Nicardipine is prescribed for high blood pressure, and to prevent angina.
When you first start taking the capsules you may get a headache or feel flushed. These symptoms usually go after a few days.
You can take nicardipine capsules before or after meals.
|Type of medicine||A calcium-channel blocker|
|Used for||High blood pressure; to prevent angina|
|Also called||Cardene®; Cardene® SR|
|Available as||Standard capsules (Cardene®) and prolonged-release capsules (Cardene® SR), injection|
Nicardipine belongs to a group of medicines called calcium-channel blockers. It is prescribed to treat high blood pressure (hypertension), or to prevent angina chest pain. You will have been prescribed it for one of these reasons.
It works by causing some of your blood vessels to relax and widen. This lowers your blood pressure. It also reduces the force and the rate of your heartbeat, and this helps to prevent angina chest pain. It does these things by blocking the amount of calcium that goes into the 'smooth' muscle cells in the walls of your arteries and in your heart. Calcium is needed for muscles to contract, so reducing the amount of calcium causes the muscle cells to relax.
In some countries nicardipine is available as a modified-release capsule. This means that the capsules release nicardipine more slowly than the standard capsules. They can be prescribed for people with high blood pressure.
Before taking nicardipine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking nicardipine it is important that your doctor knows:
- If you have any heart problems (other than angina or high blood pressure), or if you have recently had a heart attack.
- If you have angina pain when you are resting as well as when you are active.
- If you have been told you have narrowing of the main blood vessel from your heart (aortic stenosis).
- If you are pregnant or breastfeeding.
- If you have problems with the way your liver works, or problems with the way your kidneys work.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
- If you have a rare inherited blood disorder called porphyria.
How to take nicardipine
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. It will give you more information about nicardipine and will provide you with a full list of the side-effects which you may experience from taking the capsules.
- Standard nicardipine capsules (Cardene®) are taken three times a day. There are two strengths available - 20 mg and 30 mg. You will be prescribed the lower-strength capsule first, and then the higher-strength capsule after a few days if your doctor feels it is necessary.
- Modified-release capsules are taken twice daily - morning and evening. There are three strengths available - 30 mg, 45 mg and 60 mg. You will be prescribed the lower-strength capsule to begin with and your dose adjusted later if needed.
- Space out your doses during the day, and try to take them at the same times each day as this will help you to remember to take your doses regularly. Swallow the capsules whole with a drink of water. You can take nicardipine before or after meals.
- If you forget to take a dose, take it as soon as you remember. If when you remember, it is nearly time for your next dose then take your next dose when it is due but leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- Your doctor will discuss with you the possibility of unwanted side-effects. When you first start taking nicardipine you may experience headaches, feeling flushed, and some dizziness. These effects usually only last for a few days, but if they continue or become troublesome, you should let your doctor know.
- If you drink alcohol, ask your doctor for advice. Your doctor may recommend that you do not drink alcohol while you are on nicardipine as it can increase the chance that you experience side-effects, such as feeling dizzy or light-headed.
- You should not drink grapefruit juice while you are on nicardipine. This is because a chemical in grapefruit juice increases the amount of nicardipine in your blood and this makes side-effects more likely.
- Nicardipine is a medicine which helps to prevent angina pain from developing, it will not provide you with immediate pain relief if you have an angina attack. Your doctor will give you a different medicine to take for this.
- If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines. Some anti-inflammatory painkillers can reduce the effectiveness of nicardipine.
- If you need to have an operation or any medical treatment, tell the person carrying out the treatment which medicines you are taking. Nicardipine and some anaesthetics can interact and may cause your blood pressure to drop too low.
- Treatment with nicardipine is usually long-term unless you experience an adverse effect. Continue to take the capsules unless you are told otherwise by your doctor. If it is necessary for you to stop, your doctor may want you to reduce your dose over a few days, as there is some evidence to suggest that stopping taking nicardipine suddenly can cause some symptoms to return.
Can nicardipine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with nicardipine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common nicardipine side-effects||What can I do if I experience this?|
|Headache, feeling hot or flushed||These may occur when you first start treatment, but usually go away after a few days. If the headache continues discuss the problem with your doctor|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple foods - avoid rich or spicy meals|
|Feeling dizzy||Do not drive and do not use tools or machines while affected|
|Swollen ankles, being aware of fast heartbeats (palpitations)||Speak with your doctor about these if troublesome|
Important: a few people taking nicardipine have experienced worsening of chest pain at the start of treatment or after a dose increase - if this happens to you, you must let your doctor know straightaway.
If you experience any other symptoms which you think may be due to the capsules, you should speak with your doctor or pharmacist for further advice.
How to store nicardipine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Cardene® 20 mg and 30 mg; Astellas Pharma Limited, The electronic Medicines Compendium. Dated November 2019.
Manufacturer's PIL, Cardene® SR 30 mg and 45 mg Capsules; Astellas Pharma Limited, The electronic Medicines Compendium. Dated March 2017.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.