About Nicardipine
Nicardipine belongs to a class of drugs known as calcium channel
blockers. They block calcium ions from some cell walls, inhibiting
the contraction of coronary and peripheral arteries. The reduced
electrical activity in the cardiovascular system lowers oxygen
requirements for the heart muscle, decreases likelihood of
spasm and contraction in the arteries, and prevents the heart
from exerting itself too rapidly or forcefully. Benefits should
be seen within 1-4 weeks of consistent use.
This medication is primarily prescribed to treat: angina from coronary
artery spasm, classical angina, and moderately high blood pressure
(hypertension).
Other uses for which it is acceptable include: halting the
progression of artherosclerosis in early stages, reducing
symptoms of Raynaud's syndrome (cold, tingling, or numb extremities),
partial therapy for postoperative pulmonary hypertension,
decreases likelihood of vessel spasm during certain types
of vascular surgery, may reduce symptoms of menstrual pain
that does not respond to NSAIDs, as a preventive therapy for
migraine, to treat premature
labor, may be used as combination therapy to prevent repeat
strokes, and eases pain after shingles (herpes zoster).
Medication for high blood pressure or other cardiovascular
problems may have to continue for the duration of the patient's
life, there are currently no treatments that will reverse
these conditions. It's important that medication prescribed
to treat these ailments be taken regularly and consistently,
as there may be no obvious symptoms before serious damage
is done to the body.
Nicardipine is only available by prescription.
Nicardipine Side Effects
Possible Side Effects: Change in menstrual cycle, constipation,
diarrhea, dizziness, fast heartbeat, flushing or warmth, headache,
low blood pressure (hypotension), nausea, sweating, swollen feet
or ankles, unusual tiredness.
Adverse Side Effects: Report any of the following infrequent
to rare symptoms to your doctor. If you experience any serious side
effects, seek medical treatment.
Mild: Allergy (fever, hives, itching, rash), coughing, difficulty
breathing, dizziness, fatigue, flushing, headache, indigestion,
muscle cramps, nausea, nervousness, poor circulation to extremities
(cold or numbness in hands or feet), reversible infertility in men,
sleep disorder, shortness of breath, tremors, unusual conditions
of the gums (bleeding, growth, tenderness), wheezing.
Serious: Allergy (severe rash), bleeding or swollen gums,
chest pain, congestive heart failure (rare), decreased circulation
in fingers, fainting induced by low blood pressure, fluid in the
lungs, kidney damage, liver damage, low blood sugar (hypoglycemia),
more frequent angina, pain or swelling in joints, racing or irregular
heartbeat, reduced blood clotting, revealing movement disorders
(rare), trouble seeing.
Cautions: This medication may not be suitable for everyone.
Discuss any history of the following conditions with your doctor,
and carefully examine your treatment options.
- Allergies: An allergic reaction to this drug in the past
is an indication that you should not use it. If you develop a
skin condition while undergoing treatment, tell your doctor at
once. Inform you doctor if you have had a poor response to another
calcium channel blocker, or have any other allergies (food, dye,
medications).
- Aortic Stenosis: Speak to a specialist regarding treatment
options, this medication will probably not be the correct treatment
for you.
- Circulatory or Heart Conditions: Any history of heart
attack, stroke, congestive heart failure, heart rhythm disorders,
or any other condition of the circulatory system needs to be discussed
with your prescribing physician.
- Congestive Heart Failure/2nd or 3rd Degree Heart Block:
You should not use this medication.
- Diabetes: Consult your specialist.
- Glaucoma: If you have glaucoma, and must administer any
of the following beta blocker eye drops, consult your physician
regarding possible interactions: Betagan (levobunolol), Betoptic
(betaxolol), OptiPranolol (metipranolol), or Timoptic (timolol).
- Heart Medications: If you take any other medication for
a cardiovascular condition, there may be a risk of significant,
possibly dangerous, drug interactions.
- Kidney or Liver Disease: Your doctor may decrease the
normal dose from 20-75%, depending on the severity of the condition.
Nicardipine should not be prescribed for individuals with active
liver disease. In rare cases, this drug has caused liver damage,
and should be prescribed with caution to individuals whose livers
have been damaged by other drugs.
- Low Blood Pressure (Hypotension): Do not use.
- Muscular Dystrophy: Consult your specialist.
- Poor Circulation: Frequently cold or tinging extremities
should be discussed with your doctor.
- Recent Heart Attack: Use with caution.
- Recent Stroke: Use with caution.
Nicardipine Interactions
This medication may interact with other treatments. Always keep
your prescribing physician informed about any prescription or over
the counter preparations you may use. While some of the following
medications may be used with Nicardipine even though there is a possibility
for interaction, some should not be mixed. Your doctor will have
to make this determination based on the necessity of treatment,
the possibility of dosage adjustments, and your medical history.
- Alcohol - Use with caution as directed by your doctor.
Alcohol may lower blood pressure too much, and its side
effects may be more pronounced when used with this medication.
- Anti-diabetic drugs or Insulin - This combination may
result in undesirably low blood sugar, regular testing for
hypoglycemia is recommended.
- Azole antifungals - Diflucan
(fluconazole), Nizoral
(ketoconazole), Sporanox
(itraconazole), and possibly others, may cause Nicardipine
toxicity.
- Beta Blockers - Drugs like Blocadren (timolol), Cartrol
(carteolol), Corgard (nadolol), Inderal
(propranolol), Kerlone (betaxolol), Levatol (penbutolol),
Lopressor (metoprolol),
Normodyne (labetalol), Sectral (acebutolol), Sotacor (sotalol),
Tenormin (atenolol),
Trasicor (oxprenolol ), or Visken (pindolol) may alter heart
rhythm and blood pressure undesirably when used with calcium
channel blockers. The beta blocker drops administered by
eye as a treatment for glaucoma may also interact with Nicardipine,
speak to your doctor if you take Betagan (levobunolol),
Betoptic (betaxolol), OptiPranolol (metipranolol), or Timoptic
(timolol) drops.
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline,
Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur,
etc...) - May be toxic when mixed with Nicardipine, as well
as reducing benefits of treatment.
- Calcium - Supplemental calcium may reduce the effectiveness
of calcium channel blockers. Take any vitamin supplement
containing calcium either 2 hours before, or 2 hours after,
taking your medicine.
- Cardizem (diltiazem)
- Toxic build ups of Nicardipine may occur.
- Cerebyx (fosphenytoin) or Dilantin
(phenytoin) - May build up to toxic levels in the body
when used with Nicardipine treatment.
- Cordarone (amiodarone) - This combination may cause cardiac
arrest.
- Coumadin (warfarin)
- Increased risk of gastrointestinal hemorrhage.
- Digitalis glycosides - Toxicity may occur when these compounds
are combined with calcium channel blockers.
- Lanoxin (digoxin) -
Toxicity may occur when these compounds are combined with
calcium channel blockers.
- Magnesium - May further lower blood pressure, consult
your doctor about vitamin supplements and dosage adjustments.
- Nicotine (chewing tobacco, cigarettes, nicotine gum or
patches) - This substance may reduce the effectiveness of
your treatment. Do not combine.
- Norpace (disopyramide) - Undesirable Nicardipine buildup
may occur. Increased muscle weakness may occur when these
treatments are combined.
- Oncovin (vincristine) - May build up to toxic levels.
- Prograf (tacrolimus) - Effects of Prograf may be increased.
- Pronestyl (procainamide) - Calcium channel blockers can
increase the effects of this drug.
- Protease inhibitors such as Agenerase (amprenavir), Norvir
(ritonavir), and perhaps others, may lead to higher levels
of Nicardipine in the body.
- Quinaglute (quinidine) - Calcium channel blockers increase
the risk of quinidine side effects.
- Rifampin (Rifadin, Rimactane) - May decrease usefulness
of Nicardipine.
- Sandimmune (cyclosporine) - Increased risk of side effects.
- Synercid (dalfopristin, quinupristin) - The effects of
Nicardipine may be increased.
- Tagamet (cimetidine)
- Can increase Nicardipine's effects.
- Tambocor (flecainide) - Calcium channel blockers can increase
the effects of this drug.
- Tegretol (carbamazepine)
- Tegretol may build up to toxic levels in the body.
- Zantac (ranitidine)
- May increase Nicardipine side effects.
Nicardipine Dosages
This medication is available in the following dosages and forms
of delivery:
- Capsules: 20 mg, 30 mg
- SR Capsules: 30 mg, 45 mg, 60 mg
The following are general guidelines for adults, your doctor will
need to give you a specific dosage depending on your body size and
medical history. Dosage should not exceed 120 mg daily. A typical
starting dose is 20 mg, 3 times daily, and may be increased gradually
every 3 days. Your doctor will probably start with the minimum dose
and increase as needed, follow your doctor's instructions for use
exactly.
- Angina: 30 mg - 60 mg daily, in divided
doses or one extended release dose.
- Hypertension: 30 mg - 60 mg daily, in
divided doses or one extended release dose.
Nicardipine Directions
If you miss a dose of Nicardipine, take it as soon as you remember,
unless it is almost time for the next one. In that case, skip the
missed dose and go back to your schedule. Taking double doses of
Nicardipine is not recommended. This medication is most effective
when it is used consistently according to the schedule recommended
by your doctor.
Notify any health care personnel that you take this medication.
Carry a card or alert bracelet in case you should require emergency
services. Nitroglycerin, or another nitrate medication, is a safe
treatment for any acute angina episodes.
Nicardipine ampuls and tablets are most comfortably taken with
food. This medication should be swallowed whole, and not altered
in any way. Do not take this medication with grapefruit juice, or
within two hours of a calcium supplement.
Stopping this Nicardipine abruptly may lead to rebound angina. Decrease
your dose gradually according to the advice of your doctor if you
must stop treatment for any reason.
Store Nicardipine away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep Nicardipine away from children; both when storing it, and when
discarding any unused medication.
Nicardipine and Pregnancy
In animal studies, this medication caused a greater incidence of
growth problems with the unborn child, but did not cause birth defects.
Nicardipine should not be used at all during the first trimester,
consult with your doctor about treatment during the rest of your
pregnancy. Inform you doctor if you are planning a pregnancy, use
effective contraception while taking.
This drug appears in breast milk. It is not recommended to combine
therapy with breastfeeding.
Nicardipine and Children
This medication has not been established as as safe and effective treatment for children.
Nicardipine and Seniors
There is a greater likelihood of dizziness, fainting, falls, or
weakness. Changes in thirst or urination should be reported to your
doctor immediately.
Cardene is trademark of Wyeth-Ayerst
Generic Nicardipine is produced by Mylan and Par
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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