Nicardipine

Nicardipine is a dihydropyridine calcium channel antagonist that binds to the alpha-1 subunit of L-type Ca2+ channels, reducing Ca2+ flux through these channels. This action primarily relaxes vascular smooth muscle, leading to dilation of coronary and peripheral arteries. Similar to nifedipine, its main influence is on vessels rather than the myocardium, and it may produce less reduction of myocardial contractility.

Renal adjustment

Manufacturer advises avoid in heart failure if serum creatinine greater than 250 micromol/litre

Hepatic adjustment

Manufacturer advises avoid (limited information available)

• Heart failure (can further depress cardiac function and exacerbate symptoms)
• Myocardial infarction with left ventricular dysfunction and pulmonary congestion (can increase mortality)