Cardene

(Nicardipine Hydrochloride)

The active ingredient in Cardene is nicardipine hydrochloride. It is a dihydropyridine calcium channel blocker (a type of antihypertensive agent) or calcium ion influx inhibitor. Its mechanism of action involves relaxing blood vessels (vasodilation), which lowers blood pressure and can improve blood flow. Lowering blood pressure helps to reduce strain on the heart and blood vessels.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Cardene. However, the following is a synopsis of the general guidelines for the use of Cardene:

Cardene I.V. is intended for intravenous use and is typically started and managed in a hospital or monitored clinic setting.

Cardene is meant for short-term use, and patients are typically switched to an oral medicine as soon as their condition allows.

If you are switching to oral nicardipine, your first oral dose may be given before the IV infusion is stopped, based on your prescriber’s plan.

If you are switching to a different oral antihypertensive, it may be started when the Cardene infusion is stopped.

Some mild or common adverse events of Cardene include:

Headache.

Low blood pressure (hypotension).

Fast heartbeat (tachycardia).

Nausea and vomiting.

Swelling in the legs (peripheral edema).

Some individuals may experience serious adverse reactions while using Cardene. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

Severe low blood pressure, including fainting or feeling like you may pass out.

Severe chest pain (angina) or worsening chest pain.

Signs of heart problems, such as sudden shortness of breath, swelling, or feeling much more tired than usual.

Severe allergic reaction, such as hives, swelling of the face, lips, tongue, or throat, or trouble breathing.

Severe IV-site problems, such as intense pain, swelling, blistering, skin changes, or signs of extravasation (medicine leaking into surrounding tissue).

Signs of a severe skin reaction (rare), such as widespread rash with blisters or peeling skin.

Symptoms that could suggest a serious heart event (such as a heart attack) include crushing chest pain, sweating, nausea, or pain spreading to the arm or jaw.

These are not all of the possible side effects of nicardipine. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Cardene, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

Heart disease or heart problems.

Heart failure or left ventricular dysfunction.

Angina or a history of chest pain.

Recent stroke, bleeding in the brain, or other serious brain conditions, where a sudden drop in blood pressure could be harmful.

Kidney disease or kidney problems.

Liver problems or liver disease.

Cardene is contraindicated in patients with advanced aortic stenosis. In this condition, lowering the afterload and reducing diastolic pressure may worsen the balance of oxygen supply to the heart muscle, which can make symptoms worse.

Cardene can start lowering blood pressure within minutes of starting the infusion. With a steady infusion, blood pressure reaches about half of its full effect in about 45 minutes. Your health care team will adjust the infusion rate based on how quickly and how much your blood pressure changes.

When Cardene is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

Beta-blockers may increase the risk of worsening heart failure symptoms in susceptible patients, so Cardene should be titrated slowly when used together, especially in heart failure.

Cimetidine may increase nicardipine levels in the body, which can increase effects such as low blood pressure or tachycardia, so the response should be monitored closely.

Cyclosporine or tacrolimus levels may increase when used with nicardipine, which can raise the risk of cyclosporine side effects.

It is available in premixed bags containing 20mg of intravenous nicardipine in 200mL of diluent, either dextrose or sodium chloride.

Cardene is stored at room temperature by the hospital and protected from light until ready to use.

It is manufactured by Baxter Healthcare Corporation.

Yes, it is available from many manufacturers of generic drugs.

Do not stop or change Cardene on your own. Because Cardene is given by IV infusion, a health care professional will stop it when appropriate. After stopping the infusion, the blood pressure–lowering effect decreases by about 50% in around 30 minutes. If you are switching to an oral antihypertensive, your prescriber will guide exactly when to start the oral medicine to maintain safe blood pressure control.

There are no adequate, well-controlled studies in pregnant women, and Cardene should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. If you are pregnant, also tell your health care provider right away if you develop symptoms such as severe dizziness, fainting, or chest pain during treatment.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Nicardipine is minimally excreted into human milk, and infant exposure appears low in the data described. Your health care provider can help weigh the benefits of breastfeeding and the need for treatment.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.