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isradipine (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 2.5mg
  • 5mg

tablet, extended release

  • 5mg
  • 10mg
more...

Hypertension

Capsule: 2.5 PO q12hr; may increase dose q2-4week at 2.5-5 mg increments to maximum 20 mg/day (most patients show no improvement with doses >10 mg/day); maximum in older adults is 10 mg/day

Controlled release tablet: 5 mg PO qDay; may increase dose by 5 mg q2-4week; not to exceed 20 mg/day (freqency of adverse effects increases with doses >10 mg/day)

Dosage Forms & Strengths

capsule

  • 2.5mg
  • 5mg

tablet, extended release

  • 5mg
  • 10mg
more...

Hypertension (Off-label)

Capsule: 0.15-0.2 mg/kg PO qDay or divided q8-12hr, not to exceed 0.8 mg/kg/day (20 mg/day) 

Controlled release tablet: 0.15-0.2 mg/kg PO qDay or divided q12hr

Capsules: 2.5 mg PO q12hr initially

Controlled release tablet: 5 mg PO qDay initially

The bioavailabilty of isradipine is increased in the elderly population

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Interactions

Interaction Checker

isradipine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache (2-22%)

            1-10%

            Edema (1-9%)

            Dizziness (2-8%)

            Palpitation (1-5%)

            Flushing (1-5%)

            Tachycardia (1-3%)

            Chest pain (2-3%)

            Rash (2%)

            Nausea (1-5%)

            Vomiting (≤1%)

            Diarrhea (≤ 3%)

            Weakness (≤1%)

            Dyspnea (1-3%)

            Urinary frequency (1-3%)

            <1%

            Drug-induced gingival hyperplasia

            Angioedema

            Drowsiness

            Hyperhidrosis

            Leg pain

            Nasal congestion

            Drug fever

            Dysuria

            Impotence

            Pruritus

            Urticaria

            Weight gain

            Myocardial infarction

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            Warnings

            Contraindications

            Hypersensitivity to isradipine or other calcium channel blockers; hypotension (<90 mm Hg systolic)

            Cautions

            Use caution in CHF, aortic stenosis, hypotension (initially or after dose increases), persistent progressive dermatologic reactions, exacerbation of angina (during initiation of treatment, after dose increase, or withdrawal of beta blocker), liver impairment

            Reflex tachycardia resulting in angina and/or MI in patients with obstructive coronary disease reported

            Peripheral edema may occur within 2-3 weeks of initiating therapy

            Hypotension with or without syncope is possible (particularly with severe aortic stenosis)

            Avoid taking with grapefruit juice

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted into breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Ca channel blocker: inhibits the transmembrane influx of extracellular Ca ions across the membranes of myocardial cells and vascular smooth muscle cells, without changing serum calcium concentrations, resulting in inhibition of cardiac and vascular smooth muscle contraction, thereby dilating the main coronary and systemic arteries

            Pharmacokinetics

            Onset: 1 hr (initial response; regular release); 2 hr (SR)

            Peak response: 2-3 hr (regular release); 8-10 hr (SR)

            Excretion: Urine (60-65%); feces (30%)

            Peak plasma time: 1.5-3 hr (regular release); 7-18 hr (SR)

            Bioavailability: 15-24%

            Protein Bound: 95-97%

            Vd: 3 L/kg

            Metabolism: Hepatic P450 enzyme CYP3A4

            Metabolites: Mono acids and a cyclic lactone product (inactive)

            Clearance: 40 L/hr

            Half-Life: 5-10.7 hr

            Duration: 12 hr (regular release); 24 hr (SR)

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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