Cardene is indicated for the prophylaxis of patients with chronic stable angina. For the treatment of hypertension considered to be mild to moderate in severity.
Cardene (Nicardipine) capsules for oral administration each contain 20mg or 30mg of nicardipine hydrochloride. Cardene is a calcium ion influx inhibitor and belongs to the dihydropyridine class of calcium channel blockers.
Nicardipine should be taken with a little water.
Prophylaxis of chronic stable angina:
Starting dose: 20 mg every 8 hours titrating upwards as required.
Usual effective dose: 30 mg every 8 hours (range of total dose 60 mg - 120 mg per day).
Allow at least 3 days before increasing the dose of Cardene to ensure steady state plasma levels have been achieved.
Hypertension:
Starting dose: 20 mg every 8 hours titrating upwards as required.
Usual effective dose: 30 mg every 8 hours (range of total dose 60 mg - 120 mg per day).
Use in elderly:
Starting dose is 20 mg 3 times a day. Titrate upwards with care as nicardipine may lower systolic pressure more than diastolic pressure in these patients.
Children:
Cardene is not recommended in patients under the age of 18.
Cardene capsules are for oral administration.
Majority are not serious and are expected consequences of the vasodilator effects of Cardene.
The most frequent side-effects reported are headache, pedal oedema, heat sensation and/or flushing, palpitations, nausea and dizziness.
Other side-effects noted in clinical trials include the following:
Cardiovascular System: As with the use of other short-acting dihydropyridines in patients with ischaemic heart disease, exacerbation of angina pectoris may occur frequently at the start of treatment with nicardipine capsules. The occurrence of myocardial infarction has been reported although it is not possible to distinguish such an event from the natural course of ischaemic heart disease.
Central nervous system: Drowsiness, insomnia, tinnitus, paraesthesia, functional disorders.
Skin: Itching, rashes.
Hepato-Renal: Impairment, frequency of micturition.
Dyspnoea, gastro-intestinal upset and, rarely, depression, impotence and thrombocytopenia, have also been reported.
Contraindications: (1) Pregnancy and lactation. (2) Hypersensitivity to nicardipine hydrochloride or other dihydropyridines because of the theoretical risk of cross reactivity. (3) Because part of the effect of nicardipine is secondary to reduced afterload, the drug should not be given to patients with advanced aortic stenosis. Reduction of diastolic pressure in these patients may worsen rather than improve myocardial infarction.
(4) Cardene should not be used in cardiogenic shock, clinically significant aortic stenosis, unstable angina, and during or within one month of a myocardial infarction. (5) Cardene should not be used for acute attacks of angina. (6) Cardene should not be used for secondary prevention of myocardial infarction.