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Nicardipine Hydrochloride

Cardene Capsules

Cardene capsules are an FDA-approved treatment widely prescribed to manage conditions such as chest pain and hypertension. As a calcium channel blocker (CCB), Cardene works by relaxing the blood vessels, which facilitates lowering blood pressure and alleviating chest pain associated with restricted blood flow to the heart. This medication can also influence heart rate, further promoting its therapeutic effects. Originally introduced under a brand name, Cardene is now also available in its generic form, allowing broader accessibility. It comes in doses of 20mg, 30mg, and 45mg, providing flexibility in addressing individual patient needs and conditions. These capsules are also available in sustained-release forms of 30mg, 45mg, and 60mg. So, if you need to buy Cardene for hypertension and chest pain, you need a doctor’s prescription first.

Product Overview

Cardene (nicardipine hydrochloride) is a medication primarily prescribed to manage hypertension (high blood pressure) and alleviate symptoms of angina (chest pain). As a member of the calcium channel blockers drug class, Cardene functions by relaxing the muscles of the heart and blood vessels. This relaxation promotes decreased blood pressure and enhanced blood flow, which aids in easing chest pain, reducing the risk of heart attacks, & preventing strokes.

Cardene is available in capsule form in 20mg, 30mg, and 45mg doses and should be administered 2-4 times daily, depending on the seriousness of the condition and specific patient requirements. It is essential for patients to follow the dosage instructions provided by their medical professional or healthcare provider, as the dosage needs can vary significantly among individuals. While Cardene can be taken with or without food, it is important to note that food intake might alter the amount of the drug that the body absorbs. However, dosage adjustment based on meal timing is generally not recommended.

Common side effects of Cardene include dizziness, headache, nausea, and flushing, most of which are generally mild & tend to decrease as the body adjusts to the medication. However, patients experiencing severe side effects such as a rapid heartbeat, shortness of breath, or significant swelling of the hands or feet should seek immediate medical attention. Additionally, individuals with pre-existing heart or liver conditions should use Cardene with caution, and it is imperative to inform the doctor of all medical history and concurrent medications to prevent adverse drug interactions.

Uses of Cardene Capsules

Cardene capsules are used to treat the following conditions:

  • Stable angina is chest pain caused by reduced blood flow to the heart. This treatment is specifically applicable to the oral capsule form of Cardene.
  • High blood pressure, also known as hypertension, where Cardene helps in regulating blood pressure levels.

How to Use Cardene Capsules?

Dosage

Cardene medication is available in various forms and strengths as follows:

Capsules 

  • 20mg 
  • 30mg
  • 45mg

Capsules Sustained-Release

  • 30mg 
  • 45mg 
  • 60mg

Infusion Solution 

  • 20mg/200mL 
  • 40mg/200mL

Injectable Solution 

  • 2.5mg/mL

Recommended Dosage for Cardene

Dosage Instructions for Cardene Capsules

For Treating Chest Pain: 

Adults: Initially, take 20mg three times daily. Based on your response, your doctor may adjust this dosage.

Children: The use and dosage must be determined by a pediatrician.

For Managing High Blood Pressure: 

Adults: Start with 20mg three times daily. Your doctor may modify the dose depending on your medical response.

Children: A doctor should determine whether and how to use this medication.

Dosage Instructions for Cardene Sustained-Release Capsules

Adults: Begin with 30 mg of Cardene SR administered twice daily. Remember that the dose should be individually adjusted based on the patient’s blood pressure response. 

Children: The usage and dosage should be prescribed by a pediatrician. 

[Note: These recommended doses of Cardene may vary depending on person to person. Discuss it with your doctor or healthcare giver, and they’ll customize your Cardene dosage accordingly.]

How to Take It?

  • Take Cardene capsules by mouth, usually three times a day, with or without food.
  • Follow your doctor’s instructions on the dosage, which will depend on your various medical conditions and how you respond to the medication.
  • Your doctor might adjust your dosage over time. Always adhere to their directions.
  • For the best results, take this medication regularly at the same times each day.
  • Continue taking Cardene even if you feel well, as high blood pressure often shows no symptoms.
  • If your condition does not improve or worsen (e.g., your blood pressure stays high or increases, or your chest pain becomes more frequent or severe), inform your doctor.
  • Do not crush or chew the Cardene capsules; swallow them whole.
  • Avoid skipping doses and do not stop taking the medication unless directed by your doctor.
  • Check the expiration date regularly and do not use it if the medication has expired.

[Note: Your doctor will decide the appropriate amount of Cardene capsules for you based on your medical condition, following guidelines & studies on the drug. They’ll adjust it as required over time.]

How Does Cardene Work?

Nicardipine Hydrochloride, commonly known by the brand name Cardene, is a medication classified as a calcium channel blocker (CCB). This pharmaceutical works by inhibiting the influx of calcium ions into the smooth muscle cells lining the blood vessels. As a result, it causes these vessels to relax and dilate, which leads to a reduction in blood pressure. This relaxation effect not only helps lower blood pressure but also alleviates chest pain, particularly in angina cases where the heart muscles are deprived of adequate oxygen due to constricted coronary arteries. Through its action, nicardipine hydrochloride improves blood flow, which can be beneficial for patients experiencing cardiovascular issues.

Important Safety Information

Side Effects

Common side effects of Cardene include:

  • Unusual tiredness or weakness
  • Sweating
  • Dizziness
  • Confusion
  • Blurred vision

Mild side effects of Cardene include:

  • Itching
  • Tingling
  • Rash
  • Redness
  • Numbness
  • Discoloration of skin
  • Tenderness
  • Increased thirst

Serious side effects of Cardene include:

  • Hives
  • Scarring
  • Bleeding
  • Coldness
  • Blistering
  • Burning
  • Feeling of pressure

[Note: Remember, this above-mentioned list may not cover all possible side effects of Cardene. It is better to consult your healthcare giver for medical advice about side effects.]

Warnings

Allergies and Ingredient Sensitivity: When starting treatment with Cardene capsules, it’s essential to thoroughly discuss your allergy history with your healthcare provider. This discussion should specifically include any known allergies to nicardipine hydrochloride, which is the active ingredient in Cardene. If you’ve previously had adverse reactions to medications similar to nicardipine hydrochloride, it’s important to alert your healthcare provider to these as well. Furthermore, Cardene capsules may contain several inactive ingredients that, while not having therapeutic effects, could potentially cause allergic reactions or other health problems. To ensure that you have all the necessary information about these components and how they might affect you, please consult with your pharmacist, who can provide detailed insights and guidance.

Blood Pressure: Due to its mechanism of action where Cardene reduces peripheral resistance, it is highly recommended to closely monitor blood pressure during the initial administration and subsequent titration of the medication. Cardene functions as a calcium channel blocker and, similar to other drugs in this category, it may sometimes lead to symptomatic hypotension, or abnormally low blood pressure (BP) that may cause dizziness or fainting. Particular caution should be exercised when administering Cardene to patients who have recently experienced an acute cerebral infarction (stroke caused by a blood clot) or hemorrhage (stroke caused by bleeding). Maintaining stable blood pressure in these patients is crucial because drastic drops in blood pressure could worsen their condition or lead to other serious complications. Therefore, managing and monitoring systemic blood pressure is essential to avoid inducing hypotensive episodes in these vulnerable patients.

Precautions

Use in Patients with Impaired Hepatic Function: Cardene undergoes extensive biotransformation primarily in the liver, which serves as the central organ for metabolizing substances in the body. Additionally, Cardene is affected by first-pass metabolism, a process where the liver metabolizes a significant portion of the medication before it enters the bloodstream. Consequently, patients with compromised liver function or decreased hepatic blood flow should use Cardene cautiously. This caution is essential because impaired liver function can significantly alter the drug’s metabolism, potentially leading to adverse effects. Furthermore, the half-life of Cardene, which is the time it takes for half of the drug to be eliminated from the body, is prolonged to about 19 hours in these patients compared to those with normal liver function. This prolongation and increased exposure may enhance the risk of toxicity and necessitate careful monitoring and potential dosage adjustments.

Various Health Conditions: Cardene should not be used if you have certain health conditions, particularly structural heart problems like aortic stenosis. Always discuss your complete medical history with your healthcare provider before starting this medication, paying special attention to any past issues related to kidney disease.

Surgical Considerations: If you are scheduled for any type of surgery, including dental procedures, make sure to inform your doctor or dentist that you are taking Cardene. This precaution helps manage any potential interactions or complications during the surgery.

Impact on Daily Life Considerations: Nicardipine Hydrochloride, the active component of Cardene, can cause dizziness, affecting your ability to drive, operate machinery, or engage in any activity that demands sharp alertness. You should not perform these activities until you are certain of your reaction to the medication. Additionally, it is highly advisable to limit your intake of alcoholic beverages as they can exacerbate dizziness.

Other Important Precautions

Use During Pregnancy and Breastfeeding: During pregnancy, Cardene should only be used when absolutely necessary, after a thorough discussion of the risks and benefits with your doctor. The impact of this medication on an unborn child is not entirely known, making it essential to use this drug under direct medical advice. It is also unknown whether Cardene passes into breast milk, so breastfeeding mothers can consult their healthcare giver to understand the potential risks and make an informed decision.

Contradiction of Cardene Capsules

Patients with Aortic Stenosis: Cardene is contraindicated in patients suffering from advanced aortic stenosis. The mechanism of action of Cardene involves the reduction of afterload, which is the pressure the heart must work against to eject blood. In the context of advanced aortic stenosis, lowering the diastolic pressure can lead to a paradoxical situation where the myocardial oxygen balance is further compromised rather than improved. Therefore, using Cardene in such patients could worsen their condition by exacerbating the existing obstruction in the heart’s aortic valve.

Missed Dose

  • If you forget to take a dose of Cardene, take it as soon as you remember.
  • If the next scheduled dose is nearly due when you remember, skip the missed dose to maintain your regular dosing routine.
  • Avoid taking a double dose of Cardene to compensate for the missed one.
  • Continue with your usual dosing schedule after skipping the missed dose.
  • Do not adjust the timing of future doses based on the missed dose.
  • Keep a medication schedule or set reminders to help prevent missing future doses.

[Note: If you missed a dose of Cardene & are unsure about when to take the next dose, immediately consult your doctor or healthcare giver.]

Overdose

If you suspect an overdose of Cardene, it may lead to symptoms such as systemic hypotension (low blood pressure), bradycardia (slow heart rate), which can follow an initial period of tachycardia (fast heart rate), and progressive atrioventricular conduction block, affecting the heart rhythm. Immediately contact or call a poison control center or seek emergency medical attention. Residents in the US may call their local poison control center for guidance.

[Note: If you consumed more than the recommended Cardene dose, get medical help immediately, or you can call the Poison Helpline at 1-800-222-1222.]

Storage

  • Place Cardene in a closed container.
  • Keep it at a stable room temperature (25 ℃).
  • Protect from excessive heat, moisture, and direct sunlight.
  • Prevent freezing of the medication.
  • Ensure that Cardene is out of the reach of children.
  • Do not retain Cardene that is expired or no longer required.

[Note: Discuss with your healthcare professional or doctor about the proper disposal of any unused Cardene capsules and any questions you may have regarding its storage.]

Cardene Interactions

Beta-Blockers: In controlled clinical trials, adrenergic beta-receptor blockers have frequently been used in conjunction with Cardene. Patients have generally tolerated this combination well. However, healthcare providers should monitor patients to ensure no adverse effects arise from this concurrent therapy.

Cimetidine: The administration of cimetidine alongside Cardene has been shown to increase the plasma levels of Cardene. Due to this interaction, it is crucial for healthcare professionals to closely monitor patients receiving both medications, to ensure that Cardene levels remain within a therapeutic range and to adjust dosages as necessary.

Digoxin: While some calcium channel blockers can elevate the blood concentrations of digitalis-based drugs, Cardene typically does not influence digoxin plasma levels. Nevertheless, checking serum digoxin levels after initiating combined therapy with Cardene is recommended to ensure that they stay within safe limits.

Fentanyl Anesthesia: Severe hypotension has been observed during fentanyl anesthesia when used in conjunction with beta-blockers and calcium channel blockers. Although clinical studies with Cardene have not demonstrated similar interactions, there is a potential risk. It is advised that an increased volume of circulating fluids be prepared and available during such anesthesia procedures to mitigate the risk of severe hypotension.

Cyclosporine: When Cardene is administered with cyclosporine, there is a notable increase in plasma cyclosporine levels. It is essential for healthcare providers to monitor these levels closely in patients undergoing such combined treatment. Adjustments to the dosage of cyclosporine should be made accordingly to maintain appropriate therapeutic levels and prevent toxicity.

Interactions with Food/Tobacco/Alcohol: Cardene capsules should be avoided at or near meal times, as consuming food can lead to potential interactions. Specifically, certain foods may interact with the medication, altering its effectiveness or side effects. Additionally, the concurrent use of alcohol or tobacco with Cardene capsules is discouraged as these substances can interact with the Cardene, potentially leading to adverse effects. 

[Note: This is not a complete list, & there could be other drugs that interact with Cardene. Make sure to tell your doctor or healthcare giver about any prescription, over-the-counter medicines, and herbal products you’re currently taking.]

Cardene Alternatives

[Note: Your doctor will determine the best treatment option for you, including whether Cardene or an alternative medication is appropriate. Do not use any alternative medications without consulting your healthcare provider, as self-medicating could lead to serious side effects.]

Frequently Asked Questions

Is Cardene safe?

Certainly! Cardene, a medication used to prevent chest pain, is generally safe. However, it’s crucial to note that individuals with severe heart disease might experience rare side effects like worsening chest pain or even a heart attack when they begin or increase their dose of Cardene. While it effectively addresses angina, it’s very important for patients to discuss any associated risks with their healthcare provider to ensure safe & effective treatment.

What should I monitor with Cardene?

When using Cardene, keeping a close eye on your blood pressure and heart rate is important. This medication can sometimes cause your blood pressure to drop too low, leading to symptoms like dizziness or fainting. It can also speed up your heart rate, which may cause palpitations or a feeling of rapid heartbeat. Your doctor may likely want to monitor these vital signs regularly to ensure that nicardipine works safely for you.

What are the benefits of nicardipine?

Nicardipine, also known as Cardene, offers several benefits due to its action as a calcium channel blocker. By influencing the flow of calcium into the heart and blood vessels, nicardipine helps to relax the blood vessels. This relaxation allows for improved blood circulation and greater delivery of oxygen to the heart. Consequently, nicardipine reduces the strain on the heart, promoting overall cardiovascular health.

Can you stop taking nicardipine?

It’s crucial that you stick to the prescribed dosage to effectively lower your blood pressure and maintain it at a healthy level. Remember, managing high blood pressure might mean taking medication for the long haul. Ignoring high blood pressure could lead to severe issues like heart failure, problems with your blood vessels, strokes, or kidney diseases. So, it’s vital to stay consistent with your treatment plan to safeguard your health and well-being.

Is nicardipine better than nifedipine?

Nicardipine works by causing a slower and longer-lasting decrease in blood pressure compared to nifedipine. This means that it takes more time for the blood pressure to go down, but the effect lasts longer. Because of this, nicardipine tends to be easier for people to handle without as many side effects.

Is nicardipine a vasodilator or vasoconstrictor?

Nicardipine, a recently developed short-acting calcium channel blocker, plays a very crucial role in regulating blood vessel function. It acts as a vasodilator, meaning it may help widen blood vessels. This effect is particularly notable in the coronary arteries, which supply adequate blood to the heart’s muscles, compared to its impact on the broader systemic circulation. Nicardipine’s ability to selectively dilate coronary arteries makes it valuable in various medical contexts, such as managing hypertension or angina. Its precise targeting of blood vessels helps improve blood flow to the heart, aiding cardiac function. This distinction between its vasodilatory effects in specific areas underscores its significance in cardiovascular care, offering tailored therapy for patients with diverse needs.

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