When administering nicardipine intravenously (IV), health care professionals often refer to the treatment as a nicardipine drip. The diluted medication enters a drip chamber from the IV bag, and the chamber opens into the IV tubing. Physicians might also administer the medication using a syringe inserted into an IV port, usually located on the patient's arm. Physicians often use nicardipine drip administration for the control of high blood pressure or angina stabilization.
Nicardipine belongs to the class of medications known as calcium channel blockers. They act by inhibiting calcium ions from entering cardiac and smooth vascular muscles, which causes tissue relaxation and dilation. Besides nicardipine drip preparations, pharmaceutical companies also manufacture nicardipine in tablet and capsule forms. Physicians often combine nicardipine with diuretics, which eliminate fluid retention, and other antihypertensive medications, which control blood pressure.
Physicians often prescribe a nicardipine drip for patients who are suffering from high blood pressure after a stroke. Hospitals may acquire premixed IV nicardipine, but staff members can also mix 25 milligrams (mg) of the medication with 240 milliliters (ml) of a dextrose or sodium chloride solution contained in an IV bag. This mixture provides 0.1 mg for every ml of fluid. Patients generally receive 5 mg (50 ml of fluid) of a nicardipine dose initially, which may be increased by 2.5 mg (25 ml of fluid) every 5 to 15 minutes until the blood pressure drops to a desirable level. After blood pressure decreases, patients receive 3 mg of the medication IV or begin taking the appropriate dose of medication orally.
The rapid response produced by a nicardipine drip requires constant vital sign monitoring. The most common side effect of nicardipine administered IV includes hypotension, or low blood pressure. If the vein in which the medication travels develops a blood or fibrous clot, the medication backs up into the surrounding tissues, which causes swelling and bruising. Patients may also experience headache, nausea and vomiting, and increased heart rate.
Physicians may not prescribe nicardipine for patients diagnosed with congestive heart failure because of the medication's action on the heart. The medication binds to proteins in the body and individuals with liver disease may not have a sufficient protein level, which increases the amount of nicardipine circulating in the blood, and increases the risk of side effects. Increased levels of nicardipine in the bloodstream also occur in patients with kidney disease as the organs are unable to effectively eliminate the drug from the body.