Blood pressure and rate control
Nicardipine (Cardene) drip
Cardene
Dosing
| Start | 5 mg/h |
|---|---|
| Titrate | 2.5 mg/h every 5–15 minutes |
| Maximum | 15 mg/h |
| Common bags | 20 mg in 200 mL (100 mcg/mL); 40 mg in 200 mL (200 mcg/mL) |
| Dose units | mg/h |
Line and administration
- Peripheral is fine; change the site every 12 hours (phlebitis)
Watch for
- Reflex tachycardia
- Hypotension overshoot after stopping is slow to reverse
Nicardipine: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Aortic Dissection and Hypertensive EmergencyAortic dissection: Beta-blocker FIRST (esmolol or labetalol), then a vasodilator (nicardipine, clevidipine or nitroprusside) if BP stays high
- Subarachnoid HemorrhageUntil the aneurysm is secured: BP: frequent checks; nicardipine, clevidipine or labetalol; avoid MAP below 65 and swings. No proven target; many units keep SBP below 160, some below 140 (ESO 2026 consensus: about 160, lowered gradually).
- After Cardiac SurgeryHemodynamics, low output and vasoplegia: Afterload: hypertension strains suture lines and raises bleeding; use nicardipine, clevidipine or nitroprusside, or nitroglycerin when ischemia or radial spasm is the worry. After mitral repair for regurgitation the LV loses its low-pressure outlet into the atrium and tolerates afterload poorly.
- Endocrine EmergenciesPheochromocytoma crisis: Lower pressure with α-blockade or an arterial vasodilator: phentolamine 1–5 mg IV boluses or infusion, nicardipine, clevidipine or nitroprusside. Add esmolol for tachycardia only after α-blockade; labetalol alone is a poor choice because its IV β effect is about 7 times its α effect. Patients are volume-contracted, so expand volume as vessels relax. Catecholamine cardiomyo
- Obstetric EmergenciesPreeclampsia with severe features, eclampsia and HELLP: For sustained control, PB 222 also lists infusions of labetalol 1–2 mg/min or hydralazine 0.5–10 mg/h, and ICUs often use nicardipine. Aim for a safe range, not normal, because placental flow follows maternal pressure: 130–150/80–100 in the 2025 ACOG/NAEMSP guideline, 135/85 in NICE NG133. NSAIDs remain preferred over opioids for postpartum p
- Peripheral Vascular EmergenciesCarotid endarterectomy and stenting in depth: Hyperperfusion syndrome: after a tight stenosis is opened, flow can exceed what the brain's autoregulation can handle. Signs are a severe headache on the operated side, eye or facial pain, seizures, focal deficits and confusion, usually with high blood pressure; intracerebral hemorrhage is the feared result. In the review by Zhou et al., pooled inciden
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.