Nicardipine Intravenous Infusion for Adults

Who can administer

Administration RESTRICTED - see Appendix 1

Intravenous nicardipine should only be used to treat acute life-threatening hypertension, and post-operative hypertension ^{(ref 1,2)}
Should only be given in specialist unit or Intensive Care
Unlicensed drug

10mg in 10mL ampoule

Not required- already in solution

Glucose 5% ^{(ref 2,3)}

Continuous intravenous infusion ^{(ref 2)} (administer using a electronically controlled infusion device)

Peripheral line
- Dilute to a concentration of 0.1 or 0.2mg/mL ( i.e. 100 to 200microgram/mL)
- Example: add 50mg nicardipine to 450mL infusion fluid (100micrograms/mL)
- Example: add 50mg nicardipine to 200mL infusion fliud (200micrograms/mL)
- If administration is via a peripheral line- change line every 12 hours to minimise the risk of venous irritation ^{(ref 2)}
Central line
- May be given undiluted via central line access device ^{(ref 1,3)}

Life-threatening hypertension, Post-operative hypertension (Specialist use only)

Initially 3 to 5mg/hour for fifteen minutes, increased in steps of 0.5 to 1mg every fifteen minutes, adjusted according to response. A rapid titration of 2.5mg/hour every five minutes may be considered (ref 4)
Maximum rate 15mg/hour
Reduce dose gradually when target blood pressure achieved
Maintenance 2 to 4mg/hour
Use with caution and at lower doses in patients with liver or kidney problems
Elderly patients ^{(ref 2)}
- Initially 1 to 5mg/hour, then adjusted in steps of 0.5mg/hour after 30 minutes, adjusted according to response
- Maximum rate 15mg/hour
Renal or hepatic impairment^{(ref 2)}
- Initially 1 to 5mg/hour, then adjusted in steps of 0.5mg/hour after 30 minutes, adjusted according to response
- Maximum rate 15mg/hour

Monitor blood pressure and heart rate at least every five minutes during the infusion and then until vital signs are stable, and for at least 12 hours after the end of the infusion
Rapid or excessive reduction in systolic or diastolic blood pressure during IV therapy should be avoided
Avoidance of hypotension is especially important in patients who have sustained an acute cerebral infarction or haemorrhage

Store below 25⁰C

1: SPC (UK) 31st Dec 2020

2: BNF accessed online 7th Dec 2021

3: Injectable medicines administration guide Medusa accessed online 7th Dec 2021

4: Martindale - accessed online 7th Dec 2021

Calcium channel blocker