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Nicardipine

Hypertensive emergency, ICH blood pressure management, Acute ischemic stroke BP control

Indications

  • Hypertensive emergency
  • ICH blood pressure management
  • Acute ischemic stroke BP control

Adult dosing

  • infusion: dose: 5; maxDose: 15; unit: mg/hr; route: IV; interval: titrate q5-15min by 2.5 mg/hr; fixed: true

Pediatric dosing

  • infusion: dose: 1; maxDose: 3; unit: mcg/kg/min; route: IV; weightBased: true

Contraindications

  • Severe aortic stenosis

Clinical pearls

  • Preferred drip for most hypertensive emergencies — predictable, titratable
  • Start 5 mg/hr, increase by 2.5 mg/hr q5-15min to max 15 mg/hr
  • Does NOT need central line — can run peripheral
  • ICH target: SBP <140 within 1 hour (INTERACT2)

Source and review

  • AHA/ASA ICH Guidelines 2022; JNC-8. Last reviewed: 2024-11-01