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
Contraindicated (0)
Serious - Use Alternative (1)
- lofexidine
lofexidine, clevidipine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
Monitor Closely (63)
- acebutolol
acebutolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aldesleukin
aldesleukin increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfuzosin
alfuzosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- amifostine
amifostine, clevidipine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amlodipine
amlodipine and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- asenapine
asenapine and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- atenolol
atenolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- avanafil
avanafil increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- betaxolol
betaxolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- bisoprolol
bisoprolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- bretylium
clevidipine, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- calcium acetate
calcium acetate decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- calcium chloride
calcium chloride decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- calcium citrate
calcium citrate decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- calcium gluconate
calcium gluconate decreases effects of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
carvedilol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- celiprolol
celiprolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- clarithromycin
clarithromycin will increase the level or effect of clevidipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased effect of calcium channel blockers may lead to hypotension, edema, decreased HR, and acute kidney injury due to reduced renal blood flow
- diltiazem
clevidipine and diltiazem both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- doxazosin
doxazosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- esmolol
esmolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- felodipine
clevidipine and felodipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- isradipine
clevidipine and isradipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- itraconazole
itraconazole will increase the level or effect of clevidipine by Other (see comment). Modify Therapy/Monitor Closely. CCBs elicit negative inotropic effects which may be additive to those of itraconazole; additionally, itraconazole can inhibit the metabolism of calcium channel blockers. Monitor for adverse reactions. Concomitant drug dose reduction may be necessary.
- labetalol
labetalol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- lasmiditan
clevidipine increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.
- levodopa
levodopa increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lurasidone
lurasidone increases effects of clevidipine by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- magnesium supplement
magnesium supplement, clevidipine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Calcium channel blockers may increase toxic effects of magnesium; magnesium may increase hypotensive effects of calcium channel blockers.
- maraviroc
maraviroc, clevidipine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension.
- mefloquine
mefloquine increases levels of clevidipine by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.
- metformin
clevidipine decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.
- methylphenidate
methylphenidate will decrease the level or effect of clevidipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.
- metoprolol
metoprolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- moxisylyte
moxisylyte and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- nadolol
nadolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nebivolol
nebivolol, clevidipine. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure.
- nicardipine
clevidipine and nicardipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- nifedipine
clevidipine and nifedipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- nisoldipine
clevidipine and nisoldipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- nitroglycerin rectal
nitroglycerin rectal, clevidipine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Observe for possible additive hypotensive effects during concomitant use. .
- nitroglycerin sublingual
clevidipine, nitroglycerin sublingual. Either increases toxicity of the other by additive vasodilation. Modify Therapy/Monitor Closely. Marked orthostatic hypotension reported with concomitant use.
- nitroprusside sodium
clevidipine increases effects of nitroprusside sodium by pharmacodynamic synergism. Use Caution/Monitor.
- ombitasvir/paritaprevir/ritonavir & dasabuvir
ombitasvir/paritaprevir/ritonavir & dasabuvir will increase the level or effect of clevidipine by altering metabolism. Modify Therapy/Monitor Closely. May decrease calcium channel blocker dose if necessary
- penbutolol
penbutolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phenoxybenzamine
phenoxybenzamine and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- phentolamine
phentolamine and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- pindolol
pindolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- prazosin
prazosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- propranolol
propranolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- silodosin
silodosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
clevidipine, sodium sulfate/?magnesium sulfate/potassium chloride. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- sodium sulfate/potassium sulfate/magnesium sulfate
clevidipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.
- sotalol
sotalol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- tadalafil
tadalafil increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- temsirolimus
clevidipine increases toxicity of temsirolimus by Other (see comment). Use Caution/Monitor. Comment: Combination of mTOR inhibitors with calcium channel blockers increases risk of angioedema.
- terazosin
terazosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- timolol
timolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- verapamil
clevidipine and verapamil both increase anti-hypertensive channel blocking. Use Caution/Monitor.
- voriconazole
voriconazole increases levels of clevidipine by decreasing metabolism. Use Caution/Monitor.
- xipamide
xipamide increases effects of clevidipine by pharmacodynamic synergism. Use Caution/Monitor.
Minor (23)
- agrimony
agrimony increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- atracurium
clevidipine increases effects of atracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- brimonidine
brimonidine increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- cisatracurium
clevidipine increases effects of cisatracurium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- cornsilk
cornsilk increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- fo-ti
fo-ti increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- forskolin
forskolin increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- lithium
clevidipine increases toxicity of lithium by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of neurotoxicity.
- maitake
maitake increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- metipranolol ophthalmic
metipranolol ophthalmic increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- octacosanol
octacosanol increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- onabotulinumtoxinA
clevidipine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- pancuronium
clevidipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- porfimer
clevidipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.
- rapacuronium
clevidipine increases effects of rapacuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- reishi
reishi increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- rocuronium
clevidipine increases effects of rocuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- shepherd's purse
shepherd's purse, clevidipine. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- succinylcholine
clevidipine increases effects of succinylcholine by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- tizanidine
tizanidine increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- treprostinil
treprostinil increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- vecuronium
clevidipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- verteporfin
clevidipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
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
Available data based on post-marketing reports with use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes; there are risks to mother and fetus associated with poorly controlled hypertension in pregnancy
Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section and postpartum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordingly
Animal data
- In animal studies, drug was associated with increased incidences of intrauterine deaths, slightly reduced fetal weight, retarded skeletal development, abortion, and embryo lethality at doses higher than the expected human dose
- No evidence of embryo-fetal malformation was found with continuous IV infusion of clevidipine administered to pregnant rats and rabbits during the period of organogenesis at multiples of 2.8 and 7.6 times the expected human dose of 16 mg/hr respectively
Lactation
There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production
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
clevidipine intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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