Dosing & Uses
Dosage Forms & Strengths
infusion solution
- 0.5mg/mL
Hypertension
1-2 mg/hr (2-4 mL/hr), double dose q90sec initially; as blood pressure approaches goal, increase dose by less than doubling, and increase time between adjustments to q5-10min
Maintenance: 4-6 mg/hr; not to exceed 21 mg/hr (1000 mL within 24 hour period)
Renal Impairment
Dose adjustment not necessary
Hepatic Impairment
Dose adjustment not necessary
Safety and efficacy not established
Initiate dosing at the low end of the dosage range
Hypertension
1-2 mg/hr (2-4 mL/hr), double dose q90sec initially; as blood pressure approaches goal, increase dose by less than doubling, and increase time between adjustments to q5-10min
Maintenance: 4-6 mg/hr; not to exceed 21 mg/hr (1000 mL within 24 hour period)
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Adverse Effects
>10%
AFib (21%)
Nausea (21%)
1-10%
Acute renal failure (9%)
Headache (6%)
Vomiting (3%)
<1%
Cardiac arrest
Myocardial infarction
Postmarketing Reports
Increased blood triglycerides
Ileus
Nausea
Hypersensitivity
Hypotension
Reflex tachycardia
Decreased oxygen saturation (possible pulmonary shunting)
Warnings
Contraindications
Hypersensitivity to drug, soy or egg products
Defective lipid metabolism
Acute pancreatitis if accompanied by hyperlipidemia
Severe aortic stenosis
Cautions
Use aseptic technique and discard unused product within 12hr of stopper puncture
May produce systemic hypotension and reflex tachycardia; if either occurs, decrease dose of drug; there is limited experience with short-duration therapy with beta-blockers as a treatment for drug-induced tachycardia; beta-blocker use for this purpose not recommended
Drug contains approximately 0.2 g of lipid per mL (2.0 kcal); lipid intake restrictions may be necessary for patients with significant disorders of lipid metabolism; for these patients, a reduction in quantity of concurrently administered lipids may be necessary to compensate for amount of lipid infused as part of drug formulation
Dihydropyridine calcium channel blockers can produce negative inotropic effects and exacerbate heart failure; monitor heart failure patients carefully
Drug is not a beta-blocker, does not reduce heart rate, and gives no protection against effects of abrupt beta-blocker withdrawal; beta-blockers should be withdrawn only after gradual reduction in dose
Patients who receive prolonged infusions and are not transitioned to other antihypertensive therapies should be monitored for possibility of rebound hypertension for at least 8 hr after infusion is stopped
There is no information to guide use of drug in treating hypertension associated with pheochromocytoma
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Not known if excreted into breast milk, do not nurse
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.Pharmacology
Mechanism of Action
Calcium channel blocker (dihydropyridine): inhibits transmembrane influx of extracellular Ca ions across 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 main coronary and systemic arteries
Pharmacokinetics
Onset: 2-4 minutes
Protein Bound: 99.5%
Metabolized in blood and extravascular tissues
Half-Life: Initial 1 minute; terminal 15 minutes
Excretion: Urine (63-74%); feces (7-22%)
Administration
IV Compatibilities
Not diluted but compatible w/ following solvents: SWI; NS; D5W; D5/NS; D5/LR; LR; 10% aminoacid
IV Administration
Milky white emulsion
No preservatives-use within 4 hr of puncturing stopper
Doesn't need dilution
Images
Patient Handout
Formulary
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