CARDENE® I.V. (nicardipine hydrochloride) User Guide
NARRATOR: When timely, precise blood pressure control is critical, CARDENE I.V. Nicardipine hydrochloride premixed injection is a proven steady, premixed ready agent for use in a variety of hypertensive emergencies. Cardene i.v. Is indicated for the short term treatment of hypertension when oral therapy is not feasible or not desirable. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits. This program reviews the dosing and administration of CARDENE I.V. And provides clinical evidence to support its use in appropriate patients.
Cardene i.v. Nicardipine hydrochloride is available in formulations of 40mg in 200 mL and 20 mg in 200 mL in either sodium chloride or dextrose solutions straight from your automated dispensing cabinet. The premixed ready formulation is immediately available for rapid intervention at the point of care and minimizes the risk of medication admixture errors. Cardene i.v. Can be stored at room temperature in its original packaging for 24 months. Before administering CARDENE I.V., inspect the product for particulate matter and discoloration.
Check for leaks by squeezing the bag firmly and ensure that the seal is intact. If leaks are found, discard the bag as sterility may be impaired. Note that there is only one port on the bag. Do not combine CARDENE I.V. With any product in the same intravenous line or premixed container.
When connecting the administration set, fully insert the spike into the port and twist until the line is firmly attached. Cardene i.v. Should be administered through large peripheral veins or central veins. Cardene i.v. Does not contain soy or egg allergens. The most common adverse reactions occurring in more than 3% of patients are headache, nausea, vomiting, hypotension and tachycardia.
The starting dose for CARDENE I.V. Is 5mg per hour in patients not receiving oral nicardipine. The infusion rate for this formulation containing 40mg of CARDENE I.V. In 200mL of normal saline is 25mL per hour.
You can administer CARDENE I.V. Using rapid or gradual titration in increments of 2.5mg per hour up to a maximum dose of 15mg per hour. For rapid titration increase the dose every 5 minutes. Once the desired blood pressure is achieved, decrease the infusion rate to 3mg per hour.
For gradual titration, increase the dose every 15 minutes until desired blood pressure is achieved. For either approach, adjust the infusion rate as needed to maintain the desired blood pressure. This chart shows dose to infusion rate conversion. You can find this information at cardeneiv.com or within the full prescribing information. Monitor blood pressure and heart rate continually during infusion and avoid a too-rapid or excessive blood pressure drop during treatment. Now, let's review some of the evidence that demonstrates how CARDENE I.V.
Performs in clinical settings. Cardene i.v. Begins to work within minutes.
In a multicenter randomized study 110 patients with hypertensive emergencies were treated with CARDENE I.V. In the emergency department. Median initial systolic blood pressure was 212.5 and most of these patients had history of hypertension.
By 15 minutes the mean percent change in systolic blood pressure from baseline was within target range. 92% of patients reached their target systolic blood pressure range within 30 minutes using the rapid titration schedule. In addition to a rapid onset of effect, CARDENE I.V.
Also demonstrated smooth, predictable blood pressure control over 24 hours. In a study of hypertensive patients admitted through the emergency department for primary intracerebral hemorrhage, subarachnoid hemorrhage or acute ischemic stroke CARDENE I.V. Was initiated at a dose of 5mg per hour and increased using gradual titration every 15 minutes by 2.5mg per hour until target systolic blood pressure range was reached or a maximum of 15mg per hour was achieved. 89% of patients achieved their respective target ranges based on consensus guidelines within 60 minutes.
The majority of patients did not require a dose adjustment to reach goal and no rescue therapy was needed in any patient. Cardene i.v. Maintained blood pressure control for 24 hours.
Discontinuation of CARDENE I.V. Infusion is followed by a 50% offset of action in about 30 minutes. If treatment includes transfer to an oral antihypertensive agent other than oral nicardipine, initiate therapy upon discontinuation of CARDENE I.V. Premixed injection. If oral nicardipine is to be used, administer the first dose one hour prior to discontinuation of the infusion.
For proven steady control of blood pressure in hypertensive emergencies, CARDENE I.V. Delivers rapid precise control within minutes. Cardene i.v.
Increases cardiac output and has not been associated with coronary steal, bradycardia or rebound hypertension. The premixed ready formulation is immediately available at the point of care, which helps minimize medication admixture errors. The sealed product is stable for 24 months in original packaging under appropriate storage conditions.
Indication CARDENE I.V. (nicardipine hydrochloride) Premixed Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits. Important Safety Information CARDENE I.V. (nicardipine hydrochloride) is contraindicated in patients with advanced aortic stenosis.
Hypotension and reflex tachycardia may potentially occur during treatment with CARDENE I.V.; therefore, close monitoring of blood pressure and heart rate is required. If unacceptable hypotension or tachycardia occurs, the infusion should be discontinued. Slow titration of CARDENE I.V. Is recommended in patients with heart failure or significant left ventricular dysfunction, particularly in combination with a beta-blocker. Close monitoring of response to CARDENE I.V. Is advised in patients with angina, heart failure, impaired hepatic function, or renal impairment. Cardene i.v. May elevate serum concentrations of cyclosporine or tacrolimus.
Serum concentrations of cyclosporine or tacrolimus should be monitored during coadministration with CARDENE I.V. To reduce the possibility of venous thrombosis, phlebitis, local irritation, and extravasation, administer CARDENE I.V. Through large peripheral veins or central veins rather than arteries or small peripheral veins. If CARDENE I.V.
Is administered in a peripheral vein, to minimize the risk of venous irritation, change the site of infusion every 12 hours. The most common adverse reactions (greater than 3%) are headache, nausea/vomiting, hypotension, and tachycardia. Please see full prescribing information. For more information about this important solution for hypertensive emergencies visit cardeneiv.com or call 888-466-6505.
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NARRATOR: When timely, precise blood pressure control is critical, CARDENE I.V. Nicardipine hydrochloride premixed injection is a proven steady, premixed ready agent for use in a variety…By: CARDENE® I.V. (nicardipine hydrochloride)