Section 13 · Monograph
Nicardipine IV
Reviewed Nov 2026FDA label
Cardene IVCalcium channel blocker · IV
- Forms
- IV: 25mg/10mL vial | Premixed bags: 20, 40mg
- Dose
- Start 5mg/h, increase 2.5mg/h every 5-15 min, max 15mg/h
- MOA
- Arterial vasodilation via L-type Ca2+ channel blockade
Indications
- Short-term treatment of hypertension when oral therapy is not feasible (including acute BP control in stroke and intracerebral hemorrhage)FDA-labeled
Mechanism of Action
- Dihydropyridine calcium channel blocker producing arterial vasodilation with minimal negative inotropy
Full Dosing
Adult / usual
- Start 5mg/h; increase by 2.5mg/h every 5-15 minutes to goal; maximum 15mg/h
- Stroke/ICH BP targets per current guidelines
- Rotate peripheral infusion site every 12 hours
Contraindications
- Advanced aortic stenosis
- Known hypersensitivity to nicardipine
Drug Interactions
- Beta-blockers and other antihypertensives are additive
- Cimetidine and CYP3A4 inhibitors may increase levels
- Increases cyclosporine and tacrolimus levels
Adverse Effects
- Hypotension
- Headache
- Reflex tachycardia
- Phlebitis at peripheral site
- Nausea
Monitoring Parameters
- Continuous BP and heart rate
- Infusion site
- Neurologic status
Pregnancy & Lactation
- Limited data; use if benefit justifies risk
- Present in milk in small amounts