do not combine Cardene I.V. Premixed Injection with any product in the same intravenous line or premixed container. Do not add supplementary medication to the bag. Protect from light until ready to use.
Is Cardene I.V. premixed?
Cardene I.V. Premixed Injection is available as a single-use , ready-to-use , iso-osmotic solution for intravenous administration. No further dilution is required.
What is Cardene I.V. used for?
Cardene I.V. is intended for intravenous use. Titrate dose to achieve the desired blood pressure reduction. Individualize dosage depending on the blood pressure to be obtained and the response of the patient.
How much Cardene I.V. is in a 200 ml container?
Premixed Injection is supplied as a single-use, ready-to-use, iso-osmotic solution for intravenous administration in a 200 mL GALAXY container with 20 mg (0.1 mg/mL) nicardipine hydrochloride in either dextrose or sodium chloride or 40 mg (0.2 mg/mL) nicardipine hydrochloride in sodium chloride.
How to check for cardene injection?
Inspect Cardene I.V. Premixed Injection visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Check the container for minute leaks prior to use by squeezing the bag firmly; ensure that the seal is intact. If leaks are found, discard solution as sterility may be impaired. Cardene I.V. Premixed Injection is normally a clear, colorless to yellow solution.
How much cardene should I take for tachycardia?
Then, when blood pressure has stabilized, infusion of Cardene I.V. Premixed Injection may be restarted at low doses such as 30-50 mL/hr (3 - 5 mg/hr) for 20 mg in 200 mL or 15-25 mL/hr (3 - 5 mg/hr) for 40 mg in 200 mL and adjusted to maintain desired blood pressure.
How much nicardipine is in sodium chloride?
Injection: 200 mL nicardipine (0.2 mg/mL) in sodium chloride (0.83%) as a clear, colorless solution, ready-to-use, iso-osmotic solution in a single use GALAXY container
Why is it not always possible to estimate reliably their frequency or to establish a causal relationship to drug exposure?
Because adverse reactions are reported voluntarily from a population of uncertain size , it is not always possible to estimate reliably their frequency or to establish a causal relationship to drug exposure. The following adverse reaction has been identified during post-approval use of Cardene I.V.: decreased oxygen saturation (possible pulmonary shunting).
Where is nicardipine metabolized?
Since nicardipine is metabolized in the liver, consider lower dosages and closely monitor responses in patients with impaired liver function or reduced hepatic blood flow.
Why is nicardipine used for hypertension?
Because of its effectiveness in dilating blood vessels, nicardipine is most useful in treating hypertension and angina.
What is the drug cardene used for?
Dosage. Side Effects. Warnings and Interactions. Cardene (nicardipine) is a calcium channel blocker that is used most often to treat hypertension , stable angina, and Prinzmetal's angina caused by spasm of the coronary arteries. Nicardipine is a member of the dihydropyradine family of calcium channel blockers, which means its major effects are ...
What are the two subgroups of calcium channel blockers?
Calcium channel blockers are divided into two subgroups — the dihydropyridine group, and the non-dihydropyradine group. Nicardipine belongs to the former.
Why was Cardene SR removed from the market?
Subsequently, the FDA released a determination stating that Cardene SR was not removed due to any safety or effectiveness concerns, so its removal seems to have been for market-based reasons. 6 .
What is the use of nicardipine?
Common clinical uses for nicardipine are: Treatment of stable angina. Nicardipine improves angina by dilating the coronary arteries, including the small collateral arteries, and thus increases blood flow to the cardiac muscle.
How much nicardipine is available?
Nicardipine is available in an immediate-release capsule (Cardene, and in generic forms), in doses of 20 and 30 milligrams (mg). It is also available in sustained-release generic capsules in doses of 20 mg, 45 mg, and 60 mg.
How do calcium channel blockers work?
Calcium channel blockers work by slowing the movement of calcium ions into certain types of cells, in particular, the smooth muscle cells that line the blood vessels, and cardiac muscle cells.
How long does it take for nicardipine to increase?
Plasma concentrations increase at a much slower rate after the first few hours, and approach steady state at 24 to 48 hours. The steady-state pharmacokinetics of nicardipine are similar in elderly hypertensive patients (>65 years) and young healthy adults. On termination of the infusion, nicardipine concentrations decrease rapidly, with at least a 50% decrease during the first two hours post-infusion. The effects of nicardipine on blood pressure significantly correlate with plasma concentrations. Nicardipine is highly protein bound (>95%) in human plasma over a wide concentration range.
What is a cardene IV?
Cardene IV is a prescription medicine used to treat the symptoms of High Blood Pressure ( Hypertension) and Chronic Stable Angina. Cardene IV may be used alone or with other medications. Cardene IV belongs to a class of drugs called Calcium Channel Blockers; Calcium Channel Blockers, Dihydropyridine. It is not known if Cardene IV is safe and ...
Why is it not always possible to estimate reliably their frequency or to establish a causal relationship to drug exposure?
Because adverse reactions are reported voluntarily from a population of uncertain size , it is not always possible to estimate reliably their frequency or to establish a causal relationship to drug exposure. The following adverse reaction has been identified during post-approval use of Cardene I.V.: decreased oxygen saturation (possible pulmonary shunting).
Where is nicardipine metabolized?
Since nicardipine is metabolized in the liver, consider lower dosages and closely monitor responses in patients with impaired liver function or reduced hepatic blood flow.
How long does it take for blood pressure to decrease?
With constant infusion, blood pressure begins to fall within minutes. It reaches about 50% of its ultimate decrease in about 45 minutes.
How long does it take for a 50% offset to occur?
Discontinuation of infusion is followed by a 50% offset of action in about 30 minutes.
Can you use Cardene I.V. with beta blockers?
In most patients, Cardene I.V. Premixed Injection can safely be used concomitantly with beta blockers. However, titrate slowly when using Cardene I.V. Premixed Injection in combination with a beta-blocker in heart failure patients [see WARNINGS AND PRECAUTIONS ].
What is Cardizem Used for and How Does it Work?
Cardizem is a medication administered for cardiac conditions. According to AdocateHealth.com:
What is the bravest nursing profession?
Cardiac nurses are some of the bravest and skilled nurses I know. I’ve seen CCU nurses bring patient’s back from near death through an organized ballet of V-Fib. I have personally saved a life by paying close attention to my patient’s condition and pushing a few ml of Cardizem. Whether you work in the ER, OR, ICU, CCU, Med Surg, or a long-term care facility, you have the ability to make a difference and save a life by paying attention to their needs and delivering the best nursing care possible. This means knowing how to titrate a Cardizem drip.
What is the job of a nurse?
Your biggest job as a nurse is to keep the patient’s best interest at heart. Even if you know how to titrate a Cardizem drip, it doesn’t mean that you should if it is putting the patient at more risk. You need to make sure you have ample resources, training, and confidence to get the job done. You also need to make sure that the patient can handle the medication, and you need to explain the medication to their patient and their families,
Why do you need a cardiac telemetry monitor?
At the very least the patient needs to be on a cardiac telemetry monitor so that a telemetry nurse can monitor their rhythm and help you stay aware of any changes they see. This is not a substitute for eyeing the patient, but is an extra safeguard and is usually required by the hospital.
What happens when you have a rapid heart rate?
When the patient sustains a rapid heart rate it could lead to an increased risk of myocardial damage (cardiomyopathy) and deterioration into ventricular fibrillation. The varying stroke volume (amount of blood pumped out of the ventricle with each contraction) decreases and causes the cardiac output to decrease.
What to do if a patient tells you they are about to die?
If the patient tells you they feel like something bad is going to happen or that they are about to die LISTEN TO THEM!
Can a nurse titrate a Cardizem drip?
Many nurses are apprehensive about having to titrate a Cardizem drip. Patients who require Cardizem are usually facing life-threatening conditions like A-fib and this can be very stressful to a nurse who doesn’t typically deal with this sort of condition. Depending on your floor there may actually be policies that state ...
What is nicardipine?
Nicardipine is a calcium channel blocker that relaxes (widens) your blood vessels, which makes it easier for the heart to pump and reduces its workload.
What should I avoid while taking nicardipine?
Avoid driving or hazardous activity until you know how nicardipine will affect you. Your reactions could be impaired. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
What other drugs will affect nicardipine?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
What are the symptoms of an allergic reaction?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: a light-headed feeling , like you might pass out; pounding heartbeats or fluttering in your chest ; or. severe or ongoing chest pain.
How to store a syringe?
Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.
Can you take nicardipine if you have aortic stenosis?
You should not use nicardipine if you have severe narrowing of the aortic valve in your heart (aortic stenosis).
Can nicardipine harm an unborn baby?
Older adults may be more sensitive to the effects of this medicine. It is not known whether nicardipine will harm an unborn baby.
Indications and Usage For Cardene Injection
Nicardipine is used with or without other medications to treat high blood pressure (hypertension).
Status: Discontinued
May Treat: Hypertension · Anginal pain in coronary artery disease
Drug Class: Calcium Channel Blockers - Dihydropyridines
Availability: Prescription Required
Pregnancy: Consult a doctor before using
Status: Discontinued
May Treat: Hypertension · Anginal pain in coronary artery disease
Drug Class: Calcium Channel Blockers - Dihydropyridines
Availability: Prescription Required
Pregnancy: Consult a doctor before using
Lactation: Consult a doctor before using
Alcohol: Limit intake while taking this medication
Driving: May cause drowsiness or dizziness. Use caution
Manufacturer: ROCHE LABS.
- Take doses regularly, even when feeling well
- May take with or without food
- May make you dizzy. Use caution when driving.
- Take doses regularly, even when feeling well
- May take with or without food
- May make you dizzy. Use caution when driving.
- Be careful not to stand up too quickly
- Tell doctor what medicines you are taking
- It is important to check blood pressure regularly.
- Diet and exercise will improve therapy response
- Review all drugs you are taking with your doctor
Cardene Injection Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings and Precautions
- Hypertension
CARDENE® I.V. (nicardipine hydrochloride) 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 [see Do…
Adverse Reactions
- Recommended Dosing
CARDENE I.V. is intended for intravenous use. Titrate dose to achieve the desired blood pressure reduction. Individualize dosage depending on the blood pressure to be obtained and the response of the patient. Dosage as a Substitute for Oral Nicardipine Therapy The intravenous infusion rat… - Monitoring
The time course of blood pressure decrease is dependent on the initial rate of infusion and the frequency of dosage adjustment. With constant infusion, blood pressure begins to fall within minutes. It reaches about 50% of its ultimate decrease in about 45 minutes. Monitor blood press…
Drug Interactions
- Injection: 200 mL nicardipine (0.1 mg/mL) in either dextrose (4.8%) or sodium chloride (0.86%) as a clear, colorless solution, ready-to-use, iso-osmotic solution in a single-dose GALAXY container Injection: 200 mL nicardipine (0.2 mg/mL) in sodium chloride (0.83%) as a clear, colorless solution, ready-to-use, iso-osmotic solution in a single-dose GALAXY container
Use in Specific Populations
- Advanced Aortic Stenosis
CARDENE I.V. is contraindicated in patients with advanced aortic stenosis because part of the effect of CARDENE I.V. is secondary to reduced afterload. Reduction of diastolic pressure in these patients may worsen rather than improve myocardial oxygen balance.
Overdosage
- Exacerbation of Angina
Increases in frequency, duration, or severity of angina have been seen in chronic therapy with oral nicardipine. Induction or exacerbation of angina has been seen in less than 1% of coronary artery disease patients treated with CARDENE I.V. The mechanism of this effect has not been establis… - Exacerbation of Heart Failure
Titrate slowly when using CARDENE I.V., particularly in combination with a beta-blocker, in patients with heart failure or significant left ventricular dysfunction because of possible negative inotropic effects.
Cardene Injection Description
- Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction informatio… - Postmarketing Experience
Because adverse reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate reliably their frequency or to establish a causal relationship to drug exposure. The following adverse reaction has been identified during post-approval use of CARD…
Uses
- Beta-Blockers
In most patients, CARDENE I.V. can safely be used concomitantly with beta blockers. However, titrate slowly when using CARDENE I.V. in combination with a beta-blocker in heart failure patients [see Warnings and Precautions (5.2)]. - Cimetidine
Cimetidine has been shown to increase nicardipine plasma concentrations with oral nicardipine administration. Frequently monitor response in patients receiving both drugs. Data with other histamine-2 antagonists are not available.
Before Taking
- Pregnancy
Pregnancy Category C There are no adequate and well-controlled studies of nicardipine use in pregnant women. However, limited human data in pregnant women with preeclampsia or pre-term labor are available. In animal studies, no embryotoxicity occurred in rats with oral doses 8 times … - Nursing Mothers
Nicardipine is minimally excreted into human milk. Among 18 infants exposed to nicardipine through breast milk in the postpartum period, calculated daily infant dose was less than 0.3 mcg and there were no adverse events observed. Consider the possibility of infant exposure when usi…
Dosage
- Several overdosages with orally administered nicardipine have been reported. One adult patient allegedly ingested 600 mg of immediate-release oral nicardipine, 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 res…
Side Effects
- CARDENE I.V. (nicardipine hydrochloride) is a calcium ion influx inhibitor (slow channel blocker or calcium channel blocker). CARDENE I.V. for intravenous administration contains 20 mg (0.1 mg/mL) of nicardipine hydrochloride per 200 mL in either dextrose or sodium chloride or 40 mg (0.2 mg/mL) of nicardipine hydrochloride per 200 mL in sodium chloride. Nicardipine hydrochlori…
Warnings and Interactions
- Nicardipine is a member of a large class of drugs known as the calcium channel blockers. Calcium channel blockers work by slowing the movement of calcium ions into certain types of cells, in particular, the smooth muscle cells that line the blood vessels, and cardiac muscle cells.