Nicardipine
Brand names
Usage
To prevent attacks of angina
(chest pain associated with
heart disease) and to control
high blood pressure.
How it works
Nicardipine interferes with the
movement of calcium into
heart muscle cells and the
smooth muscle cells in the
walls of the arteries. This
action relaxes
blood vessels
(causing them to widen),
which lowers blood pressure,
increases the blood supply to
the heart, and decreases the
heart's overall workload.
Side effects
- Serious
- Breathing difficulty, coughing, or wheezing; irregular or
pounding heartbeat; chest pain; fainting. Get medical help
right away.
- Common
- Headache;
dizziness; skin flushing and feeling of warmth;
swelling in the feet, ankles, or calves;
palpitations.
- Less common
- Constipation or
diarrhea,
nausea, unusual
fatigue and
weakness, skin rash, increased urination,
heartburn.
Possible interactions
- Other medicaments:
Nicardipine may increase the effects of:
Nicardipine taken concurrently with:
- amiodarone (Cordarone) may result in cardiac arrest.
- beta-blocker medicaments or digitalis preparations may affect
heart rate and rhythm adversely; careful monitoring by your physician is
necessary if these medicaments are taken concurrently.
- delavirdine (Rescriptor) and other medicines that inhibit cytochrome
P450 3A4 may lead to increased nicardipine levels and toxicity.
- magnesium may cause worsening of neuromuscular blockade and further
lowering of blood pressure.
- nonsteroidal anti-inflammatory agents may
blunt the therapeutic effects of nicardipine.
- oral anticoagulants (warfarin, others) increase
bleeding risk.
- phenytoin (Dilantin) or fosphenytoin (Cerebyx) may result in phenytoin or
fosphenytoin toxicity or decreased efficacy of nicardipine.
- rifampin (Rifadin, others) has caused loss of control of blood pressure with
some other calcium channel blockers; caution is advised if these medicines
are combined.
- sirolimus (Rapamune) or tacrolimus (Prograf) may result in sirolimus or
tacrolimus toxicity. The doses of the immunosuppressants may need to be
reduced.
The following medicaments may increase the effects of nicardipine:
- cimetidine (Tagamet).
- imidazole antifungals (ketoconazole [Nizoral]) or triazole antifungals
(itraconazole [Sporanox] or fluconazole [Diflucan]).
- quinupristin/dalfopristin (Synercid) may result in nicardipine toxicity.
- ritonavir (Norvir) and other protease inhibitors.
- Foods:
- Food decreases the amount of this medicament that is absorbed. Do not take
this medicine with grapefruit or grapefruit juice. It is also prudent to avoid
excessive salt intake.
- Herbal medicines or minerals:
- Ginseng may increase blood pressure, blunting the benefits of this medicine.
Hawthorn,
saw palmetto,
ma huang,
goldenseal,
yohimbe and
licorice may also
increase blood pressure. Calcium and
garlic may help lower blood pressure.
Indian snakeroot has a German Commission E monograph indication for
hypertension-talk to your doctor. Eleuthero root should be avoided by people
living with hypertension. Talk with your doctor before adding any herbal medicine to nicardipine.
- Beverages:
- Do not take this medicine with grapefruit or grapefruit juice.
- Alcohol:
- Use with caution until combined effects have been determined.
Alcohol
may exaggerate the drop in blood pressure experienced by some individuals.
- Tobacco smoking:
- Nicotine may reduce the effectiveness of this
medicament.
- Marijuana smoking:
- Possibly causes reduced effectiveness of this medicament; mild to
moderate increase in angina; possible changes in electrocardiogram,
confusing interpretation.
- Exposure to heat:
- Hot environments can exaggerate the
blood-pressure-lowering effects of this medicament. Observe for light-headedness
or weakness.
- Heavy exercise or exertion:
- This medicament may improve your ability to be more
active without resulting angina pain. Use caution and avoid excessive exercise
that could impair heart function in the absence of warning
pain.
- Discontinuation:
- Do not stop this medicament abruptly. Ask your doctor about gradual
withdrawal. Watch for possible development of rebound angina.
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