Cardimed Dosage/Direction for Use

As a Substitute for Oral Nicardipine Therapy: The intravenous infusion rate required to produce an average plasma concentration equivalent to a given oral dose at steady state is shown in the following table (see table).

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For Initiation of Therapy in a Drug Free Patient: The time course of blood pressure decrease is dependent on the initial rate of infusion and the frequency of dosage adjustment. Nicardipine hydrochloride is administered by slow continuous infusion at a concentration of 0.1 mg/mL. With constant infusion, blood pressure begins to fall within minutes. It reaches about 50% of its ultimate decrease in about 45 minutes and does not reach final steady state for about 50 hours.
When treating acute hypertensive episodes in patients with chronic hypertension, discontinuation of the infusion is followed by a 50% offset of action in 30 ± 7 minutes but plasma levels of drug and gradually decreasing antihypertensive effects exist for about 50 hours.
Titration: For gradual reduction in blood pressure, initiate therapy at 50 mL/hr (5 mg/hr). If desired blood pressure reduction is not achieved at this dose, the infusion rate may be increased by 25 mL/hr (2.5 mg/hr) every 5 minutes up to a maximum of 150 mL/hr (15 mg/hr), until desired blood pressure reduction is achieved. Following achievement of blood pressure goal, the infusion rate should be decreased to 30 mL/hr (3 mg/hr).
Maintenance: The rate of infusion should be adjusted as needed to maintain desired response.