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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Nicardipine Hydrochloride
Brand Name
Nicardipine Hydrochloride In Sodium Chloride
Generic Name
Nicardipine Hydrochloride
Active Ingredient
NicardipineCategory
Dihydropyridine Calcium Channel Blocker [EPC]
Salt Form
Hydrochloride
Variants
2
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Nicardipine Hydrochloride In Sodium Chloride, you must consult a qualified healthcare professional.
Detailed information about Nicardipine Hydrochloride In Sodium Chloride
Nicardipine is a potent dihydropyridine calcium channel blocker used primarily for the management of hypertension and chronic stable angina. It works by relaxing vascular smooth muscle to lower blood pressure and improve oxygen delivery to the heart.
Dosage for Nicardipine must be highly individualized based on the patient's clinical response and the specific condition being treated. According to clinical guidelines, the following are standard dosage ranges:
Nicardipine is not currently FDA-approved for use in pediatric patients under the age of 18. While some specialized pediatric cardiologists may use Nicardipine off-label for severe hypertension in children, safety and efficacy have not been formally established in this population. If a child is prescribed this medication, it is done under strict specialist supervision with weight-based dosing calculations.
Patients with impaired kidney function should be monitored closely. While Nicardipine is primarily metabolized by the liver, renal impairment can affect the overall clearance of the drug. Healthcare providers usually start at the lowest possible dose (e.g., 20 mg three times daily) and titrate slowly.
Because Nicardipine is extensively metabolized by the liver, patients with significant liver disease (such as cirrhosis) will have much higher blood levels of the drug. In these cases, the dose must be significantly reduced, often starting at 20 mg twice daily or even lower, with very careful monitoring of blood pressure and side effects.
Older adults may be more sensitive to the blood-pressure-lowering effects of Nicardipine. There is an increased risk of hypotension (excessively low blood pressure) and falls. Clinical practice suggests starting at the lower end of the dosing range and monitoring for signs of dizziness or lightheadedness.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not take two doses at once to make up for a missed one, as this can lead to a dangerous drop in blood pressure.
Signs of a Nicardipine overdose include severe hypotension (very low blood pressure), bradycardia (slow heart rate), palpitations, flushing, and severe dizziness or fainting. In the event of a suspected overdose, seek emergency medical attention immediately. Treatment in a hospital setting typically involves intravenous fluids to support blood pressure and medications to support heart function.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking the medication without medical guidance, as sudden discontinuation can lead to a rapid rise in blood pressure.
Nicardipine is generally well-tolerated, but because it works by dilating blood vessels, certain side effects are common. These typically occur as the body adjusts to the medication and may include:
Nicardipine is a powerful cardiovascular medication that requires careful oversight. Patients must be aware that while this drug is effective at lowering blood pressure, it does not 'cure' hypertension; it manages it. Therefore, it is usually a lifelong medication. You should never stop taking Nicardipine abruptly, as this can cause a 'rebound' effect where your blood pressure spikes to dangerously high levels, increasing the risk of a stroke or heart attack.
As of 2026, there are no FDA black box warnings for Nicardipine. It is considered a safe and well-established medication when used according to professional medical guidelines.
There are certain medications that should never be used in combination with Nicardipine due to the risk of severe adverse reactions:
There are specific circumstances where Nicardipine must NEVER be used because the risks far outweigh any potential benefits:
Relative contraindications are conditions where the drug should only be used if the benefit clearly justifies the risk, and only under intense medical supervision:
Nicardipine is classified by the FDA as Pregnancy Category C. This means that studies in animals have shown adverse effects on the fetus, but there are no adequate and well-controlled studies in humans. Data suggest that Nicardipine should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. In late pregnancy, calcium channel blockers are sometimes used to manage severe preeclampsia (high blood pressure in pregnancy), but this is always done in a high-risk hospital setting. There is a theoretical risk that Nicardipine could interfere with labor contractions, as calcium is necessary for the uterus to contract.
Small amounts of Nicardipine have been found to pass into breast milk. While the levels are generally thought to be low, the effects on a nursing infant are not fully known. Because of the potential for serious adverse reactions in the infant (such as low blood pressure), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. If you are breastfeeding, consult your pediatrician and your doctor to weigh the risks and benefits.
Nicardipine is a second-generation dihydropyridine calcium channel blocker. Its primary molecular mechanism involves the inhibition of the transmembrane influx of calcium ions into cardiac muscle and vascular smooth muscle cells. It specifically binds to the L-type calcium channels, preventing the opening of the channel pore. By blocking the entry of calcium, Nicardipine prevents the calcium-calmodulin binding that activates myosin light-chain kinase, an enzyme necessary for muscle contraction. This results in the relaxation of the vascular smooth muscle, particularly in the peripheral and coronary arteries. Its selectivity for vascular tissue over cardiac tissue is significant; it is roughly 100 times more potent at dilating blood vessels than it is at slowing the heart's contractions.
The onset of action for oral immediate-release Nicardipine is approximately 30 to 60 minutes, with peak effects occurring within 1 to 2 hours. The duration of the antihypertensive effect is roughly 8 hours. With the sustained-release formulation, the onset is slower, but the effect is maintained for up to 12 hours. Nicardipine produces a dose-related decrease in systemic blood pressure. Interestingly, it often causes a slight 'reflex' increase in heart rate (tachycardia) and cardiac output because the body attempts to compensate for the lower blood pressure. Tolerance to the antihypertensive effects of Nicardipine has not been observed in long-term clinical trials.
Common questions about Nicardipine Hydrochloride In Sodium Chloride
Nicardipine is primarily used to treat high blood pressure (hypertension) and chronic stable angina, which is a type of chest pain caused by reduced blood flow to the heart. The oral capsules are typically used for long-term management of these conditions to prevent serious complications like heart attacks or strokes. The intravenous (IV) form is used in hospital settings for rapid blood pressure control during hypertensive emergencies or surgery. It belongs to a class of drugs called dihydropyridine calcium channel blockers, which work by relaxing and widening blood vessels. Your doctor may prescribe it alone or in combination with other heart medications.
The most common side effects of Nicardipine are related to its action of dilating blood vessels and include headaches, flushing (redness and warmth in the face), and peripheral edema (swelling of the ankles or feet). Many patients also report feeling dizzy or lightheaded, especially when first starting the medication or when standing up too quickly. Some people may experience 'reflex tachycardia,' which is a sensation of a racing or pounding heart. Most of these side effects are mild and tend to improve as your body becomes accustomed to the medication over several weeks. However, if they become severe or persistent, you should consult your healthcare provider.
It is generally recommended to avoid or significantly limit alcohol consumption while taking Nicardipine. Alcohol can lower blood pressure on its own and cause blood vessels to dilate, which can add to the effects of the medication. This combination can lead to a dangerous drop in blood pressure, resulting in severe dizziness, fainting, or an increased risk of falls. Alcohol can also increase the risk of certain side effects like headaches and flushing. If you choose to drink, you must discuss it with your doctor to understand your specific risks. For safety, it is best to see how the medication affects you before consuming any alcohol.
Nicardipine is classified as a Pregnancy Category C medication, meaning its safety in pregnant women has not been fully established. Animal studies have shown some potential for harm to the fetus, but there is limited data from human trials. It is generally only used during pregnancy if the potential benefits to the mother outweigh the risks to the baby, such as in cases of severe, life-threatening high blood pressure. If you are pregnant or planning to become pregnant, it is crucial to discuss alternative blood pressure management options with your doctor. They will carefully monitor both you and the baby if this medication is deemed necessary.
The time it takes for Nicardipine to work depends on the formulation you are using. For the immediate-release oral capsules, you may begin to see a reduction in blood pressure within 30 to 60 minutes, with the maximum effect occurring about 1 to 2 hours after the dose. The intravenous (IV) form used in hospitals works much faster, often showing results within minutes of starting the infusion. For chronic conditions like angina, it may take several days of consistent use for you to notice a significant reduction in the frequency of chest pain. Always follow your doctor's instructions and do not expect immediate results for long-term blood pressure control.
No, you should never stop taking Nicardipine suddenly without consulting your healthcare provider. Abruptly discontinuing this medication can cause 'rebound hypertension,' where your blood pressure rises rapidly to levels that may be higher than before you started treatment. This sudden spike can increase the risk of serious medical emergencies, including heart attack or stroke. If you need to stop the medication due to side effects or a change in treatment, your doctor will provide a schedule to gradually decrease your dose. Always ensure you have a sufficient supply of your medication so you do not miss doses unexpectedly.
If you miss a dose of Nicardipine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, you should skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time to 'make up' for the one you missed, as this can cause your blood pressure to drop too low and lead to severe dizziness or fainting. Consistency is key to managing blood pressure effectively, so using a pillbox or a phone reminder can be helpful. If you miss multiple doses in a row, contact your doctor for advice on how to restart your treatment safely.
Nicardipine is not typically associated with an increase in body fat, but it can cause 'peripheral edema,' which is the retention of fluid in the ankles and legs. This fluid retention may lead to a slight increase in the number on the scale and a feeling of heaviness or bloating in the lower extremities. This is not the same as gaining fat, but it can be uncomfortable. If you notice a sudden, large increase in weight (such as several pounds in a single day) or if you experience shortness of breath along with the swelling, contact your doctor immediately. These could be signs of worsening heart function rather than a simple side effect of the medication.
Nicardipine can interact with many other medications, so it is vital to provide your doctor with a full list of everything you take. It can interact with other blood pressure drugs, certain antifungals, antibiotics, and even herbal supplements like St. John's Wort. Specifically, it can increase the levels of drugs like Cyclosporine or Digoxin in your blood, which may require dose adjustments. It also interacts with grapefruit juice, which can dangerously increase the amount of Nicardipine in your system. Your healthcare provider will check for these interactions to ensure that your combination of medications is safe and effective for your specific health needs.
Yes, Nicardipine is available as a generic medication in both its immediate-release and sustained-release oral forms, as well as the intravenous formulation. Generic versions are required by the FDA to have the same active ingredient, strength, dosage form, and route of administration as the brand-name version (such as Cardene). Generic medications are typically much more affordable than brand-name drugs and are covered by most insurance plans. When you fill your prescription, your pharmacist can confirm if you are receiving the generic version. The effectiveness and safety of the generic are considered equivalent to the brand-name product.
Other drugs with the same active ingredient (Nicardipine)
Some patients may experience the following effects, which should be reported to a doctor if they become bothersome:
Rarely, Nicardipine may cause more unusual reactions, such as:
> Warning: Stop taking Nicardipine and call your doctor or emergency services immediately if you experience any of the following:
With prolonged use, the most significant concern is the persistence of peripheral edema (swelling). While not usually dangerous, it can be uncomfortable and may require the use of compression stockings or a change in medication. Long-term use of Nicardipine does not typically lead to organ damage; in fact, its primary purpose is to protect the heart and kidneys from the long-term damage caused by high blood pressure. However, regular monitoring of liver and kidney function is recommended to ensure the drug is being processed correctly over the years.
There are currently no FDA Black Box Warnings for Nicardipine. However, this does not mean the drug is without risk. It must be used with extreme caution in patients with certain pre-existing heart conditions, such as advanced aortic stenosis (narrowing of the heart's aortic valve), as the vasodilation can lead to a dangerous drop in blood flow to the brain and heart.
Report any unusual symptoms or changes in your health to your healthcare provider immediately. Regular follow-up appointments are essential to ensure the medication is working safely for you.
When you are taking Nicardipine, your healthcare provider will require regular monitoring to ensure safety:
Nicardipine can cause dizziness, lightheadedness, or blurred vision, especially during the first few days of treatment or after a dose increase. Do not drive, operate heavy machinery, or engage in dangerous activities until you know how this medication affects you. If you feel dizzy, sit or lie down immediately.
Alcohol should be avoided or strictly limited while taking Nicardipine. Alcohol also has blood-pressure-lowering effects and can cause blood vessels to dilate. Combining the two can lead to an additive effect, causing a dangerous drop in blood pressure, severe dizziness, and an increased risk of fainting and falls.
If your doctor decides to stop your Nicardipine treatment, they will likely provide a tapering schedule. Do not stop taking the medication on your own. Sudden discontinuation can lead to 'rebound hypertension,' which is a rapid and severe increase in blood pressure that can lead to medical emergencies.
> Important: Discuss all your medical conditions, including any history of heart, liver, or kidney disease, with your healthcare provider before starting Nicardipine.
Nicardipine is not known to interfere significantly with most common laboratory tests. However, it is always important to inform laboratory personnel and your doctors that you are taking this medication, as it can affect physiological parameters like heart rate and blood pressure recorded during stress tests.
For each major interaction, the mechanism usually involves the Cytochrome P450 3A4 enzyme system. Inhibitors of this enzyme increase Nicardipine levels (toxicity risk), while inducers decrease Nicardipine levels (efficacy risk). Management strategies include frequent blood pressure monitoring and dosage adjustments by a qualified healthcare professional.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter drugs like ibuprofen or cold medicines.
Patients who are allergic to other drugs in the dihydropyridine class (such as Amlodipine, Nifedipine, or Felodipine) may also be allergic to Nicardipine. If you have ever had a reaction (like swelling or a severe rash) to any 'blood pressure pill,' inform your doctor before starting Nicardipine.
> Important: Your healthcare provider will evaluate your complete medical history, including any underlying heart valve issues or liver conditions, before prescribing Nicardipine. Always be honest about your medical history to ensure your safety.
Clinical studies of Nicardipine did not include sufficient numbers of subjects aged 65 and over to determine if they respond differently than younger subjects. However, clinical experience suggests that elderly patients may have decreased liver or kidney function and may be taking multiple other medications (polypharmacy). This increases the risk of drug interactions and side effects. Elderly patients should start at the lowest end of the dosing range. There is also a significant concern regarding the risk of falls due to dizziness or orthostatic hypotension in this population.
In patients with impaired kidney function, the pharmacokinetics of Nicardipine are altered. Specifically, the peak plasma levels and the 'area under the curve' (total exposure to the drug) are higher. Healthcare providers typically start with 20 mg three times daily and titrate very slowly. Nicardipine is not removed by hemodialysis because it is highly protein-bound, so no 'booster' dose is needed after dialysis treatments.
This is the most critical special population for Nicardipine. In patients with severe liver disease, the half-life of Nicardipine can increase from 8 hours to over 50 hours. This means the drug stays in the system much longer and can easily reach toxic levels. For patients with significant hepatic impairment, the recommended starting dose is 20 mg twice daily, with careful monitoring and slow titration based on response.
> Important: Special populations require individualized medical assessment. Never share your medication with others, especially those in these high-risk categories.
| Parameter | Value |
|---|---|
| Bioavailability | ~35% (due to high first-pass metabolism) |
| Protein Binding | >95% (primarily to albumin) |
| Half-life | ~8.6 hours (terminal phase) |
| Tmax | 0.5 to 2 hours (immediate-release) |
| Metabolism | Extensive hepatic metabolism (CYP3A4, 2D6, 2C8) |
| Excretion | Renal 60%, Fecal 35% |
Nicardipine hydrochloride is chemically described as 2-(benzyl-methyl amino) ethyl methyl 1,4-dihydro-2,6-dimethyl-4-(m-nitrophenyl)-3,5-pyridinedicarboxylate monohydrochloride. Its molecular formula is C26H29N3O6 • HCl, and it has a molecular weight of 515.99 g/mol. It is a yellow, crystalline powder that is sparingly soluble in water but soluble in alcohol and chloroform. The presence of the nitro group on the phenyl ring is a characteristic feature of the dihydropyridine class that contributes to its potent vasodilatory activity.
Nicardipine belongs to the Dihydropyridine Calcium Channel Blocker class. Related medications in this same class include Amlodipine (Norvasc), Nifedipine (Procardia), and Felodipine (Plendil). It is distinct from non-dihydropyridine calcium channel blockers like Diltiazem and Verapamil, which have much stronger effects on the heart rate and the heart's electrical conduction system.