Nicardipine

'Nicardipine (HCl) is a dihydropyridine calcium-channel blocking agent used for the treatment of vascular disorders such as chronic stable angina, hypertension, and Raynaud''s syndrome. its mechanism of action and clinical effects closely resemble those of nifedipine and the other dihydropyridines (amlodipine, felodipine), except that nicardipine is more selective for cerebral and coronary vessels. Furthermore, nicardipine does not intrinsically decrease myocardial contractility and may be useful in the management of congestive heart failure. Nicardipine also has a longer half-life than nifedipine. Nicardipine was approved by the FDA in December 1988. Mechanism of action is similar to nifedipine, nicardipine inhibits the influx of extracellular calcium across the cell membranes of myocardial and vascular smooth muscle without altering serum calcium concentrations and inhibits intracellular phosphodiesterase. The decrease in intracellular calcium inhibits the contractile processes of the myocardial smooth muscle cells, resulting in dilation of the coronary and systemic arteries. These effects elicit an increased oxygen delivery to the myocardial tissue, and a decreased total peripheral resistance, systemic blood pressure, and afterload.'

Brands
NICAPRESS-R
Adult Dose
Dose: 60 to 120 mg
Single Dose: 90 (90)
Frequency: 24 hourly
Route: PO
Instructions: In div.doses.
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
Nicardipine (HCl) is the derivative of Nicardipine. It is of Synthetic origin and belongs to Dihydropyridine. It belongs to Calcium L-channel antagonist pharmacological group on the basis of mechanism of action. The Molecular Weight of Nicardipine is 515.99. Its pKa is 7.2.
Contraindications
Nicardipine is contraindicated in conditions like Hypersensitivity,Aortic stenosis.
Effects
The severe or irreversible adverse effects of Nicardipine, which give rise to further complications include Nausea, Allergic reactions, Orthostatic hypotension, Jaundice, Jaundice, Psychosis, Palpitation, Flushing, Headache, Oedema, Dizziness, Heat sensation.Nicardipine produces potentially life-threatening effects which include Myocardial infarction, Angina pectoris, Syncope, Hypotension, syncope, Pericarditis, Ventricular tachycardia, Atrial fibrillation. which are responsible for the discontinuation of Nicardipine therapy.The signs and symptoms that are produced after the acute overdosage of Nicardipine include Bradycardia, Hypotension, Flushing, Coma, Drowsiness, Confusion, Palpitations, Dizziness, AV block, Hepatic necrosis, Weakness, Slurred speech, Chest pain, Hepatic function abnormalities.The symptomatic adverse reactions produced by Nicardipine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Fatigue, Nausea, Dyspnea, Tachycardia, Insomnia, Tinnitus, Abdominal pain, Rashes, Frequent of micturition, Cardiac arrhythmias, Flushing, Tremor, Asthenia, Heart burn, Edema, Lassitude, dizziness, Tachycardia.
Indications
Nicardipine is primarily indicated in conditions like Angina, Cerebrovascular disease, Hypertension, Mild to moderate hypertension, Prophylaxis of angina.
Interactions
Nicardipine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCimetidine (HCl)Cyclosporin ACyclosporin ADigoxinFentanyl (Citrate)NitrendipineMay increase the levels/effects of nitrendipine.RepaglinideNicardipine may increase the levels/effects of repaglinide.VORICONAZOLENicardipine may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Caps Store Below 40°C. Protect from Sunlight and Moisture. Inf (reconstituted) Store at room temperature. Use within 24 hrs if kept at room temperature.
Warnings
Nicardipine should be used with caution in patients with heart, liver or kidney disease or if have any allergy. Limit intake of alcohol while taking this drug. This should be used only when clearly needed during pregnancy or lactation. Use caution when you stand up or sit up from a lying position especially if you wake up during night. Avoid alcohol.
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