Nicardipine dosage

Increased angina Occasional patients have increased frequency, duration or severity of angina on starting nifedipine or nicardipine or at the time of dosage increases. 

Nakamichi, K., H. Yasuura, H. Fukui, M. Oka, and S. Izumi. 2001. Evaluation of a oating dosage form of nicardipine hydrochloride and hydroxypropylmethylcellulose acetate succinate prepared using a twin-screw extrudetnt J Pharm218 103-112. 

There are approximately a dozen calcium channel antagonists marketed in the United States for the treatment of hypertension, certain dysrhythmias, and some forms of angina (see Chaps. 13,15, and 17). The calcium channel blockers are classified by their chemical structure as phenylalkylamines (e.g., verapamil), benzothiapines (e.g., diltiazem), and dihydropyridines (e.g., amlodipine, felodipine, nicardipine, and nifedipine). Several of these agents, namely, diltiazem, nicardipine, nifedipine, and verapamil, are formulated as sustained-release oral dosage forms or have a slow onset of action and longer half-life (e.g., amlodipine " ), allowing once-daily administration. 

Calcium chaimel blockers traditionally have been the first-line agents to treat hypertension after transplantation. In addition to their ability to control blood pressure, calcium channel blockers may ameliorate the nephrotoxic effects of CSA, improve renal hemodynamics, decrease the incidence of delayed graft function and development of allograft atherosclerosis, and provide some immunosuppression. Calcium channel blockers, however, also may contribute to gingival hyperplasia that is often associated with CSA-based immunosuppression. CYP 3A4 interactions with CSA and TAC are of concern with this class of medications, particularly with dil-tiazem, verapamil, and nicardipine, and CSA or TAC concentrations must be monitored to ensure proper dosage adjustments. 

The plasma levels of diltiazem, isradipine and nifedipine are increased by cimetidine and it may possibly be necessary to reduce the dosages of these calcium-channel blockers. High doses of cimetidine may increase the bioavailability of lercanidipine. Although studies surest no important interactions occur between nicardipine or nisoldipine and cimetidine, the manufacturers advise caution. Plasma felodipine, lacidipine, nimodipine, and... 

Diltiazem and verapamil raise sirolimus levels, and dosage adjustments may be necessaiy. Nicardipine is predicted to interact similarly. Nifedipine appears not to interact with sirolimus. 

Nakamichi, K. Yasuura, H. Fukui, H. Oka, M. Izumi, S. Evaluation of a floating dosage form of nicardipine hydrochloride and hydroxypropyhnethylcellulose acetate succinate prepared nsing a twin-screw extruder. Int. J. Pharm. 2001, 218(1-2), 103-112. 

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